help with assignment due tomorrow

flyinchic · Apr 7, 2008

Hey Monique...

For Nursing Implications, this would be directly correlating with each of your Nursing Interventions. Say, perhaps you chose...RN will ensure pt eats a low fat diet at all meals....as your nursing intervention for atherosclerosis. A nursing implication of this would be something that you would watch for, labs you could monitor to follow up on whether or not the intervention is doing what you want it to do. Assessing the pt for whether or not giving them a low-fat diet is helping them maintain or improve their health...assess pt for weekly weights, assess for episodes of angina, etc. You chose a difficult diagnosis, because atherosclerosis is not something you can easily measure or change in the short term. But, one good & easy way to approach it is to list the signs/symptoms of atherosclerosis and come up with interventions that can reduce those signs/symptoms and from those interventions, determine how you can measure the effectiveness. Hope this helped! Good luck!

Christie

Student RN

rachiee · Apr 7, 2008

i am an lpn student in first clinical rotation. the following is the assignment i have due tomorrow and i'm embarrassed to say that i don't quite understand what is wanted. i have been working on it for days and its making me crazy!
assignment
on a loose-leaf notebook paper, pick one of your resident's primary diagnosis. describe the disease process and include the pathophysiology, signs and symptoms: subjective and objective, causes, diagnostic tests, treatment including drug therapy, medical and surgical interventions and nursing implications with assessment and care.
i chose atherosclerosis and what i am really struggling with is nursing implications with assessment and care.
i just don't know how to do this portion of the assignment. i would very much appreciate any help with this.
thanks so much for reading.
monique

dont know if this will help but as ur assignment is due tomorrow thought id offer my suggestions

i would put in place the following nursing interventions

modify diet to reduce lipid intake
avoid: smoking, tight clothing, cold temps - all lead to vasoconstriction
avoid direct heat- risk of burns in a limb with decreased sensation
promote increased blood supply by a generally warm environment and elevation of the head of the bed
avoid maintaining a completely dependent position since the resultant oedema will further reduce circulation
encourage excercise up to the limit of pain, partly to maintain joint and muscle function and to promote collateral circulation. by walking three to four times a day, ischaemic time will decrease and pain control can also be improved by increasing blood flow, however,ischaemic pain is notoriously difficult to manage and may require opiate analgesics and night sedation
avoid trauma to impaired limb
avoid ill-fitting shoes, referral to a chiropodist may be required

following the assessment,sympathectomy may be considered to increase blood flow by obliterating neural control of vasoconstiction. percutaneous transluminal balloon angioplasty (ptba) is a minimally invasive treatment for patients with atherosclerotic peripheral vascular disease. the surgical technique involves placing an intra-arterial balloon within an obstructing arterial lesion and forcibly dilating the balloon under fluroscopy.

i have no idea if those nursing interventions is what u needed just know how stressful it can be the day before something is due! can be mind boggling :bugeyes:

anyways hope i helped somewhat

rachiee

moneekw · Apr 7, 2008

Thank you, Christie.

You helped me to understand it better. I was/am getting so anxious about it because there are so many interventions needed for atherosclerosis and I don't know what to focus on. I'm unsure if the assignment requires that I come up with any and all and I feel overwhelmed. The main problem is that I feel so...clueless. This is all new to me and I find myself sitting here scratching my head and feeling a bit , well, stupid. lol

I'm also having a difficult time with what we as LPN students are being taught and expected to know vs what we are actually allowed to do as LPNs. Its just confusing at times. But I digress.

So, does it seem acceptable that I go with just the intervention and implication you mentioned or do I need more?

The next two weekly assignments are the same but I am to pick a different dx, so I definetly want to get this right.

Thanks again!

moneekw · Apr 7, 2008

Thank you, Rachiee !

I appreciate your time and help. As I read what you wrote It makes sense to me but is scares me that I have no idea how to come up with all of that. I guess my head just isn't there yet. :bugeyes:

Thanks again

Daytonite, BSN, RN · Apr 7, 2008

this kind of assignment is why i developed the critical thinking flow sheet for nursing students. the active link for it is at the very end of all my posts. click on it to open it up to copy or download it.

assessment involves looking for the specific signs and symptoms of the disease. in some cases you will want to focus and do a more thorough assessment of one body system rather than another in order to find those symptoms. with atherosclerosis you'll want to assess the cardiovascular system a little more closely. there is a sticky thread on the student forums that has good guidelines for any number of assessments of different body systems: https://allnurses.com/forums/f205/health-assessment-resources-techniques-forms-145091.html
nursing implications, or nursing interventions, are always going to be based upon the symptoms (manifestations) of the disease. these are, in nursing lingo, the patient's responses to what the disease and the doctor's treatments are doing to them and that is what we nurses address as "nursing problems". in the old days we just, for example, said that a patient was nauseated or vomiting. today, we are fancier and give it a nursing diagnosis and say they have deficient fluid volume. but what we do for these things are still the same nursing implications. unfortunately, nursing school is going to force you to learn the lingo.