Need help with a nursing diagnosis.

[Juicy925]

any suggestions for a nursing diagnosis for a patient with a-fib?

[dragonflyRN]

Decreased cardiac output

[purple_rose_3]

What have you come up with so far?

[suzy253, RN]

replied in your other post. Giving the dx does not help understanding the disease process

[javajaydon]

Potential for altered tissue perfusion

[RedhairedNurse, BSN, RN]

Altered coagulation. When a pt has a-fib, the blood can pool in the atrium and thus cause the pt to be at risk for thrombosis/embolus. Usually, a pt with a-fib has to be on coumadin to prevent this complication.

[MissKitty21]

The best way to come up with a diagnosis is to think of the symptoms that coincide with the medical condition.

I'd suggest showing us the diagnoses you have come up with yourself, so that we don't feel as though we're doing your homework for you. Then we can work together.

[Daytonite, BSN, RN]

answered:

https://allnurses.com/forums/f205/need-help-nursing-diagnosis-336358.html - need help with a nursing diagnosis

i've been waiting for you to reply back and have heard nothing. i won't give out diagnoses until students post assessment information. atrial fib is a medical diagnosis. it tells us nothing about the patient's nursing problems. a care plan is about the patient's nursing problems. i have atrial fib and as i am sitting here i can give you two symptoms i am having right now because my medication was changed yesterday. what about your patient?

• http://www.merck.com/mmpe/sec07/ch075/ch075e.html - atrial fibrillation
  

• 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)
  • a physical assessment of the patient
    
  • assessment of the patient's ability and any assistance they need to accomplish their adls (activities of daily living) with the disease
    
  • data collected from the medical record (information in the doctor's history and physical, information in the doctor's progress notes, test result information, notes by ancillary healthcare providers such as physical therapists and dietitians
    
  • knowing the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for the medical disease or condition that the patient has. this includes knowing about any medical procedures that have been performed on the patient, their expected consequences during the healing phase, and potential complications. if this information is not known, then you need to research and find it.
    
  • https://allnurses.com/forums/f205/medical-disease-information-treatment-procedures-test-reference-websites-258109.html - medical disease information/treatment/procedures/test reference websites

  [*]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)

  • it helps to have a book with nursing diagnosis reference information in it. there are a number of ways to acquire this information.
    
  • your instructors might have given it to you.
    
  • you can purchase it directly from nanda. nanda-i nursing diagnoses: definitions & classification 2007-2008 published by nanda international. cost is $24.95 http://www.nanda.org/html/nursing_diagnosis.html
    
  • many authors of care plan and nursing diagnosis books include the nanda nursing diagnosis information. this information will usually be found immediately below the title of a nursing diagnosis.
    
  • the nanda taxonomy and a medical disease cross reference is in the appendix of both taber's cyclopedic medical dictionary and mosby's medical, nursing, & allied health dictionary
    
  • there are also two websites that have information for about 75 of the most commonly used nursing diagnoses that you can access for free:
    • http://www1.us.elsevierhealth.com/evolve/ackley/ndh7e/constructor/
      
    • http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm

  [*]planning (write measurable goals/outcomes and nursing interventions)

  • goals/outcomes are the predicted results of the nursing interventions you will be ordering and performing. they have the following overall effect on the problem:
    • improve the problem or remedy/cure it
      
    • stabilize it
      
    • support its deterioration

    [*]interventions are of four types

    • assess/monitor/evaluate/observe (to evaluate the patient's condition)
      • note: be clear that this is assessment as an intervention and not assessment done as part of the initial data collection during step 1.

      [*]care/perform/provide/assist (performing actual patient care)

      [*]teach/educate/instruct/supervise (educating patient or caregiver)

      [*]manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)

  [*]implementation (initiate the care plan)

  [*]evaluation (determine if goals/outcomes have been met)

[Juicy925]

sorry i did not get a chance to check this soon after i posted. been busy studying for 2 tests.

the patients admitting diagnosis was a-fib, he is still in the hospital s/p pericardial effusion and is still draining fluid. on the day of admission, was given amiodarone blous and then was on an amiodarone drip for 24 hours.. since then he has been in SR and and is taking amiodarone po daily. he is continuosly on 3L of oxygen and gets breathing treatments albuterol/atrovent every 6 hours. he has dyspnea only upon exertion when transferring to a chair, and denies any chest pain or shortness of breath. the nursing diagnosis i came up with is Activity Intolerance related to compromised oxygen transport system secondary to dysrhythmia/atrial fibrillation.

[Daytonite, BSN, RN]

Decreased Cardiac Output R/T altered rhythm AEB atrial fibrillation

and

Activity Intolerance R/T imbalance between oxygen supply and demand AEB dyspnea only upon exertion when transferring to a chair

Make sure you consult a NANDA diagnosis reference so you get the related factors and symptoms correct for the diagnoses when composing 3-part diagnostic statements for school.