Need Help with Care Plan

hi, mandquent, and welcome to allnurses! :welcome:

i'm sitting here wondering what you meant by "eo". i really don't like the use of abbreviations. people assume that others know what they mean. i have a copy of medical abbreviations: 15,000 conveniences at the expense of communications and safety, 10th edition, by neil m. davis which i bought when i was working as a medical coder and having to read doctor's dictations--docs abbreviate all kinds of stuff and arrogantly assume everyone knows what the abbreviations mean. this book says "eo" means

• elbow arthrosis
  
• embolic occlusion
  
• eosinophilia
  
• ethylene oxide
  
• eyes open

somehow, none of those sound like what you meant in your post, so i just don't know what you meant by "eo". sorry.

but i can tell you a lot about care plans and outcome criteria. a care plan is the written documentation of the nursing process. the nursing process is the problem solving method that we nurses use to, well, solve problems. and, believe me when i say this. . .as an rn, this is what you will be expected to do every day on the job--i called it "stamping out fires". that is what rns do. you can also thank the nursing process for critical thinking skills. once you the hang of how to work with and use the nursing process you can pretty much solve most problems quite logically and by putting 2 and 2 together to get 4 (that's thinking critically). in actuality, you have already been doing some basic problem solving in your personal life but just not putting the label of "nursing process" on it or defining it's 5 steps. (hang in here with me, i'm getting to outcome criteria in a minute!)

you must follow the steps, there are 5 of them, of the nursing process in the sequence that they occur or your thinking process gets confused and a bit messed up. i think your instructor jumped the gun in giving you a specific nursing diagnosis to use for this reason: all nursing diagnoses are based on the symptoms that a patient has. in order to use the nursing diagnosis of knowledge deficient r/t pacemaker placement secondary to sss (and that is not worded exactly correctly) you are now going to have to backtrack into it which i think is an unfair thing for an instructor to have made you do. the way to get to a nursing diagnosis is to follow these steps of the nursing process:

1. assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
   
2. determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
   
3. planning (write measurable goals/outcomes and nursing interventions)
   
4. implementation (initiate the care plan)
   
5. evaluation (determine if goals/outcomes have been met)

you need to do a thorough assessment of this patient first to determine what might be lacking, specifically, with regard to his "absence or deficiency of cognitive information related to a specific topic" (the definition of the nursing diagnosis deficient knowledge (specify). if you ignore everything else i've written in this post, do not ignore this: nursing diagnoses, outcomes and nursing interventions are all dependent and based upon the abnormal data (patient symptoms, or nanda calls them defining characteristics) that the patient has. burn that into your brain. what this means for you in developing this care plan is that you will have defining characteristics to support using this particular diagnosis such as (i write from experience since i myself have a pacemaker):

• patient verbalizes the desire to learn about what he will be able and not able to do in his daily life now that he has a pacemaker
  
• patient expressed worry about going near a microwave oven causing his pacemaker to malfunction
  
• patient worries about his pacemaker setting off metal detectors at the airport since he is a frequent flyer

these examples of defining characteristics for this type of problem are the symptoms that you will treat. on your careplan you would develop nursing interventions for each of these symptoms, or defining characteristics. you will research information about pacemakers. i have a medtronics one and received a booklet when it was inserted that answered all the above problems. i believe that medtronics has a website where these booklets can be accessed online for free. however, check with your patient. he should have been given information by the surgeon who inserted the pacemaker as well. part of this care plan should be to make sure he gets that information or that he knows how to get information from the manufacturer of his pacemaker. the information about his pacemaker will be in the surgical progress notes of his chart along with identifying information, including a unique identification number for the pacemaker and the lead wires that were inserted by the cardiologist.

now, here's the answer to your question, needing help with outcome criteria. the outcomes you develop are intimately tied in with the symptoms and nursing interventions. outcomes are the predicted results of your independent nursing actions. so, if your nursing intervention (action) for the symptom of "patient worried about his pacemaker setting off metal detectors at the airport since he is a frequent flyer" is to teach him that he will receive a plastic card which has information on it about him having an implanted metal pacemaker that he is to carry in his wallet at all times to show to officials to explain why he set off the metal detectors, then you will have an outcome statement that is going to reflect this, something like this: after tomorrow's teaching session patient will be able to state how to handle situations in public where his pacemaker might set off metal detectors. do you see how the symptom, the nursing intervention and the outcome are connected to each other? and, by the way, i've walked through the metal detectors at the public library and many stores and my pacemaker hasn't set one off yet. but, i still carry my card with me at all times. and, i microwave stuff all the time and haven't had a problem although i do try to stand an arms length away when the microwave is working.

i wrote a post some time ago on the actual way to word outcome statements. you can view it here: https://allnurses.com/forums/2509305-post157.html.

there is also more information, if you need to see it, on how to write care plans in the posts on these threads:

• https://allnurses.com/forums/f50/help-care-plans-286986.html - assistance - help with care plans (in the general nursing discussion forum)
  
• https://allnurses.com/forums/f205/desperately-need-help-careplans-170689.html - desperately need help with careplans (in nursing student assistance forum)
  
• https://allnurses.com/forums/f50/careplans-help-please-r-t-aeb-121128-7.html - careplans help please! (with the r\t and aeb) (in general nursing student discussion forum)

hope that helps you. oh, and by the way, i would word the diagnostic statement as deficient knowledge (pacemaker operation) secondary to sss related to lack of information aeb [these are examples only, you'll have your own defining characteristics that you'll have discovered during your assessment of this patient] patient verbalizes the desire to learn about what he will be able and not able to do in his daily life now that he has a pacemaker, patient expressed worry about going near a microwave oven causing his pacemaker to malfunction, and patient worries about his pacemaker setting off metal detectors at the airport since he is a frequent flyer. the "related to" part of the nursing diagnostic statement is supposed to be the etiology, or underlying cause, of the problem. "pacemaker placement" is not the cause of someone's lack of information. that makes absolutely no sense and you can tell your instructor i said so. nanda clearly identifies what the related factors are for this nursing diagnosis. you can read about them here: [color=#3366ff]deficient knowledge (specify).