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Is This a Difficult Patient,or is it a Genuine Concern?

Posted

Ms.M is a 26years patient admitted to the medical/surgical ward for overnight observation RE: complaint of shortness breath since the last two weeks..... there is no significant medical history. The nurse she is assigned to measured her vital signs ....the findings are: BP 130/70, Pulse 82, RR 21 and non-labored, Temp. 98, O2 sat 98% on 2liters of oxygen, no complaint of pain, and no visible distress observed.

Every 15 mins. Ms. M rings the call bell and reports that she cannot breathe; the nursing assessment reveals no significant deviation from the vital signs above. What action should we take regarding Ms. M's behavior? And what possible nursing diagnosis can we assign to her?

"I do not have all the answers, but together we can find them."

(M Ecallawh

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 11 years experience.

Ms.M is a 26years patient admitted to the medical/surgical ward for overnight observation RE: complaint of shortness breath since the last two weeks..... there is no significant medical history. The nurse she is assigned to measured her vital signs ....the findings are: BP 130/70, Pulse 82, RR 21 and non-labored, Temp. 98, O2 sat 98% on 2liters of oxygen, no complaint of pain, and no visible distress observed.

Every 15 mins. Ms. M rings the call bell and reports that she cannot breathe; the nursing assessment reveals no significant deviation from the vital signs above. What action should we take regarding Ms. M's behavior? And what possible nursing diagnosis can we assign to her?

So....what do YOU think?

What actions do YOU think should be taking regarding this behavior?

What potential nursing diagnosis does your data point you towards?

We are happy to HELP GUIDE you with your assignment but please let us know your thoughts and research ...

kiszi, RN

Has 9 years experience.

Were lung sounds assessed? CXR? Chest CT?

Why wouldn't we take her concerns seriously?

Anxiety can't be ruled out but at this moment it is more important to look at physiological causes. However, giving an anxiety med with a doctor's order may help her feel better in the interim.

This is homework. We need to hear more from you, IsisPhoenix, as you must know by now. :)

IsisP, IsisP, IsisP, dear.... You must know by now that we won't do your homework for you. Tell us what you have learned already, let us know what confuses you or what you have questions about, and then we can talk. Posting in multiple fora won't help.

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 40 years experience.

^^^ what tea said ^^^

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 11 years experience.

Posting the same thread twice won't get someone to do your homework for you...

I have a correction of this post .....please see other. This is a case study, thanks for your kind cooperation.

“I do not have all the answers, but together we can find them.”

(M Ecallawh

Edited by Isis Phoenix

What is the unit or chapter r/t to your case study?

"I've saved some sunlight if you should ever need a place away from darkness where your mind can feed." - Rod McKuen

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 11 years experience.

I have a correction of this post .....please see other. This is a case study, thanks for your kind cooperation.

Where is your work? I already graduated. I don't mind helping but I'm not doing your assignment for you.

LadyFree28, BSN, RN

Specializes in Pediatrics, Rehab, Trauma. Has 10 years experience.

Not to belabor the point...but YOU go first...what do YOU think?

Start with a holistic assessment and go from there. ;)

I was thinking anxiety, as well. But, shouldn't there would be other findings in the assessment r/t anxiety? I experience SOB, increased HR, sweating...

OP - I posted this on your other thread but what unit or chapter is this discussion post assigned along with?

"I've saved some sunlight if you should ever need a place away from darkness where your mind can feed." - Rod McKuen

LadyFree28, BSN, RN

Specializes in Pediatrics, Rehab, Trauma. Has 10 years experience.

I have a correction of this post .....please see other. This is a case study, thanks for your kind cooperation.

"I do not have all the answers, but together we can find them."

(M Ecallawh

Still constitutes "homework" in this forum-just FYI.

Nonyvole, BSN, RN

Specializes in Emergency.

Case studies can be a pain, sometimes, yes?

So, like other people have said, think holistically. I'm also going to say remember your basic assessment skills.

When you first see a patient, what do you look at? The patient, or the monitor?

So, once you've thought about all that, take a dive into your textbook. What are some causes of SOB? Think it through, then start letting your brain go nuts. Come back and talk about your thoughts, and maybe people'll give their thoughts.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

duplicate thread merged as per the TOS

IP....a case study is still school work. It is a long detailed care plan. Is this a real patient? Is there any other information?

You start with an assessment. What do YOU think this patient needs.

I thought this was a forum where students come together to discuss cases,as well as pertinent issues affecting the nursing profession;if it is not please accept my apology.

The scenario is plain.....how do we proceed? Shouldn't we begin by looking at the current situation... physical,and psychological,her chart,labs,chest x-ray,and other pertinent diagnostic testing in order to rule out Anxiety? This is a topic to be discussed as not everyone see eye to eye,but together we can do a better job of constructing our nursing diagnosis,as well as taking care of the patient.

“I do not have all the answers, but together we can find them.”

(M Ecallawh

Edited by Isis Phoenix

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

it is...however you need to start the discussion. Tell me what YOU think first. After researching this what do YOU feel this patient needs.

The nurse she is assigned to measured her vital signs ….the findings are: BP 130/70, Pulse 82, RR 21 and non-labored, Temp. 98, O2 sat 98% on 2liters of oxygen, no complaint of pain, and no visible distress observed.

Every 15 mins. Ms. M rings the call bell and reports that she cannot breathe; the nursing assessment reveals no significant deviation from the vital signs above. What action should we take regarding Ms. M’s behavior? And what possible nursing diagnosis can we assign to her?

What do YOU think is going on?

I am trying to get you to use your critical thinking skills. Take away the written word. You are the nurse on the floor with a "healthy" 26 year old female who WANTS to be sick and is driving you nuts with the call bell. What could be going on? What would you think the patient needs?

Giving you what I think doesn't help you learn.