NANDA Nursing Diagnosis...mult. etiologies

[cheezwhiz]

Is it acceptable to use multiple etiologies for a nursing diagnosis? I have two that are applicable, and not sure which to choose...or if I must choose just one. Thanks.

[RNTutor, BSN, RN]

Do you mean multiple "r/t" or multiple "aeb"? Yes, I would say it would be okay to use multiples, but sometimes you can summarize in one statement instead of two to simplify. If you post your nursing dx, maybe I can give a better suggestion or tell you if you're on the right track?

[cheezwhiz]

I mean multiple "r/t"s.

For example, Decreased cardiac output r/t effects of chronic heart failure and effects of hyperkalemia...

What do you think?

[RNTutor, BSN, RN]

You can definitely use multiple r/t's for something like that, but I would state it a little differently. It's usually a good idea to avoid using the medical diagnosis unless there's just no other possible way to state the r/t. Remember, as nurses we don't treat the disease, we treat the pt's response to disease. In other words, their symptoms.

So instead of "effects of chronic heart failure," I might say something like "increased afterload" (especially if it's left-side CHF and they have high BP). Altered stroke volume or decreased contractility would also be possibilities.

As for "effects of hyperkalemia," well there are many. So let's state the one in particular that you are probably referring to, which is dysrhythmias. Did the pt have an abnormal heart rhythm? If so, I would just state that as one of your r/t's.

Does that make sense to you?