Published Oct 2, 2008
jbw1017
13 Posts
Hi, I'm new to posting, so please forgive me. I'm looking for any sugggestions or advice. I'm currently working on my careplan for my 68 yo patient. She was admitted with cellulitis & dry gangrene on her 3rd toe of her right foot due to an acute injury 2 1/2 weeks ago. She is diabetic, overweight, smokes and has PVD, hypertension, hyperlipidemia & Hx of an MI.
My nursing diagnoses so far are as follows:
Ineffective Tissue Perfusion - peripheral r/t impaired transport of oxygen 2nd/t Diabetes Mellitus & PVD AEB absent R post-tibial pulse & dry gangrene on 3rd toe on R foot.
Imbalanced Nutrition – More than body requirements r/t poor eating habits AEB client is overweight, has hyperlipidemia & admits to noncompliance with diabetic meal plan.
Disturbed Body Image r/t change in foot appearance AEB 3rd toe on R foot is black & patient was informed that it will fall off.
Risk for Infection r/t decreased sensation & circulation in lower extremities 2nd to DM & PVD.
Any suggestions to tweak these diagnoses or other diagnoses to think about would be greatly appreciated.
Daytonite, BSN, RN
1 Article; 14,604 Posts
in order of priority:
ineffective tissue perfusion - peripheral r/t impaired transport of oxygen 2nd/t diabetes mellitus, pvd and effects of smoking aeb absent r post-tibial pulse & dry gangrene on 3rd toe on r foot.
imbalanced nutrition - more than body requirements r/t poor eating habits aeb client is overweight, has hyperlipidemia & admits to noncompliance with diabetic meal plan.
ineffective health maintenance r/t history of lack of health-seeking behaviors aeb poor eating habits and failure to follow diabetic meal plan
disturbed body image r/t change in foot appearance aeb 3rd toe on r foot is black & patient was informed that it will fall off.
risk for infection r/t decreased sensation & circulation in lower extremities 2nd to dm & pvd.
Hi Daytonite,
I just want to thank you for sharing your invaluable experience & insight. You've really helped me better understand writing proper nursing diagnoses. I'm sure I'll be looking forward to your feedback & suggestions in the future.
By the way, in regards to: "evidence: "patient was informed that it will fall off" is not a clear statement of evidence and sounds like charting of an intervention that was done." I was actually in the pt's room with the physician when he relayed that info to the pt.
So glad your boo-boo healed!
Thanks again for your help, JoDee
Me, too.