Nursing Diagnosis/Care Plan Help

[cjcsoon2bnp, MSN, RN, NP]

Hey everyone. I have been trying to figure this out for hours now and after consulting with my nursing professor and running through care plan books I am pretty much at the same place I started at and I'm at wits end. Basically here is my situation...

My assignment is to come up with one nursing diagnosis and appropriate care plan for this particular patient. What makes this assignment particularly tricky is that we needed to find a nursing based research article that has nursing interventions that we can incorporate into the care plan. After hours of searching through the database that we are told to use I have finally found an article that does not exclude my patient (based upon age, gender, race etc.) and it does have an intervention that I could use for my patient. My problem is that I am having trouble writing the nursing diagnosis and deciding what to include in the care plan. Here is some basic info. about the patient.

Patient came to the hospital for elective surgery and was expected to be discharged same day. Experienced a few post-op complications, based upon the patient's extensive medical history the patient was hospitalized for observation and stabilization. Among other issues including Cardiac and GI conditions the patient also has Cancer but based upon the other conditions it's being observed but not being aggressively treated at this time. During my conversation with the patient I found that the patient is aware of and accepting the plan of care and was actively seeking information on how to avoid future unplanned hospitalizations.

I found an article that fit my parameters of the assignment, the article is about the risk of unplanned hospital readmission of patients with cancer and from the article I can find one thing that I believe is an intervention "the nurse can provide patient education about self care activities and make sure resources such as medication are available and used". So my issue comes when I am trying to turn all of this into a nursing diagnosis and care plan. I thought that I could use the "Health-Seeking Behaviors" diagnosis. Perhaps something like...

"Health-Seeking Behaviors R/T preventing unplanned hospitalization AEB expressed concern about current health status and desire to prevent future threats to health status."

I have a care plan book that has a lot of recommended interventions for this nursing diagnosis and while some apply to my patient some do not. I am relatively inexperienced with making care plans so I am trying to figure out if I can pick and choose from the book which interventions to use and customize them for my patient. So basically what I'm trying to figure out is if this sounds like I'm even going in the right direction with this and what people think of it. This is so overwhelming and somehow I think that I'm not even close on this one. Thanks ahead of time!

!Chris

[Fig77]

cjcsoon2brn said:

"Health-Seeking Behaviors R/T preventing unplanned hospitalization AEB expressed concern about current health status and desire to prevent future threats to health status."

I like your three part statement, but I was thinking the problem statement Health Seeking Behavior applies to patients who are in a stable health condition actively seeking ways to alter personal health habits and the environment to move toward optimal health. But I see your client is not in stable health - surgery, cardiac, cancer and gi. How can the patien achieve self actualization needs of optimal wellness, recovery and rehabilitation without first addressing these extreme physiological problems he is going through. My 2 cents... I m a student nurse too, so take my advice as used in a salt and grain analogy.

Quote

Maslow (1954), believed that man has a natural drive to healthiness, or self actualization. He believed that man has basic, (biological and psychological) needs that have to be fulfilled in order to be free enough to feel the desire for the higher levels of realization. He also believed that the organism has the natural, unconscious and innate capacity to seek its needs. (Maslow 1968)

[cjcsoon2bnp, MSN, RN, NP]

Hmmm interesting... Well is there any other nursing diagnosis that you could see working with that article? I saw "knowledge deficit" but we can't use that because we have another project that uses that diagnosis. I'm really stuck everyone, I have been searching through the database of available work for two days straight and this is the only article that fit the parameters of the assignment and that could apply to my patient so I have to make this work somehow. Any ideas?

!Chris

[Fig77]

I think there are lots of nursing dx you can make out of surgery, cancer, gi and cardiac. If you have any more information about any of these deficits your patient is going thru maybe someone or I could figure some out. Otherwise, I will try to think with this limited info.

[cjcsoon2bnp, MSN, RN, NP]

Fig77 said:

I think there are lots of nursing dx you can make out of surgery, cancer, gi and cardiac. If you have any more information about any of these deficits your patient is going thru maybe someone or I could figure some out. Otherwise, I will try to think with this limited info.

I'm sorry I didn't provide enough information about the project. I have come up with other nursing diagnoses for this patient but I need to have an article that I can get interventions for to put into the care plan and if the patients demographics aren't represented in the article or the article doesn't fall in the parameters of the assignment then I can't use it and that's where the problem is so that's why I am trying to use this article and come up with an appropriate diagnosis to use.

!Chris

[Fig77]

I see. I don't have a care plan book, but I can see the problem statemet could be something similar to educating or providing resources and guidance since it is evident that patient wants to get better or taken well care of. I m sure there should be couple of them in the NANDA.

[Daytonite, BSN, RN]

"Health-seeking behaviors r/t preventing unplanned hospitalization aeb expressed concern about current health status and desire to prevent future threats to health status."

First of all, you are not using the diagnosis correctly. The health seeking behavior needs to be specified in the title, so "Preventing unplanned hospitalization" really needs to be a part of your diagnostic title: health seeking behavior: preventing unplanned hospitalization. Since this can be used as one of the wellness diagnoses the related factor (cause of this nursing problem) is quite simply their motivation behind all this. Why are they so hung up about "Unplanned hospitalizations". Is there a financial problem? Social problem? Health insurance problem? Fear of being in the hospital? Fear of metastasis? What is really at the root of this? Hearing the diagnosis of cancer usually scares people to death and they begin thinking about their mortality. Hospitals still are thought of as places where people go to die and people are afraid of them.

Insofar as your supporting data is concerned, what does "Concern about current health status" mean? It needs to be specified as does "Desire to prevent future threats to health status". Did you talk with the patient? What concerns and threats did the patient talk about? I have colon cancer that we have recently discovered has metastasized. I can tell you exactly what my concerns are and what threats I am afraid of. I think about them all the time and am more than glad to discuss them with anyone who has the time to listen. I can't say the same about your patient, but did you ask?