HElP with Care Plans

[TaraSNKC]

Help! I am beating my head against the wall. My pt is a 85 yr old male with CHF. His BNP is 2290, he is paced, he has had a 20lb weight gain over the last 2 weeks, his feet have +4 pitting edema and are cool and dry. I am trying to do a care plan for Ineffecctive tissue perfussion r/t hypervolemia aeb sluggish cap refill, DOE, and use of accessory muscles. I have no idea where to start with my interventions. None of my books address the cardiopulmonay issue.

Tara

[Daytonite, BSN, RN]

well. . .

• tissue perfusion has to be specified by the type of perfusion involved. which one is it? here's a link to two webpages on this diagnoses to help you out: [color=#3366ff]ineffective tissue perfusion specify type: renal, cerebral, cardiopulmonary, gastrointestinal, peripheral and http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=55
  
• your nursing interventions treat the symptoms that support the evidence that helped you determine the problem existed (the defining characteristics, or symptoms). that would be the sluggish cap refill, doe, and use of accessory muscles to breathe.
  
• what are you going to do about the weight gain and edema?
  
• read the information on
  • https://allnurses.com/forums/f50/help-care-plans-286986.html - assistance - help with care plans
    

[happynewLPN]

Based on what you said, I might also go with the NANDA of Fluid Volume Excess.