maternity nursing care plan

Daytonite, BSN, RN · May 27, 2008

imbalanced nutrition: less than body requirements r/t inadequate food intake secondary to substance abuse aeb weight loss, electrolyte imbalances and poor skin turgor

i wouldn't have included poor skin turgor as a symptom of malnutrition. it's more a symptom of dehydration and fluid deficit.

risk for injury for self and fetus r/t chronic alcohol/drug abuse (no aeb ?)

what is the specific tool of injury here? not the alcohol and drug abuse, but the drugs and alcohol themselves, so just say that:

risk for injury to self and fetus r/t drug and alcohol use.

you basically want to look at the worst case complications that can occur to the mother and baby and you need to address them specifically. i would limit it to one or two conditions at the most, each, for the mom and the baby. it's fetal alcohol syndrome for sure in the baby.

no, there are no aeb's (manifestations) that are normally listed in the diagnostic statement of a potential problem. this is because the problem does not exist, so there can be no actual symptoms as of yet. however, when you are writing the nursing interventions you do have specific problems in mind that you are trying to prevent. so, you do need to know the symptoms of the conditions you want to prevent because your nursing interventions will include monitoring for them. fetal alcohol syndrome in children; liver damage and cirrhosis in the mom.

https://allnurses.com/forums/2751313-post8.html

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- diagnosing anticipated problems

risk for ineffective health maintenance r/t a lack of information about the impact of substance abuse on the fetus (no aeb ?)

this diagnosis is used when someone is advised by health professionals not to do something, like not use drugs or alcohol while pregnant, and then does it anyway. it's not really non-compliance, but it's the powerlessness to not stop what they are doing that is wrong. they would like to do the right thing, but can't for any number of reasons. drug and alcohol addiction certainly applies here. but, is the related factor (cause) really a lack of information about the impact of substance abuse on the fetus, especially in this day and age? did this patient actually tell you that she didn't know that doing drugs and alcohol would harm the baby? i worked on an alcohol detox unit. these patients hide a lot from healthcare personnel to give them excuses for their behavior. consider this. . .my thinking would be that this patient's addiction makes them so that they can't think straight and make the right decisions about their health in the first place. addicts will always find a way to justify their next dose or drink. you know, this "i'll quit tomorrow, but i need this one last drink today" mentality that recycles and never ends. this then would put the focus of this diagnostic problem on addressing and treating the drug and alcohol addiction of the mom. the definition of this diagnosis is the

inability

[which means unable, incapable, powerless, incompetent, or have no skill at]

to identify, manage, and/or seek out help to maintain health.

i would re-word the diagnostic statement to be:

risk for ineffective health maintenance r/t inability to make appropriate judgments due to drug and alcohol abuse.

this then, allows you to address the issue of the substance abuse and it's effects on her decision making ability, plus what specific steps she needs to take to detox and get clean. this mom needs to detox and detox

now

. this view also allows you to bring in teaching interventions about the effects of alcohol and drugs on her as well as the fetus that weren't addressed in

risk for injury

.

hope i haven't confused you and that gives you some direction. it usually helps to clarify a diagnosis by looking at its definition. the nanda definition is a more precise statement of the nursing problem the diagnosis is addressing. good luck with this assignment.