nclex question

hello. i had a med-surg question as my last question on the nclex before it shut off. could you please tell me what you think the answer would be. thanks for your input. "A pt. was diagnosed with CHF. He has a history of having two M.I.'s. what is the nursing diagnosis?" Thanks for your help.:rotfl:

CHF and MI are two very big medical diagnosis and could include any number of nursing diagnosis. I would say that there could be one for alteration in tissue perfusion or at least a potential for as well as alteration in fluid balance. Could have activity intolerance related to increased fatigue either from the CHF or from the MI.

Have you received the results of your exam yet?

Airway.....Fluid Overload are first to come to mind. Airway is always first.....Hope you have done well

Airway.....Fluid Overload are first to come to mind. Airway is always first.....

I'm just a student but that's what came to my mind too. ...ABC's...

Do you remember the choices for the answers?

Two of my books list Impaired gas exchange, decreased cardiac output, excess fluid volume, and activity intolerance.

Never answer a test question without using the A, B, C's. In this case Airway nursing dx would be first choice such as Impaired gas exchange, if not on list of answers, go down list of priority:

Decreased cardiac output related to negative inotropic changes 2ndary to ischemia and infarction

Pain related to ischemia and infarction of myocardial tissue (then you use PQRST memonic to assess).

Low on the list would be activity intolerance.

What were your possible answers on the NCLEX? Would be interesting to hear your list of choices. Bet you passed!!!

You were so right on the money with your reply, that is one of the reasons med/surg is really a speciality, not just a catch all. We do have to know a little about a lot of different medical issues.