Need help with Nursing diagnoses

nursing diagnosis is accomplished by incorporating a logical approach and employing the use of the nursing process. you break down the information you have obtained from the patient's medical history, your physical examination, assessment of their ability to perform adls and any laboratory test results that are available and then group the resulting abnormal data or symptoms into a pattern that fits a well-defined nursing diagnosis. every nursing diagnosis has a set of defining characteristics (symptoms).

step 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 - the patient has these medical problems

• copd
  
• rectal abscess
  
• what medications was the patient being given and why?

step #2 determination of the patient's problem(s)/nursing diagnosis part 1 - make a list of the abnormal assessment data - you didn't mention what your respiratory assessment was. did you also find that the patient had crackles and wheezes? any cough? this patient has copd so there are likely to be respiratory assessment abnormalities. the heart is often involved as well.

• shortness of breath on exertion
  
• pain on his rectal area

step #2 determination of the patient's problem(s)/nursing diagnosis part 2 - match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use - this is all i can come up with based on your assessment data

• activity intolerance r/t imbalance between oxygen supply and demand aeb shortness of breath on exertion
  
• acute pain r/t inflammatory process aeb pain on his rectal area
  

I am stuck again... I have narrowed down my nursing diagnosis and I have run into a wall!! I was planning on using Impaired Skin Integrity because my care plan client had a large fluid filled blister on her knee which sat on top of a gigantic bruise. She also had cellulitis in that same leg. However, when I was reading the definition it made it sound like its only for ulcers. She also has DM is immobile and unable to reposition herself so would she be a better candidate for Risk for Impaired Skin Integrity or just Impaired Skin Integrity. Any advice would be appreciated!

In my response to your last post I explaned very specifically how to arrive at and chose nursing diagnoses. Please go back to your previous post and review the information I posted for you. Nursing diagnoses, as I told you before, are based upon the symptoms that the patient has. Make a list of your patients symptoms and make your diagnostic choices based upon them and not upon her medical diagnosis of cellulitis.

i guess i was looking for clarification of the actual meaning of the two different diagnosis's. i understand they both would apply but was trying to prioritize. thanks for the input however.

it is unclear what two diagnoses you are talking about. you mentioned a medical diagnosis and a nursing diagnosis. ??? nursing diagnoses are usually prioritized by the patient's needs. since only one nursing diagnosis was mentioned, it has priority. medical diagnoses have no meaning when it comes to nursing diagnosis. nursing diagnoses are different from medical diagnoses and they can't be mixed together in a care plan. we are nurses and we determine (diagnose) the patient's nursing problems and prioritize them.

impaired skin integrity (impaired skin integrity) is any broken skin (epidermis or dermis). if the break in the skin is deeper, such as in the subcutaneous layers, then impaired tissue integrity (impaired tissue integrity) is to be used. the weblinks are pages that have the nanda taxonomy definitions of these nursing problems.