Nursing Diagnosis based on perscribed drugs

Daytonite, BSN, RN · Oct 9, 2008

Diagnoses are based on the symptoms a patient has. Treatments (medications are a treatment) are aimed at those symptoms. Look up the medical reasons/conditions for why these drugs are prescribed. That will lead you back to the symptoms so you can find the right nursing diagnoses.

Albuterol, for example, is a bronchodilator used to treat bronchospasm. Bronchospasm causes airway obstruction that can lead to difficulty breathing and hypoxia. D5 1/2 NS is an IV Fluid. There is information on this chart (Table of Commonly Used IV Solutions.doc) on what it is used for. Maxipime is a brand name of cefepime, a 3rd generation cephalosporin used for respiratory track infections.

spongebob6286, BSN, RN · Oct 12, 2008

you can't use as a related factor of the pt's responses the medication use. because that would mean that it should be stopped and which can't be done. it was given to the pt to make him feel better.

Daytonite, BSN, RN · Oct 12, 2008

you can't use as a related factor of the pt's responses the medication use. because that would mean that it should be stopped and which can't be done. it was given to the pt to make him feel better.

That is incorrect. I don't know who told you this, but that information is wrong.

Related factors are the etiologies (cause) of a nursing problem. The following can be used as related factors with some diagnoses and I have used them as risk factors (etiologies) with Risk for Injury

drug idiosyncrasy
untoward effect

medicrn16 · Oct 13, 2008

The only thing I see that would be difficult to use is 'as evidenced by' since you are only given meds and not any objective/subjective info. A couple that come to mind are:

Impaired gas exchanged r/t altered delivery of inspired air...

Activity intolerance r/t imbalance of O2 supply and demand

Ineffective airway clearance r/t same...

D5 1/2 NS is a hypertonic solution, so maybe the pt has third spacing (HF?)...some of these symptoms would be the same as the airway stuff (crackles, UOP

I didn't really understand what spongebob was saying...excellent work Daytonite for translating!

OldShoesRock · Oct 16, 2008

Daytonite...

funny you said that "related to" was the etiology. I just got that question wrong on an exam. Over 80% of the class answered that "related to" was the same as etiology, but the teacher was not convinced, even after we gave her page numbers...etc.

I love nursing school! A new challenge every day! LOL.

medicrn16 · Oct 16, 2008

That is so odd what your teacher said!!! If r/t is not etiology, then what in the world is it r/t??? Did anyone ask your teacher that? I'd be interested to know what she said. You are right about that...new challenges every day!

OldShoesRock · Oct 22, 2008

She said the correct answer was " to individualize care for the patient"...ummm, isn't that what the whole care plan is? LOL. the really funny thing is...we took a "certain standardized test":clown: for fundamentals, and without violating any test policys...lets just say WE were right. However, it did not change her mind, or our grades!

We have learned to just take it with a grain of salt, and move on to the next task.

Daytonite, BSN, RN · Oct 22, 2008

this assignment requires a good deal of critical thinking. this is what i would do and how i would reason out this assignment.

you were assigned to do a case study where you have to come up with 3 nursing diagnosis related to these drugs

albuterol
atrovent
tylenol
maxipime
robitussin
d5 1/2 ns

this is obviously a puzzle. you have been given the medical drug treatment for a patient. it doesn't matter what their disease or condition is at this point because as a nurse, we determine what the patient's symptoms are in order to get to their nursing diagnoses. and just like the doctor treats their symptoms, so do we. hint, hint, hint!

those medications are treating symptoms.
we need symptoms to formulate nursing diagnoses (patient problems).
we can use those same symptoms in developing our care plan (a care plan is merely a determination of the patient's nursing problems)
once we know the symptoms we have to treat, we can develop the nursing interventions and goals.
symptoms, nursing diagnoses, nursing interventions and goals = a care plan.

so, i get to work looking up why each of these drugs is being given:

albuterol - given for bronchospasm and to reverse airway obstruction
atrovent (ipratropium) - a broncodilator
tylenol (acetaminophen) - given for mild pain and fever; has no anti-inflammatory properties
maxipime (cefepime) - a 3rd generation cephalosporin given for lower respiratory tract infections
robitussin (guaifenesin) - an expectorant given to increase lung mucus when there is productive or nonproductive coughing
d5 1/2 ns - iv fluid given for isotonic hydration and to provide some calories. seetable of commonly used iv solutions.doc

a picture starts to form in my mind. a medical diagnosis is missing, but this patient has some sort of respiratory infection, cough needs assistance with airway obstruction and probably has a fever. there's enough there to come up with these probable symptoms

bronchospasm
chest pain (from coughing)
cough
fever
probably a bit dehydrated

can those be translated into nursing diagnoses? you bet they can!

ineffective airway clearance r/t airway spasm and infection
hyperthermia r/t respiratory infection
acute pain r/t muscle stain [of coughing]

this is only a brief outline. this could be extended and carried out with much more specific detail. maybe you see something else i am missing. after all, i just woke up, am eating breakfast while i'm replying to this and one of my cats just started bugging me for something to eat, so i may not be thinking too clearly.

good luck with this assignment. what a brilliant way to get students to use and apply the nursing process.

medicrn16 · Oct 22, 2008

Daytonite,

This was great! However, I have one question. Since D5 1/2 NS is a hypertonic solution, then how is it used for isotonic hydration? Won't this solution pull fluid from the cells into the vascular space?

Daytonite, BSN, RN · Oct 22, 2008

i made an error. as i said, i was eating breakfast at the time i was composing my reply.

for the record. . .d51/2ns is used for hypertonic fluid replacement, to replace sodium and chloride, and some calories. sorry if that confused you. it shouldn't affect the diagnosing of the care plan.

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