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Discussion

NANDA question

I'm helping a friend with her workbook questions and we're going back and forth over one:

The pt is admitted with osteoarthritis. One assessment, the nurse notes that the pt walks with a limp. What is the priority nursing diagnosis?

a. Activity intolerance

b. Impaired physical mobility

c. Ineffective health maintenance

d. Chronic osteoarthritis

We can't decide between a) and b). The book says b), so we need to know why. Is activity intolerance not a NANDA dx?

eta: I find it odd that the teacher is having the class go over questions like this when they really haven't discussed care plans, nursing dxs, etc. Seems kind of backwards.

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    I would also choose B for the simple fact that the pt is walking with a limp...in other words, the pt's physical mobility is impaired. This is a listed NANDA Dx listed in the 2009-2010 book.

    The reason why this is a one of the first priorities is because of the osteoarthritis...it is important to find out if the disease is progressing so that appropriate PT or OT can help pt regain full use of limb causing the problem.

    I do not know if anyone else has any other suggestions but this is what I came up with

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    Is she actually not intolerating activity? Sounds like she is scooting around just fine, her mobility is just impaired.

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    • Expert

    the pt is admitted with osteoarthritis. one assessment, the nurse notes that the pt walks with a limp. what is the priority nursing diagnosis?

    a. activity intolerance

    b. impaired physical mobility

    c. ineffective health maintenance

    d. chronic osteoarthritis

    we can't decide between a) and b). the book says b), so we need to know why.

    the answer is
    b. impaired physical mobility.
    the reason has to do with the definition as well as the defining characteristics, or symptoms, that meet the criteria of the diagnosis. what you need to understand is that the nursing diagnosis itself is merely a name, or label, for a nursing problem. the nature of the nursing problem is actually described in the definition of the diagnosis. a look at the nanda taxonomy for the two diagnoses in question should clear up any questions.

    activity intolerance
    -
    definition
    : insufficient physiological or psychological energy to endure or complete required or desired daily activities
    (page 134,
    nanda international nursing diagnoses: definitions and classifications 2009-2011
    ). defining characteristics include such things as abnormal blood pressure, heart rate and breathing during activity, fatigue and weakness.

    impaired physical mobility
    -
    definition
    : limitation in independent, purposeful physical movement of the body or of one or more extremities
    (page 124,
    nanda international nursing diagnoses: definitions and classifications 2009-2011
    ). defining characteristics include such things as difficulty with movements, limited rom and slowed, uncoordinated and jerky movements.

    now, do you see the difference more clearly?

    is activity intolerance not a nanda dx?

    it
    is
    a nanda diagnosis as pointed out above. you should get a copy of the taxonomy, or at the least a copy of all the official diagnoses. nanda does not give them out for free. you can see what they have available and purchase directly from nanda at
    http://www.nanda.org/marketplace/nandaipublications.aspx
    . the nanda taxonomy (list of diagnoses, their definitions, defining characteristics and related factors) are published in the appendix of current editions of
    taber's cyclopedic medical dictionary
    .

    eta: i find it odd that the teacher is having the class go over questions like this when they really haven't discussed care plans, nursing dxs, etc.

    you are in college and expected to do some of this work on your own initiative. this all relates to the nursing process. diagnosing is step #2 of the nursing process. i write about it in answering questions here on this forum all the time. the nanda taxonomy was put together by the nurses in nanda who did extensive research in how each diagnosis should be used. the reference i quote above (
    nanda international nursing diagnoses: definitions and classifications 2009-2011
    ) is to help us determine from our initial assessment data just what nursing problems patients have and properly diagnose them. doctors diagnose disease; we diagnose nursing problems and have this nanda taxonomy to help us. part of your learning to write care plans will be to determine and use these nursing diagnoses with patient care.
    federal law in the u.s. mandates
    that every patient in a hospital and nursing home have a care plan in their permanent chart that documents the nursing process and most places do this with nursing diagnosis.

    if you want to see more on how the nursing process and the construction of care plans are interrelated see this thread:
    https://allnurses.com/general-nursing-student/help-care-plans-286986.html
    -
    help with care plans.
    if you have more questions about this ask and i will answer and help you out where your instructors may not being so clear.

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