Nanda Dx---what Fits???

[jorla9903]

we are doing these interviews of the functional health of a healthy older adult right now and need to explain their strengths and weaknesses and list at least one nanda dx. well i am having trouble because my volunteer seems to be pretty much healthy and for the weaknesses, i cannot seem to find something that fits......would someone help!!! these are the weaknesses, the two medical illnesses are controlled by medication and she has no complications with the illness or med.

1. high blood pressure

2. high cholesterol

3. smokes- pack a day

4. skin can be dry

5. drinks only coffee in the morn, a couple sodas and

very little water each day.

i appreciate any help i can get:wink2:....

[Nurse 2009]

we are doing these interviews of the functional health of a healthy older adult right now and need to explain their strengths and weaknesses and list at least one nanda dx. well i am having trouble because my volunteer seems to be pretty much healthy and for the weaknesses, i cannot seem to find something that fits......would someone help!!! these are the weaknesses, the two medical illnesses are controlled by medication and she has no complications with the illness or med.

1. high blood pressure

2. high cholesterol

3. smokes- pack a day

4. skin can be dry

5. drinks only coffee in the morn, a couple sodas and

very little water each day.

i appreciate any help i can get:wink2:....

nursing diagnoses are not my strong point but here goes

altered health maintenance r/t denial of effects of smoking as evidenced by smoking 1 ppd, hypertension

something along those lines maybe......

[Daytonite, BSN, RN]

nursing diagnoses are not based upon the medical diagnoses that the patient has, but upon the patient's responses to them. for example, with the smoking. . .how does the person respond to that? do they have a morning cough? is there a throat irritation? breathing problems? difficulty breathing or getting their breath with activities? staining of the teeth? are they around others who have asthma problems and that poses problems for them? the presence of any of those are defining characteristics (signs and symptoms) will support the existence of such nursing diagnoses as ineffective airway clearance, acute pain, ineffective breathing pattern, activity intolerance, impaired dentition, and ineffective coping.

the nursing diagnoses are not the same as medical diagnoses and do not identify diseases. you need to get a listing of them, read their definitions and what they describe so you have an idea of what kind of problems they are identifying. how can you possibly look for the evidence of them if you don't know what to look for? if you were a police detective looking for a murder you would know exactly what evidence to find because you know the definition of murder and you have a pretty good idea of the evidence you need to prove it. do you know what imbalanced fluid volume is and what evidence you need to prove it? how could you possibly detect it if you don't know what to look for?

the nanda taxonomy information must be purchased; nanda does not give it away for free. it can be obtained:

• your instructors might have given it to you.
  
• you can purchase it directly from nanda. nanda-i nursing diagnoses: definitions & classification 2007-2008 published by nanda international. cost is $24.95 http://www.nanda.org/html/nursing_diagnosis.html
  
• many authors of care plan and nursing diagnosis books include the nanda nursing diagnosis information. this information will usually be found immediately below the title of a nursing diagnosis.
  
• the nanda taxonomy and a medical disease cross reference is in the appendix of both taber's cyclopedic medical dictionary and mosby's medical, nursing, & allied health dictionary
  
• there are also two websites that have information for about 75 of the most commonly used nursing diagnoses that you can access for free:
  
  • http://www1.us.elsevierhealth.com/evolve/ackley/ndh7e/constructor/
    
  • http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm

[phuture_rn]

I don't really enjoy doing nursing dx either, because it's like trying to pull something out of thin air. One thing about nsg dx is, it's always easy to make a "risk for" or "potential" dx. With these dx's you don't have to back it up with signs or symptoms. An example, with your patient, would be Risk for ineffective breathing related to cigarrete smoking. Try to get some more info. from the patient like how long have they been smoking, what kind of cig. do they smoke (menthol???), do they cough frequently, listen to breath sounds, does patient have stained or yellow teeth. An example would be Ineffective breathing related to cigarrete smoking manifested by dry nonproductive cough in AM and bilateral wheezing breath sounds. I'm not a wiz on nsg dx by any means necessary but I hope this helps. Your Nsg textbooks should have some good examples and definitions. Try to find some med/surg books as well to help out. Always remember nsg dx is the patients problem related to the etiology manifested by signs and symptoms.

Phuture_rn