Help with Family Nursing Diagnosis

[CalvilloSN]

Back in school after many years and need helpwith nursing diagnosis of family care plan. The family has a history ofcardiovascular disease and 2nd and 3rd generation family members have cardiovasculardisease problems including hypertension, strokes, irregular heart rates withremaining family members having the hypertension. What family nursing diagnosiswould I use for this problem? Altered health maintenance r/t smoking,overweight and physical inactivity. Any help would be appreciated. Thanks.

[Esme12, ASN, BSN, RN]

Welcome back!!!!!!!!!!!

We are happy to help with homework but I need more information before helping you. What semester are you? What care plan book do you have with the NANDA I taxotomy/definitions so you may make a correct diagnosis? What is this patients assessment..... I use Ackley: Nursing Diagnosis Handbook, 9th Edition and Gulanick: Nursing Care Plans, 7th Edition.

Care plans are all about the assessment OF THE PATIENT.....the whole patient. What is the patient assessment? What do they need? Have they had any procedures? What brought them to the hospital? How long have they been hospitalized? What are their vitals signs? What is their main complaint? Tell me about your patient! Tell me about the family!

It appears that you have been out of school a long time......remember it's all about the assessment. Just because there is a history what needs to be changed or what do they need educated about to prevent problems. What are they lacking? What do they need?

[nurseprnRN, BSN, RN]

Your NANDA-I 2012-2014 is THE reference for this sort of thing. I'm looking at mine and I can see the following possibilities (for starters, and there are more). Note that you MUST assess the individual patient/family for the defining characteristics to make a diagnosis. You cannot say, "Oh, that one sounds good" and take off with it unless you know the situation warrants.

(Domain 1, Health promotion)

Readiness for enhanced self-health management

Ineffective health maintenance

Ineffective family therapeutic regimen management

(Domain 2, Nutrition)

Risk for imbalanced nutrition, more than body requirements

(Domain 4, Activity/rest, CV/pulm responses)

Several

(Domain 6, Self-perception)

Chronic or Situational low self-esteem

Disturbed body image

(Domain 7, Role relationships)

Multiple, esp in role performance section

(Domain 9, Coping/stress tolerance)

Ineffective activity planning

Impaired individual resilience

Stress overload

Readiness for enhanced coping

More

(Domain 10, Life principles)

Readiness for enhanced decision-making

A nursing diagnosis statement translated into regular English goes something like this: "I think my patient has ____(diagnosis)_____________ . He has this because he has ___(related factor(s))__. I know this because I see/assessed/found in the chart (as evidenced by) __(defining characteristics)________________."

"Related to" means "caused by," not something else. In many nursing diagnoses it is perfectly acceptable to use a medical diagnosis as a causative factor. For example, "acute pain" includes as related factors "Injury agents: e.g. (which means, "for example") biological, chemical, physical, psychological."

To make a nursing diagnosis, you must be able to demonstrate at least one "defining characteristic." Defining characteristics for all approved nursing diagnoses are found in the NANDA-I 2012-2014 (current edition). $29 paperback, $23 for your Kindle at Amazon, free 2-day delivery for students. NEVER make an error about this again---and, as a bonus, be able to defend appropriate use of medical diagnoses as related factors to your faculty. Won't they be surprised!

If you do not have the NANDA-I 2012-2014, you are cheating yourself out of the best reference for this you could have. I don’t care if your faculty forgot to put it on the reading list. Get it now. Free 2-day shipping for students from Amazon. When you get it out of the box, first put little sticky tabs on the sections:

1, health promotion (teaching, immunization....)

2, nutrition (ingestion, metabolism, hydration....)

3, elimination and exchange (this is where you'll find bowel, bladder, renal, pulmonary...)

4, activity and rest (sleep, activity/exercise, cardiovascular and pulmonary tolerance, self-care and neglect...)

5, perception and cognition (attention, orientation, cognition, communication...)

6, self-perception (hopelessness, loneliness, self-esteem, body image...)

7, role (family relationships, parenting, social interaction...)

8, sexuality (dysfunction, ineffective pattern, reproduction, childbearing process, maternal-fetal dyad...)

9, coping and stress (post-trauma responses, coping responses, anxiety, denial, grief, powerlessness, sorrow...)

10, life principles (hope, spiritual, decisional conflict, nonadherence...)

11, safety (this is where you'll find your wound stuff, shock, infection, tissue integrity, dry eye, positioning injury, SIDS, trauma, violence, self mutilization...)

12, comfort (physical, environmental, social...)

13, growth and development (disproportionate, delayed...)

Intrigued?