Help with my concept map care plan

GingerSue · Mar 28, 2008

maybe:

Risk for peripheral neurovascular dysfunction r/t vascular insufficiency and nerve compression secondary to edema

Acute pain r/t tissue trauma, disruption of skin integrity and edema AMB reluctance to move,guarading of affected area, persistent score of >8 on 10-point pain scale

Risk for impaired skin integrity r/t immobility and shearing forces

Impaired physical mobility r/t decreased muscle strength, pain, AMB inability to purposefully move, limited joint ROM, inability to bear weight

Altered nutrition: less than body requirements r/t decreased intake AMB skipping meals for three days

Daytonite, BSN, RN · Mar 28, 2008

why do your patient's priorities have to be dislocation, infection, venous thromboembolism, bleeding, or infection? where did those come from? they are complications of arthroplasty. potential complications are never more important than the actual problems the patient has. on a care plan (concept map) your priorities should be focused on the actual evidence/data/symptoms that the patient has:

pain is 9/10, in the knee, low back
edema (where?)
redness, warmth (where?)
skipping meals (in the hospital?)
hgb 7.4
hct 21.4
mpv 6.9
co2 19
gluc 118

priorities don't get turned into nursing diagnoses; data becomes the basis for the nursing diagnoses that you choose. your concept map will clearly show this. that's the beauty of concept maps.

every nursing diagnosis has a set of signs and symptoms (nanda calls them defining characteristics). a patient must have at least one or more of these defining characteristics before you can assign any nursing diagnosis to the patient. for example, a doctor would never assign a medical diagnosis of pneumonia to someone without having the evidence to back it up and support it. nursing diagnosing is no different.

so, for the nursing diagnosis of acute pain you have the data of pain of 9/10 in the knee and low back to support it.

ineffective tissue perfusion (specify) is not normally used for patients who have had this procedure. ineffective tissue perfusion, peripheral has to do with constricted capillaries (you gotta know and understand the pathophysiology behind the etiologies of these physiological based nursing diagnoses!) and that is not what is going on with this patient, is it? the cause of his edema is because of inflammation (pathophysiology of inflammation: https://allnurses.com/forums/f50/histamine-effect-244836.html) due to manual manipulation of the tissues by the surgeon and the healing process. you need to read the pathophysiology of tissue damage to understand this. their incisions and bone at the site of surgery, however, are at risk for infection (skin infection, sepsis, osteomyelitis).

now, you just had a patient who had their whole hip joint replaced. how many cartwheels can he now do? none? well, can he run down the hall now? no, to that too? does he have a continuous passive motion machine connected to the operative limb? an abduction pillow? is he getting physical therapy? don't you think there's enough evidence (which you failed to list) for a diagnosis of impaired physical mobility?

another student a week ago was working on a care plan for a patient who also had a hip arthroplasty. you might want to see that thread since i discussed the care planning with the student, including the diagnoses and interventions to use as well as weblinks to information about the surgery and nursing diagnosis webpages:

https://allnurses.com/forums/f205/nursing-diagnosis-290260.html

E.R. Rookie · Mar 28, 2008

why do your patient's priorities have to be dislocation, infection, venous thromboembolism, bleeding, or infection? where did those come from? they are complications of arthroplasty. potential complications are never more important than the actual problems the patient has. on a care plan (concept map) your priorities should be focused on the actual evidence/data/symptoms that the patient has:
pain is 9/10, in the knee, low back
edema (where?)
redness, warmth (where?)
skipping meals (in the hospital?)
hgb 7.4
hct 21.4
mpv 6.9
co2 19
gluc 118
priorities don't get turned into nursing diagnoses; data becomes the basis for the nursing diagnoses that you choose. your concept map will clearly show this. that's the beauty of concept maps.
every nursing diagnosis has a set of signs and symptoms (nanda calls them defining characteristics). a patient must have at least one or more of these defining characteristics before you can assign any nursing diagnosis to the patient. for example, a doctor would never assign a medical diagnosis of pneumonia to someone without having the evidence to back it up and support it. nursing diagnosing is no different.
so, for the nursing diagnosis of acute pain you have the data of pain of 9/10 in the knee and low back to support it.
ineffective tissue perfusion (specify) is not normally used for patients who have had this procedure. ineffective tissue perfusion, peripheral has to do with constricted capillaries (you gotta know and understand the pathophysiology behind the etiologies of these physiological based nursing diagnoses!) and that is not what is going on with this patient, is it? the cause of his edema is because of inflammation (pathophysiology of inflammation: https://allnurses.com/forums/f50/histamine-effect-244836.html) due to manual manipulation of the tissues by the surgeon and the healing process. you need to read the pathophysiology of tissue damage to understand this. their incisions and bone at the site of surgery, however, are at risk for infection (skin infection, sepsis, osteomyelitis).
now, you just had a patient who had their whole hip joint replaced. how many cartwheels can he now do? none? well, can he run down the hall now? no, to that too? does he have a continuous passive motion machine connected to the operative limb? an abduction pillow? is he getting physical therapy? don't you think there's enough evidence (which you failed to list) for a diagnosis of impaired physical mobility?
another student a week ago was working on a care plan for a patient who also had a hip arthroplasty. you might want to see that thread since i discussed the care planning with the student, including the diagnoses and interventions to use as well as weblinks to information about the surgery and nursing diagnosis webpages:
https://allnurses.com/forums/f205/nursing-diagnosis-290260.html

ineffective tissue perfusion, peripheral

this is what i have been looking for! thank you!

i have chosen, pain infection, and mobility due to the increased pain 9/10.

the warmth edema and redness are all on the upper side of the thigh above and below the incision line.

this was very helpful thank you!