Need help writing Nursing DX for child with glasses

lpifh653 · Oct 6, 2012

I didn't mean to have the poll in there... first time I've posted on here!!

nurseprnRN, BSN, RN · Oct 7, 2012

We love to help students understand nursing diagnosis-- it's the basis of our profession, the scientific base for our evidence-based nursing practice. Yes, nurses are legally required to deliver and monitor parts of the medical plan of care, but a huge part of nursing practice is developing a nursing plan of care, which is NOT the same as delivering parts of the medical plan of care.

So. Have you observed/assessed these behaviors in this child? If not, you can't assume them and you certainly can't plan care around them.

There is no magic list of medical diagnoses from which you can derive nursing diagnoses. There is no one from column A, one from column B list out there. Nursing diagnosis does NOT result from medical diagnosis, period. This is one of the most difficult concepts for some nursing students to incorporate into their understanding of what nursing is, which is why I strive to think of multiple ways to say it.

Yes, experienced nurses will use a patient's medical diagnosis to give them ideas about what to expect and assess for, but that's part of the nursing assessment, not a consequence of a medical assessment.

For example, if I admit a 55-year-old with diabetes and heart disease, I recall what I know about DM pathophysiology. I'm pretty sure I will probably see a constellation of nursing diagnoses related to these effects, and I will certainly assess for them-- ineffective tissue perfusion, activity intolerance, knowledge deficit, fear, altered role processes, and ineffective health management for starters. I might find readiness to improve health status, or ineffective coping, or risk for falls, too. These are all things you often see in diabetics who come in with complications. They are all things that NURSING treats independently of medicine, regardless of whether a medical plan of care includes measures to ameliorate the physiological cause of some of them. But I can't put them in any individual's plan for nursing care until *I* assess for the symptoms that indicate them, the defining characteristics of each.

Medical diagnoses are derived from medical assessments-- diagnostic imaging, laboratory studies, pathology analyses, and the like. This is not to say that nursing diagnosis doesn't use the same information, so read on.

Nursing diagnoses are derived from nursing assessments, not medical ones. So to make a nursing diagnosis, a nursing assessment has to occur. For THAT, well, you need to either examine the patient yourself, or (if you're planning care ahead of time before you've seen the patient) find out about the usual presentation and usual nursing care for a given patient.

That's why we can't give you an answer-- there isn't one, because we haven't seen this child. Also, we don't give you an answer because we don't do your homework for you to copy off AN and hand in. :) SO.... assuming you think this child has a disturbed body image, what do YOU think causes it, and why do you think so? Hint: Look at the NANDA-I 2012-2014, which every student should have even if your faculty didn't put it on the bookstore list (free 2-day delivery from Amazon.com for nursing students), and check out the defining characteristics of the various nursing diagnoses to give you some hints about what to look at when you assess the child.

Need help writing Nursing DX for child with glasses

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