ineffective health maintenance as a psych nursing diagnosis

[bjennings]

I have a patient who is morbidly obese with a long history of DVT's and PE's and is now in an acute care facility for another DVT and a bilat PE was discovered on her CT scan while I was at the facility in clinical rotations. I am formulating a care plan for her and must use 1 nursing diagnosis and 1 diagnosis related to psych nursing. I used impaired gas exchange as my priority nursing diagnosis and I would like to use ineffective health maintenance as my psych requirement. Is this an appropriate diagnosis? I put Ineffective Health Maintenance r/t recurrence of DVT's and PE's and morbid obesity evidenced by nonadherence to prescribed diet (I personally witnessed her family bring her mcdonalds despite prescribed cardiac diet), sedentary lifestyle (she is a carnival worker who travels the country with her family), and refusal to participate in physical therapy (this was prescribed after she was taken off of bedrest of course). Help please!!

[BowHunterRN]

I never had to have a psych diagnosis for a patient who was not a psych patient, but i will attempt to help :) As long as ineffective health maintenance can be considered a "psych" diagnosis, then I would say you have many reasons to use this. Another one I can think of would be ineffective denial, as it seems this patient is in denial of the seriousness of her diagnosis and doesn't seem to be doing anything prescribed to her. Hope this helps!