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So two weeks back I had this patient with an exacerbation of ulcerative colitis. And for my concept map for this patient I'd made three very lovely nursing diagnoses:
"Diarrhea r/t bowel inflammation and intestinal hyperactivity AEB frequent loose, liquid stools (> 10 per day)"; "Imbalanced nutrition: less than body requirements r/t decreased intake, decreased absorption, and increased nutrient loss through diarrhea AEB weakness, lethargy"; "Acute pain r/t hyperperistalsis, prolonged diarrhea, skin and tissue irritation, perirectal excoriation, fissures, fistulas AEB cramping abdominal pain".
Nice, eh?
My nursing professor looked at my concept map and noted that my patient had abnormally low calcium levels. She said, "I can think of a more important nursing diagnosis". Since hypocalcemia can affect the cardiac system, which is obviously going to be a priority, I have to do it on 'fluid and electrolyte imbalance'.
So anyway, I'm looking through my nursing care plan textbook and I don't know what I'd use.
I don't see "Electrolyte imbalance" in here, but I DO see "Risk for electrolyte imbalance".
So would my nursing diagnosis be "Risk for electrolyte imbalance r/t diarrhea", or "risk for electrolyte imbalance r/t hypocalcemia"? Or would it just be "Risk for electrolyte imbalance"?
Hey, thanks!!! I went ahead and did a care plan on another diagnosis, since I had veritably no clue how to do the "Signs and Symptoms/DEFINING CHARACTERISTICS" section of a care plan if it were going to be a "risk for'' diagnosis.
Is there any way I can email you the care plan that i finished writing up literally 5 minutes ago? Perhaps you could eyeball it and see if I'm on the right track :)
Aha!!! So if my nursing professor asks, "Why didn't you do that 'risk for electrolyte imbalance' nursing diagnosis for your care plan?", I can reply that if I had, the entire "DEFINING CHARACTERISTICS" portion of my rubric would have been left blank!
And since I didn't want a 0 on that section, I chose to do an actual diagnosis instead of a 'risk for' diagnosis. Haha :)
Hey, thanks!!! I went ahead and did a care plan on another diagnosis, since I had veritably no clue how to do the "Signs and Symptoms/DEFINING CHARACTERISTICS" section of a care plan if it were going to be a "risk for'' diagnosis.Is there any way I can email you the care plan that i finished writing up literally 5 minutes ago? Perhaps you could eyeball it and see if I'm on the right track :)
Is it an at risk diagnosis if they already have a low Calcium? and didn't your CI tell you to address this?
Well, the normal calcium levels are between 8.8 and 10.5, and this person's only labs were drawn at the time of admission. It was 8.6.
Ergo, they'd be hypocalcemic.
But I looked in the index for nursing diagnoses, and I didn't find "Hypocalcemia".
I did find diarrhea, though, so I figured I'd just do it on that.
CT Pixie, BSN, RN
3,723 Posts
It would be risk for electrolyte imbalance r/t diarrhea.
Ackely has the risk factors as diarrhea, endocrine ysfunction, fluid imbalance (eg dehydration, water intoxication), impaire regulatory mechanisms (eg, diabetes insipius, SIADH), renal dysfunction, treatment-related sie effects (eg: meds, drains), vomiting.
do you know/remember what her I&O's were, was it in balance? If not you could add
electrolyte imbalance r/t diarrhea, fluid imbalance.
You wouldn't put r/t hypocalcemia b/c hypocalcemia isn't causing the electrolyte imbalance it IS an electrolyte imbalance...but the diarrhea and fluid imbalance is causing the risk for electrolyte imbalance.