urgent question..please help!

[futurenurse85]

hey. i posted earlier but figured out what to teach. now im confused as to whether i can use altered tissue perfusion as a nursing diagnosis for a patient who has peripheral vascular disease (PVD) and has undergone endarterectomy (to remove the clot) and femoral-bypass grafting? would it be a risk for altered tissue perfusion? ah im so confused now! any other suggestions for nursing diagnoses that i could use for this patient?

[LaceyRN]

I am a fairly new student (1st semester) but isn't PVD systemic and therefore even though the procedure may have improved circulation in one extemity, the other leg would still have Altered tissue perfusion?

[Daytonite, BSN, RN]

The nursing diagnoses that you ultimately end up using are ALWAYS based upon your assessment. What are the abnormal assessment items, or symptoms (NANDA calls them defining characteristics), that you found the patient to have? That is what is ultimately supposed to determine which nursing diagnoses you will use. Then, check the likely nursing diagnoses you think those symptoms might be included under as defining characteristics in a nursing care plan book or a nursing diagnosis book to help guide you in your selection. You are attempting to pick nursing diagnoses and make them fit your patient's situation based on medical diagnosis and surgical procedures that were done to him and that is not the correct way to critical think this. You need to do this by going through the steps of the nursing process. You use information about the patient's medical diagnosis and surgical procedures to help point you to possible nursing diagnoses when you are inexperienced in working with them and do not know their definitions well enough to help save you time in searching through 188 possibilities of nursing diagnoses that you could use.