help with care plan

[cbop]

My instructor suggested that I get on a website where other nurses respond and help you with your care plan, so here I am. I am a second semester PN student and had a patient who was weaning from a ventilator so I chose the nursing Dx of risk for dysfunctional ventilatory weaning response related to artificial airway as evidenced by the use of accessory muscles when breathing. My instructor pretty much said this was completely wrong. She said I need to choose a NANDA approved diagnoses (which I showed her that this was). Can anyone offer suggestions, I thought I understood how to write these, but it seems like every instructor expects something different. Also, if anyone has advice on interventions (both nursing or collaborative) so I can compare what I had written out. Thanks!

[classicdame, MSN, EdD]

I think this site usually refrains from helping too much with school work. I will give you one hint - at least one of your dx ought to be psycho-social. Is this lady now afraid to go to sleep or afraid she will quit breathing or other fears are expressed?

[netglow, ASN, RN]

That instructor needs to give you your money's worth. What a crock of you know what!

[realnursealso/LPN, LPN]

http://www.google.com/search?hl=en&safe=off&num=100&newwindow=1&q=nursing+care+plans+vent+dependent&btnG=Search&aq=f&aqi=&oq=

[HolisticSandz]

Hi, well I'm a student like you, but I'll try to help. First off, do you have a care plan book? If not, I like ours which is: Nursing Diagnosis Handbook: An evidence-Based Guide to Planning Care, By Ackley and Ladwig, 8th edition. Next, I don't know much about your pt. I was told to think about what exactly is the problem that is keeping my pt. in the hospital/LTC. Then choose my diagnosis appropriately. I looked in my book and I did not see a Risk for DVWR, I did see DVWR. There are mild, moderate, and severe defining characteristics. Check those and figure out what pertains to your pt. There are also physiological, psychological and situational Related factors. And then your interventions and rationales. A care plan book would really help. I wouldn't know what to do without mine. I don't know if any of this helps, and I can't do much more without details. Take a look at some of the other posts about care plans on here. We have an awesome group here who have posted about them in great detail. It will give u a good idea on how to write a good care plan. Good luck!

[Silverdragon102, BSN]

I wouldn't go as far as saying we refrain from helping with coursework but we do find it helpful if you can at least show that you are or have tried to do something and not just expect the membership to do all the work

[cbop]

I am new to this website and how it works, and the last thing I wanted was to seem like a cheater and expect others to do my work for me. I did go buy a care plan book yesterday and I already know it will help tremendously. Thanks anyway.

[Daytonite, BSN, RN]

see this thread for information on how to construct a care plan: https://allnurses.com/general-nursing-student/help-care-plans-286986.html - help with care plans. all care planning begins with listing out your assessment information, not trying to diagnose the nursing problems first. the nursing problems (what everyone wants to call nursing diagnoses) are based on the abnormal assessment data that we see and observe in the patient. that data is evidence and symptoms of each nursing diagnosis that gets chosen. why or how you came up with something like dysfunctional ventilatory weaning response is kind of impressive, but it usually is used when there are a lot of problems getting the patient weaned off a ventilator. while breathing problems are symptoms of this diagnosis, using accessory muscles when breathing is a symptom of another nursing diagnoses: ineffective breathing pattern. dysfunctional ventilatory weaning response is primarily about how the patient is handling oxygen and their responses to that. you need to look at other assessment information like the patient's lung sounds, if they are coughing and their abgs. there are other respiratory diagnoses that will probably be better to consider for this patient. your nursing interventions then target the symptoms of the nursing problems the patient has.