Nanda Diagnosis...picking my brain!!!

Daytonite, BSN, RN · Apr 5, 2009

i got it. the idea with doing the "related to" part of these nursing diagnostic statements is that they identify what the etiology, or cause, of this nursing problem (nursing diagnosis) is. the nursing diagnosis itself is actually a label--a shortened few words that is supposed to stand in place of the definition which is the real description of the patient problem. so, for example, when you are using grieving, it really stands for a normal complex process that includes emotional, physical, spiritual, social, and intellectual responses and behaviors by which individuals, families, and communities incorporate an actual, anticipated, or perceived loss into their daily lives (page 263, nanda international nursing diagnoses: definitions and classifications 2009-2011). it's easier to just say grieving. since this is a behavioral type of problem it stands to reason that the cause of it would be something that evokes this behavior. so, the death of someone would be appropriate as the related factor.

fetal demise care plan

grieving related to fetal demise
- sequence grieving before an "at risk" diagnosis
[*]at risk for ineffective coping related to loss of anticipated infant
- coping has to do with making the wrong choices because of perceived threats and i don't think that is what you want to convey here, is it?
[*]use instead powerlessness r/t helplessness

amniocentesis care plan

anxiety related to invasive procedure
- anxiety is a physical response (uneasy feeling of discomfort) because of a sense of danger due to a threat to the self
- word instead as anxiety r/t threat to the fetus or anxiety r/t threat to self
[*]risk for infection related to amniocentesis
- word instead as risk for infection r/t invasive procedure

your planning is the nursing interventions that you develop after the nursing problems (nursing diagnoses) have been identified. nursing interventions are based upon the evidence that supports the nursing diagnosis. that evidence comes from initial patient assessment. evaluation is the secondary assessment that you do later to see if the problem has been resolved or still exists.

newby nurse · Apr 6, 2009

Thank you so much! So you think that Grieving related to fetal demise is not stated to cut and clear?I was wondering if Grieving related to loss of anticipated infant was better?? I always seem to overthink things and am the "why" student...meaning I have to understand more than we probably need to know...which in turn makes me overthink everything!When you explained the ineffective coping better it did not make much sense to use that one, so I thought about using Fear related to fear of unknown and painful procedures? Ihope this care plan stuff becomes more second nature...my brain is killing me! LOL!I also like your PowerlessnessR/t to helplessness but I just want to make sure I'm using my own too, although it would be very easy to just write that one down!

Daytonite, BSN, RN · Apr 6, 2009

i think you need to read my post again. i never said anything about the way grieving related to fetal demise was written. it is fine as you wrote it. what i was trying to convey regarded the sequencing of the two diagnoses. grieving is an actual problem; an at risk diagnosis is an anticipated problem. actual problems are always sequenced before anticipated problems on care plans. it doesn't matter anyway because i don't think that at risk for ineffective coping related to loss of anticipated infant is a good diagnosis to use. i suggested using powerlessness related to helplessness. powerlessness is a psychosocial diagnosis and would be in the same category a grieving in priority.

what does fear related to fear of unknown and painful procedures have to do with a care plan about fetal demise? that doesn't make sense to me.

if you are actually writing a care plan with interventions, i suggest that you write out some assessment data because all nursing diagnoses are based upon abnormal assessment data (called defining characteristics). interventions have to be designed around this abnormal assessment data. if your instructors are saying something different then they are wrong or you are not interpreting their information correctly. every nursing diagnosis has defining characteristics (signs and symptoms) listed with it. you will find them on these nursing diagnosis pages for [color=#3366ff]grieving, [color=#3366ff]powerlessness, and [color=#3366ff]anxiety. [color=#3366ff]risk for infection is an anticipated problem so it will not have any defining characteristics listed with it because the nursing interventions will be to prevent a targeting infection from occurring. [color=#3366ff]fear is listed there too.

newby nurse · Apr 6, 2009

Thank you so much for responding. I reread your post without four kids running around and now I understand what you were saying. I used the fear diagnosis for amniocentesis not fetal demise...I will be getting on here when the children our sleeping from now on! LOL! Sorry about that! I nixed that Diagnosis anyway. My whole class is up in arms with tons of questions regarding theses care plans...like I said didn't receive much instruction. Thank you.Very helpful! Sorry if I was confusing, I know I sound pretty dumb with these care plans...just need time to get the hang of it!

cjcsoon2bnp, MSN, RN, NP · Apr 6, 2009

Thanks Daytonite for your posts, I know that I have a lot of trouble with nursing diagnoses too and I think you have helped to clear it up.

!Chris :specs: