NANDA Help

[gumby1411]

I'm having a little trouble writing a NANDA. My patient is fictitious. Her reason for seeking care is she got up in the middle of the night to use the restroom, experienced urinary leakage, fell and fractured her hip. She was admitted to the hospital and had ORIF (Open reduction internal fixation) surgery on her hip. Now let's say, I'm the nurse coming on for the evening shift. This is my patient and she's in pain, screaming out for her husband, confused and combative. She was placed in bilateral wrist restraints because she keeps trying to get out of bed.

If I were to establish a NANDA for everything going on with this patient, I'd end up writing a book filled with nursing diagnoses. How do I narrow it down? I know I need to prioritize based on Maslow's hierarchy or ABCs, but how to I not end up with a million diagnoses? Where do I even begin?

[ShantheRN, BSN, RN]

I hate fictional patients. Ugh. I would start with basic/safety needs. ABCs appear to be okay (based on the info given). Look up disuse syndrome and you should get a lot of ideas.

Hope that helps!

[gumby1411]

I forgot to write that she has Alzhiemer's as well (hence the reason she's confused and combative).

Thanks Shanfuturenurse. I think I understand how to prioritize, but I just don't understand how to narrow it down. Do all care plans have a million pages? If you write a NANDA, NOCs, and NICs for everything going on with the patient, there's no way a nurse could get through all the interventions in one shift. Plus, have 2-3 other patients on top of this one...

[silverbells_star]

some that come to mind are:

activity intolerance

impaired mobility

anxiety

confusion

impaired comfort

risk for falls

impaired tissue integrity

of course the big one would be - acute pain

if you get her pain under control, she'll probably calm down some regardless of the Alzheimer's

for your interventions keep them manageable, yes you can write an entire book, but just like you said you'll never be able to get through them all. We must do our care plans differently, because ours have to fit on a one page table.