Help, what is a nursing diagnosis for tranfusion

[ginarnia]

I'm a struggling nusing student, and my teacher hates my nursing care plans that we need to turn in for every patient we help take care of, this week I have a relatively stable patient, admit Dx is dehydration and Rhabdo, she been in the hospital for 3 days before I got to her, so her labs are practically back to normal, but she is anemic and need a blood transfusion, my question is what are the PRIORITY NURSING DIAGNOSIS for her and what can be my interventions?

Thank you

[NephroBSN, BSN, RN]

I have never treated a patient with Rhabdo that was a drug user, evey single one has either been at the gym or running, or found down at home.

With a breakdown of the cells you are also going to get an anemic patient, and they were not anemic proir to this episode. If they were that anemic, they would not be running or working out at the gym, they would not have the stamina for it. And that has nothing to do with dehydration.

My last patient, just a few days ago with this diagnosis, was over 60, and had been jogging, and actually tripped and fell into some cactus plants. He went home and was home for a few days, before coming in, because of swelling in his leg from the fall. He definitely was not dehydrated, and was never alone. His issue wias strictly from the jogging/running with the fall injury thrown in to the equation. CK was over 25,000 on admission, and actually peaked at over 64,000 before going back down.

And it was never stated if the patient was young or old by the original poster.

Sorry to say but I have. ARF caused by cocaine use in Maine two summers ago.. He went to chronic hemo for about 2-3 weeks.

You can read more about rhabdomyolsis on Medline Pluse

ETOH abuse and heroin abuse can cause it and I read on another site that people in West Scotland were abusing the gel form of temazepam.

Drug abuse has no age limits.

[jenni82104]

Hi, I am not in nursing school yet, but I was wondering if someone could tell me the difference between a nursing diagnosis and a medical diagnosis? I thought nurses weren't supposed to make a diagnosis?

[maolin]

Nurses don't make medical dx (diseases). Nrsg dx are fancy ways to identify and address priority problems (caused by the diseases).

For more info: http://www.nanda.org/

Hi, I am not in nursing school yet, but I was wondering if someone could tell me the difference between a nursing diagnosis and a medical diagnosis? I thought nurses weren't supposed to make a diagnosis?

[jenni82104]

Thanks Maolin :)

[suzanne4, RN]

Sorry to say but I have. ARF caused by cocaine use in Maine two summers ago.. He went to chronic hemo for about 2-3 weeks.

You can read more about rhabdomyolsis on Medline Pluse

ETOH abuse and heroin abuse can cause it and I read on another site that people in West Scotland were abusing the gel form of temazepam.

Drug abuse has no age limits.

That is one patient and I have cared for dozens with this thru the years of a career covering too may years to count.

[bookwormom]

Don't have a nursing diagnosis book at hand, but it seems to me that impaired gas exchange suggests more of a respiratory problem. (However, the logic makes sense.) But I don't think the transfusion, per se, can be the evidence for impaired gas exchange.

[NephroBSN, BSN, RN]

That is one patient and I have cared for dozens with this thru the years of a career covering too may years to count.

I've been a nurse for 26 years. I've been a dialysis nurse for 10 of them.

Just because you haven't seen it doesn't mean it exits.

Maybe you should read the literature.

[maolin]

That's the dx we've always used when making a care plan for transfusion pts - it is valid b/c it can refer to gas exchange in the lungs (dropping off CO2 and picking up O2) or the exchange of CO2 and O2 at the tissue/cellular level - either place, the lack of Hgb (secondary to decreased RBC) impairs the amount of CO2/O2 that can be exchanged. With a transfusion, you are increasing the RBC, therefore the Hgb, therefore the ability to transport O2 & CO2, therefore improved gas exchange.

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I just looked up in Ackley's - looks like definition of IGE doesn't support anemia as a cause, but if you write it something like:

IGE r/t inability to transport adquate O2 s/t hypoxia AEB supportive data... it will work within NANDA specs. Tissue is hypoxic s/t anemia & decreased Hgb.

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It would be similar to using IGE for carbon monoxide poisioning - it isn't a lung problem per se, but CO occupies most of the Hgb on the RBC and doesn't let go as easily to allow room for CO2 & O2.

Don't have a nursing diagnosis book at hand, but it seems to me that impaired gas exchange suggests more of a respiratory problem. (However, the logic makes sense.) But I don't think the transfusion, per se, can be the evidence for impaired gas exchange.