Published Apr 22, 2008
cuca2
2 Posts
male 77 years old pvd ,previous cva,HTN
left sided weakness,able to walk with a cane pain 6/10 in (L) arm,
weak pedal pulse in (L) foot, foot cool to touch, cap refill > 3 sec.
this is my priority diagnosis. pls. help me find two great goals for my careplan
Blee O'Myacin, BSN, RN
721 Posts
Seriously?
Are you stuck, or are you just looking for someone to provide the answers?
Should this be your priority diagnosis? How about the pain? Lack of circulation = lack of oxygen from hemoglobin = pain. So it all ties together.
Now go do your homework!! :redpinkhe
Blee
i am stuck .my instructor does not believe that pain is a priority over tissue. i already have 5 other nursing diagnosis.they are prioritized according to maslow. this is my first one i have to fully develope.just looking for some pointers.
noc4senuf
683 Posts
Sorry, I believe that this forum is not for giving students the answers they need to pass a class or clinical rotation. THose of us that are already nurses had to go through the same thing overselves and probably did not use a forum like this.
RedhairedNurse, BSN, RN
1,060 Posts
You need nursing care plan books to give you this answer. Here is one that I looked up in a book. This is from the Swearingen Medical Surg Nursing Care: Maintain BP >80/60 for adequate perfusion. Pt will have adequate urine output of >30ml/hr. Pt will show no significant change in mental status.
These are some examples that you should be able to locate yourself. Just invest in a good nursing care plan book and you will find your answers.
MikeyJ, RN
1,124 Posts
I agree that impaired tissue perfusion has a much higher priority than pain -- but the goals for impaired tissue perfusion should be fairly easy.
https://allnurses.com/forums/f205/care-maps-225330.html
Postings on that link give a bunch of great links to online sites that provide care maps. Daytonite has some great links on there.
LPNEMSCT
70 Posts
here are two good sites for info, hope it helps.
http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/
http://www1.us.elsevierhealth.com/evolve/ackley/ndh7e/constructor/index.php
ontocrna
39 Posts
Hey,
go to google and search for "ackley and ladwig careplan constructor". go to the sight and go under "start a new plan" and go to the alphabet "P-Z" and you get a screen with an option "tissue perfusion, decreased". Then take the dx below it to get the generic plan for it. Client outcomes are listed and interventions with rationals are there. Betty Ackley was a professor at my school and they've basically put their textbook online for free as college is so expensive and textbooks are difficult for students afford. Keep in mind this is generic and you need to tailor it and make it relevant to your patient.
And as for pain coming second...reason that out...if you correct the problem of tissue perfusion will you still have pain and think abc's (airway, breathing, circulation are always priority as the result is ishemia of tissue if left untreated). Part of good nursing is knowing how to find information because none of us know everything! Peers, colleagues, professors, doctors, professional journal, hospital websites, etc. are all good tools when you are in doubt.
**All Heart RN**
260 Posts
Hey,go to google and search for "ackley and ladwig careplan constructor". go to the sight and go under "start a new plan" and go to the alphabet "P-Z" and you get a screen with an option "tissue perfusion, decreased". Then take the dx below it to get the generic plan for it. Client outcomes are listed and interventions with rationals are there. Betty Ackley was a professor at my school and they've basically put their textbook online for free as college is so expensive and textbooks are difficult for students afford. Keep in mind this is generic and you need to tailor it and make it relevant to your patient. .
.
Ackley and Ladwig's "Nursing Diagnosis Handbook" is a WONDERFUL resource. The book is very thorough. It's helped me through many careplans for school. I didn't know about the online resource...I'm definitely going to google it.
If you have the money, I would highly suggest you purchase the book and keep it in your permanent collection. It's very helpful for careplans.
Look, I was just trying to offer my assistance based on your question without spoonfeeding you the answer. There is no reason to get upset about that. Hope you found what you need.
Daytonite, BSN, RN
1 Article; 14,604 Posts
i agree with your instructor. ineffective tissue perfusion, peripheral which is the need for oxygen trumps acute pain which is a need for comfort on maslow's hierarchy of needs.
goals are the predicted results you expect to see as a result of the nursing interventions you plan to perform. all you listed were the symptoms that your patient had and the only ones that are evidence supporting ineffective tissue perfusion, peripheral are:
in order to give you any suggestions for goals for this diagnosis i would need to know what kind of nursing interventions you are ordering for these three symptoms. there is also a post on how to word goal statements here: https://allnurses.com/forums/2509305-post157.html
you would get better responses had you posted this on the nursing student assistance forum (https://allnurses.com/forums/f205/). for help with writing care plans see the sticky thread:
SNLou84
22 Posts
I dont think cucu got upset by your comment at all....her response was not even rude.