having hard time with 1st care plan/ nursing diagnosis

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my patient is 77, has dementia, depression, & unspecified psychosis. she also has hypothyroidism and osteoporosis.

in her chart i learned she has mycotic, dystrophic nails that are thick/deformed & ingrown so they are difficult for her to cut. when i met her her nails appeared almost black under the tips. she also has had a mental & behavioral health visit about a month ago & since then she refuses to go back. she also has a RBC count of 3.54L with the preferred range 3.8-5.0L.. is there anything i could use with this information?

i spent a little time with her & she was very anxious/fidgity.. always trying to rush & get to the next thing. "come on, lets go" "do you have anything else you need to do, or are we done" "change my sheets this way" "are you going to change them or just stand there?!" (after i had been in the room for about 3 seconds with the sheets!!) she was very demanding & wanted things done exactly her way & on her time..

anyway. im having a hard time coming up with a nanda nursing dignosis for her..

i wanted to use anxiety but i cant figure out what its related to?!

anxiety R/T ________ AS MANIFESTED BY pts fidgiting, & inpatience

or i was considering innefective health maintenance R/T __________ AS MANIFESTED BY mycotic/dystrophic nail

any help guiding me in the right direction is GREATLY appreciated!

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This book is awesome and helps a lot. You might want to buy one to help you in the future.

http://www.amazon.com/Nursing-Diagnosis-Handbook-Evidence-Based-Planning/dp/0323071503/ref=sr_1_3?ie=UTF8&qid=1319154559&sr=8-3

:D

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Specializes in Student.

Yup great book for us "beginners"

Mine came on Wed, I used a borrowed one before that.

Finally a way to navigate writeing Nursing plans

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