Help With Physiological and Psychosocial Nursing Diagnosis

I'm having a problem distinguishing between psychosocial and physiological nursing diagnosis'. Is Knowledge Deficit 1st time mother and not knowing how to perform personal cares a psychosocial or physiological nursing diagnosis? And I'm also looking for a list to separate the two.

I think a really good Care plan book is the All in One by Swearingen. It has just about got everything in it.:idea:

What would be a good psychosocial diagnosis for someone who is in a persistent vegetative state? I am not allowed to use "Risk for isolation". Her family visits her once per week.

Specializes in ER trauma, ICU - trauma, neuro surgical.

You have tell us what you think first....

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Look at your care pan book...what do you think would be a psychosocial diagnosis? We are happy to help with homework but we will not do it for you. What book do you have for your NANDA I diagnosis reference?

If you had a family member in a persistent vegetative state what would be your thoughts and concerns about your family coping, the patients dignity and comfort. Is the family dealing well...are they grieving properly.

What is your assessment and what do you think?

This is my first semester of nursing. We have been going over nursing care planning. I am having trouble with nursing diagnoses. I can't grasp the concept. We have an assignment which requires us to come up with 15 nursing diagnoses with at least 3 biophysical, 3 psychosocial, and 3 educational diagnoses for the following case study:

A 42 year old man was admitted to the hospital with a diagnosis of FUO (Fever of Unknown Origin). His assessment reveals: T- 103 degrees F., P-110, R-24, and B/P 90/50. He is alert and oriented to time, place, person, and content. His skin is hot to touch.

Crackles are noted in the bases of both lung fields. His abdomen is soft and non-distended. Bowel sounds are present in all four quadrants. He complains of malaise and just not feeling well. He states "I have been having a high temperature every afternoon for the past 3 days." He has also had loose watery stools and vomiting for the past 2 days. He has gone to the bathroom and voided 150 cc of dark amber urine. He is having lower abdominal pain. He states "my pain is a 6 on a scale of 0-10." The pain gets worse when he eats spicy foods and is relieved by taking Tylenol. He describes the pain as sharp and colicky. He has been taking Tylenol 500 mg by mouth every four hours for the temperature, and Immodium AD for the diarrhea. He is 5 feet, 10 inches tall and weighs 220 pounds. He states that he has got to get well, he is a nursing student and cannot miss school. He also is the sole supporter for his family and needs to work. His lab work reveals a WBC count of 15,000, a HGB of 16 and an HCT of 42. Blood cultures and urine cultures have been collected. He states that he works as a computer programmer and does not get any regular form of exercise. He tries to eat a low fat diet, but loves his bowl of ice cream with chocolate syrup before he goes to

bed every night. He usually has a bowel movement each morning. He normally voids about 5 times a day and does not have to get up in the middle of the night to go to the bathroom. He takes Ambien 5 mg as need for sleep, stating that he usually sleeps about 6 hours a night.

The patient is married and has two children. He states that he had a vasectomy after his last child was born. He attends the Methodist Church every Sunday and says that his religion is a great source of comfort for him. He participates in a weekly Men's Bible study and says that he deals with stress by listening to music and praying. In addition to caring for his young family, he is the sole provider for his 78 year old widowed mother. His father died at the age of 50 from a heart attack.

Nursing process is a roadmap for determining patient's needs and then planning, administering care, then evaluating whether or not it achieved the goal. As a nurse, you can't just do something because you thing it's a good idea. You have to be able to prove or show that whatever you do is not just something you made up on a whim.

First, you assess. Then "The nursing diagnosis is the nurse's clinical judgment about the client's response to actual or potential health conditions or needs." The diagnosis reflects not only the medical condition but also the other complications (actual) or potential (risk for). The nursing diagnosis is the basis for the nurse's care plan.

The nurse can't use the doctor's medical diagnosis diagnosis of FUO (Fever of Unknown Origin). The nursing diagnoses have to be things that a nurse can do something about, is what my instructor said. So, use the assessment of the patient, and out of that pull your three + three + three nursing diagnoses.

You have some clues: for example, I know that early 40s to 50s is when many men get into cardiovascular problems. So, here's a guy age 42 w/ sedentary lifestyle, 5'10" and 220# is probably overweight, you see some information about his diet, and "His father died at the age of 50 from a heart attack" which is a huge risk factor. You might pull a risk-for or an "educational diagnosis" (whatever that is, LOL) out of there.

Safety-related issues are always important.

etc. Analyze the clues they gave you, and eventually you are expected to prioritize but at this stage might just have to identify needs of patient and convert that to nursing diagnoses.

Specializes in Med/surg, Tele, educator, FNP.

Infection rt elevated temps aeb fevers and elevated WBC

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Specializes in Med/surg, Tele, educator, FNP.

Risk for ineffective coping rt lack of support aeb no support in the home

These are a few I could come up with off the top of my head.

Basically find a nursing diagnosis and support it with ur assessment

Remember u can't use a medical diagnosis in your nursing dx

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Specializes in ED.

Ok so reading through this, what pops out at you as being the priority. What is his main complaint, what will kill him faster than anything else. Then work down the list.

The crackles with fever and elevated wbc, infection process?

The diarrhea, nausea and vomiting, dark amber urine=dehydration?

start looking into the education he needs, eats spicy foods and pain worsens? Yep, one there.

It is for stuff that if you give him the information, that he could change in his life and then the symptoms would get better.

Psychosocial, how is he coping with the stress of the outside environment/stressors? Does he stress about his own mortality when thinking about his father's early death? And coping with the added stress of being a nursing student along with work and taking care of his family while he is sick, potential for alteration in coping?

There are some nd that can be appropriate for most all patients. Ineffective healthcare maitenence/management, discharge care plans, and ineffective pain managrment. Also, because he has voided so little, look at care plans about fluid as well. In this patient there is a risk of spiritual distress as well.

One of the best things that you can do is to get yourself a nursing diagnosis book. You can also find loads of examples online of care plans. The concept is not easy, however, simply put a nursing diagnosis is how a nurse looks at specific problems with a patient that is something that a nurse can intervene on, and what is the goal? What can you do as a nurse to assist the full function of this patient?

Be sure that you are setting up the plans per the assignment requirements. It usually is problem/intervention/timelined.

Good luck!

Specializes in Med/Surg, Ortho, ASC.

The best way to ask for help here is to first give YOUR first thoughts/ideas of appropriate answers to whatever you are struggling with. That way, folks can see where your mind is focused and help you work through the issue.

I can't speak for everyone, but most of us would prefer to see a student put effort into the homework problem, rather just ask for the answers. So far, you have posted the homework question in 2 different forums, but I don't see any of your own thoughts/potential answers.

I appreciate all of your help. Thanks a lot.

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