Nursing Care Plans/Diagnosis

tampanurse2000 · Mar 13, 2015

Hello, a possible NANDA DX could include Ineffective Coping (or Coping: Compromised, Coping: Readiness for Enhanced). The lack of coping skills/abilities can lead to anxiety, particularly for elderly individuals who experience financial issues that they are not readily able to resolve.

Home Health Columnist / Guide · Mar 13, 2015

Thanks tampanurse2000 --Ineffective Coping R/T anxiety over finances would be better nursing diagnosis.

Eru IlÃºvatar · Mar 13, 2015

I am working on now my ageing process paper and I cannot find the proper nursing diagnosis for Anxiety with financial issues, I am working with a group on this paper and this is the Nanda project I was given. The scenario is the patient is 99 yrs old and along with other problems is she has " good days and bad days, and get very anxious about her financial issues." I thought to use anxiety, but I don't see anything for financial issues. i am wondering if I could use depression? Any help would be much appreciated.

Anxiety R/T economic status AEB patient gets very anxious about her financial issues.

Whispera, MSN, RN · Mar 13, 2015

You can't use the diagnostic phrase and the RT phrase as the AEB phrase...

VeeVal · Mar 13, 2015

Thank you for all the help and comments. I think I made it more difficult than what it really is. I clearly understand how to establish the best care plan.

Thank you again! :yes:

VeeVal · Mar 13, 2015

Thank you, I am re-selling the nursing care plan book and investing in the other books. I appreciate all the help you have provided. I now have a much better idea on how to write my Nursing care plan.

Again thank you very much! :up:

nurseprnRN, BSN, RN · Mar 15, 2015

Did you not see the response you got on this query elsewhere? It says why you can't use "Depression," because it's not nursing diagnosis, and gives you very specific things to look at for Anxiety for this patient.

Here's the link to that discussion.

https://allnurses.com/general-nursing-student/trying-to-find-978646.html

Home Health Columnist / Guide · Mar 15, 2015

Merged threads by OP on same topic for continuity of advice.

nurseprnRN, BSN, RN · Mar 16, 2015

I'm not aware that NANDA has specific "related to" parts. If you refer to a what GrnTea wrote in another thread about the same situation, you'll see lists of the NANDA diagnoses. They are short phrases. You use them as the beginning part of your care plan nursing diagnoses and add the details from what you assess in your patient.
So, the format for a care plan would be:
NANDA phrase from the list...R/T -----... AEB ----
The R/T part is what caused the diagnosis. The AEB part is what tells you the diagnosis and its cause are possible.

Not entirely clear what that last part means, sorry.

Thee NANDA-I does, indeed, give the definitions, the (only approved) defining characteristics (the "AEB") and the (only approved) related-to (causative factors) for nursing diagnoses.

So a nursing diagnostic statement to document what decisions the nurse used in making a given nursing diagnosis would include assessment findings and causative factors that match the possibilities in the NANDA-I description and diagnostic findings in the book. It is neither possible nor acceptable to attribute a specific nursing diagnosis to defining characteristics or related factors that do not appear there.

Or am I missing something?

mooshoez · Mar 18, 2015

Not entirely clear what that last part means, sorry.
Thee NANDA-I does, indeed, give the definitions, the (only approved) defining characteristics (the "AEB") and the (only approved) related-to (causative factors) for nursing diagnoses.

So a nursing diagnostic statement to document what decisions the nurse used in making a given nursing diagnosis would include assessment findings and causative factors that match the possibilities in the NANDA-I description and diagnostic findings in the book. It is neither possible nor acceptable to attribute a specific nursing diagnosis to defining characteristics or related factors that do not appear there.

Or am I missing something?

I actually have a question. When writing the "related to" portion, I understand NANDA has specific related factors for each diagnosis. I just wanted to clarify whether or not we use the exact wording of the related factors listed in nanda definition or not. For example, one of the related factors of "excess fluid volume" is "decreased cardiac output". May I write "decreased cardiac contractility" instead? I feel like that's more specific. Thanks

nurseprnRN, BSN, RN · Mar 19, 2015

I actually have a question. When writing the "related to" portion, I understand NANDA has specific related factors for each diagnosis. I just wanted to clarify whether or not we use the exact wording of the related factors listed in nanda definition or not. For example, one of the related factors of "excess fluid volume" is "decreased cardiac output". May I write "decreased cardiac contractility" instead? I feel like that's more specific. Thanks

First: Not all NANDA-I nursing diagnoses have "related to" in them. Some have risk factors.

For example, check "Acute pain." Loads of possible defining characteristics, but no limiting set of causes. You could, then, say, "Acute pain, as evidenced by guarding behavior (clutches abdomen when moving)" or "... (limits weight bearing on right foot)." It doesn't matter how he got it, in terms of what nursing interventions you, the nurse, will apply.

Or, "Risk for infection, due to alteration in peristalsis (diabetic gastroparesis)."

Short answer to your question is, "No."

The reason is that the diagnoses and their supporting parts as noted in the NANDA-I 2015-2017 have been validated by a fairly lengthy process, and they are what's appropriate to use for a nursing process. This discourages people from making up things that may sound plausible to them, but are actually not validated. You might not know whether it's contractility or other factor(s). But you do know there are only three approved related factors for "Excess fluid volume" in the NANDA-I 2015-2017, and they are:

* Compromised regulatory mechanism

* Excessive fluid intake

* Excessive sodium intake

(I don't see "decreased cardiac output" in there at all ... Yet another reason why you have to use the current NANDA-I and not somebody's handbook that's based on out-of-date materials. This diagnosis was updated in 2013.)

It is appropriate in many cases to specify for clarification, though, to let your reader know what, exactly is the situation described in the required diagnostic language. For example, "Post-trauma syndrome related to serious threat to loved one (child has life-threatening illness), as evidenced by ..."

Or, "Interrupted family processes related to situational crisis (spouse on deployment overseas), as evidenced by ..."