need help please

[jgacers]

hello guys.....please help 2nd yr student here, and im doing NCP, case:

px dx c pre-eclampsia (c edema and hypertension) findings noted generalized edema, proteinuria, irritability, emotional tension, epigastric pain, elevated BP. V/S T=37.4 ; PR=66bpm ; RR=16bpm ; BP=150/100.

as my dx: ; excess fluid volume r/t compromise regulatory mechanism AEM generalized edema wieght gain & protein in urine

or should it be :

altered tissue perfusion r/t hypervolemia AMB elevated BP 150/100

please help...............................

[kcalohagirl]

I am far from being expert at Nursing Diagnoses.. . . . .however.

my initial thought is deal with the BP first. I am not an L&D nurse, so I'm sure someone else out there probably has a better answer. But my first impression is bring the BP down.

(we were always told to write our ND in order of what HAD to be done (think ABCs) to psychosocial. . . . .)

I know there are people out there with better answers than this.

Do you have the NANDA book of Nursing Diagnoses? It saved my LIFE in nursing school. If you don't have it, buy it!!!!!!!! It never gave me the answers, but it always gave me a starting point. After a few times, I was better at learning how MY patient fit into a diagnosis.

I still hate writing them.

And seriously. . .. .I havent' written an actual nursing diagnosis since I graduated. But writing them teaches you how to put the pieces together until you kind of do it in your head.

Hope someone can give you more help than I could.