Help With Nanda Diagnosis!

[appltini25]

I am having trouble coming up with:

Two nanda diagnoses applicable for a scrub nurse role...

And Five nanda diagnoses applicable for a circulating nurse role...

The surgical procedure is a Roux En Y

Any suggestions?

[lifes_a_beach]

Hmm bit tricky. I have no idea what that abbreviation means for that surgical procedure (im in Aus)

In General Care plans mostly on prevention

Ie risk of injury (skin, fall, neuromuscular, diathermy plates). Prevention of hypoxia, maintain resp function, adequate arterial circulation releated to positioning, releates to circulating nurse as they help with positioning. Scrub could be risk of infection etc.

Hope some of these can help you with finding a suitable NANDA

[nj1grlcrus]

Fluids, skin integrity, risk for falls, constipation, disturbed sleep pattern for circulating (can you tell I just finished a rotation in LTC), and for scrub maybe something under respiration, pain (good for both), confusion, or maybe knowledge. Good luck, I am still so bad at nursing diagnosis, think small, not big.

[Daytonite, BSN, RN]

i'm trying to see how the procedure is going to affect the operative nursing care directly. a roux-n-y gastroenterostomy (gastric bypass for weight loss) can be done as an open procedure or laparoscopically. so, you are usually dealing with very specialized equipment to accommodate very obese patients.

for the scrub nurse, two i can think of are:

• impaired skin integrity (because there will be an open wound)
  
• ineffective protection (because the scrub nurse is directly working in the open wound and concerned about maintaining the sterile field)

for the circulating nurse:

• fluid volume deficit (if it is an open procedure the patient can become dehydrated very quickly, so iv fluids will be needed. if an iv goes bad, the circulating nurse restarts it)
  
• impaired physical mobility (the patient needs to be properly set up and positioned on the or table for an undetermine period of immobility)
  
• ineffective thermoregulation (or suites are cold. while everyone else is working on the surgical site, the circulator should make sure the patient will be adequately warmed)
  
• impaired transfer ability (patient will be unable to provide much assistance in moving due to effect of anesthesia and pain, and in some cases you might be dealing with patients who weight 400+ pounds)
  
• fear (many patients are scared to death of surgery. it's often one of the nurses who gets to hold their hand)

you can see video of a roux-n-y surgery on the or-live website at http://www.or-live.com/. go to the archives for the gi operations.