Help with specific Interventions/Rationales?? PLEASE!!!

Daytonite, BSN, RN · Sep 30, 2008

ok, i had to break this down into the pes. interventions are aimed at the e (etiology) and the s (symptoms).

p (problem)

- ineffective management of therapeutic regimen

e (etiology)

- complexity of therapeutic regimen and insufficient knowledge of self care and financial cost of regimen exacerbated by barriers to comprehension secondary to anxiety about heart health and self-management

s (symptoms)

- none given

do you have a nursing diagnosis book? that would help to explain a lot about what this diagnosis is about. it's definition is "pattern of regulating and integrating into family processes a program for treatment of illness and the sequelae of illness that is unsatisfactory for meeting specific health goals" (page 223, nanda-i nursing diagnoses: definitions & classification 2007-2008). defining characteristics listed include: acceleration of illness symptoms of a family member, inappropriate family activities for meeting health goals, failure to take action to reduce risk factors, lack of attention to illness, verbalizes desire to manage illness, verbalizes difficulty with therapeutic regimen. herre are weblinks to online information about these diagnoses with some ideas for interventions:

you need to work out what this patient's specific defining characteristics are. when you assessed this person, you must have seen some of them in discussing it with your instructor to decide upon this diagnosis. there must be evidence to support every nursing diagnosis just as there must be evidence to support every medical diagnosis. that evidence is discovered during assessment. when you do your interventions, think of them as treatment for the problem. just as a doctor orders medical treatment, we nurses order nursing treatments we call interventions in the written care plan. our targets are the etiology of the problem (that is not always practical) or the symptoms/evidence that contribute to the problem (what you are doing is like chipping away at the foundation of the problem). you will express them as goals, but order interventions to get to the goals.

sounds like a lot of teaching will be needed to me. so your interventions are aimed at:

complexity of therapeutic regimen
insufficient knowledge of self care
financial cost of regimen
barriers to comprehension
anxiety about heart health and self-management
the patients defining characteristics (symptoms) (yet to be listed by you) of ineffective management of therapeutic regimen

goals/outcomes are the predicted results of the nursing interventions you will be ordering and performing. they have the following overall effect on the problem:

improve the problem or remedy/cure it
stabilize it
support its deterioration

interventions are of four types

assess/monitor/evaluate/observe (to evaluate the patient's condition)
- note: be clear that this is assessment as an intervention and not assessment done as part of the initial data collection during step 1.
[*]care/perform/provide/assist (performing actual patient care)
[*]teach/educate/instruct/supervise (educating patient or caregiver)
[*]manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)

go!