Nursing diagnosis for risk for developing c-diff?

[Blue Cat]

I am in my second semester of nursing school and doing a med-surg clinical now. For our first day of clinical, my instructor wanted us to come up with 2 nursing diagnoses and careplans. My patient was in for pneumonia so my priority nsg dx was ineffective breathing pattern. In discussing my assignment with my instructor, she questioned me about what my patient was at risk for b/c of the antibx he is being treated with. She was trying to get me to think about the risk for developing c-diff. So, now I am writing my 2nd nsg dx and trying to come up with what it would be for risk for c-diff. If he currently has an infection (pneumonia), can I still use the risk for infection dx? (or is that up to the instructor?) I already created a plan for: Risk for dysfunctional gastrointestinal motility r/t disruption in normal intestinal flora s/t antibiotic treatment for pneumonia, but am thinking that perhaps I am way off base on that. I would not have thought to focus on his risk for developing c-diff, but it was clearly a priority for my instructor, so that is why I am going that route.

Any input is greatly appreciated!

Blue

[AgentBeast, MSN, RN]

I would think impaired gas exchange would be a bigger issue for a pneumonia patient than breathing pattern. Also you need to look at the reason most people develop C Diff infections . . .

http://en.wikipedia.org/wiki/Clostridium_difficile

[Blue Cat]

Well, we had to make our dx based on reviewing the chart the night before meeting our patient and at that time, the patient had just been admitted with SOB. By the time I saw him the next day, his RR was normal. My instructor reviewed the careplan I created based on what we got from the chart and said to turn in what I had already done.

I understand why this patient could develop c diff, but cannot figure out how to build a nsg dx around it. I thought that nsg dx's were not usually supposed to be "risk for" dx's.

Blue

[AgentBeast, MSN, RN]

If nursing diagnosis aren't supposed to be "risk for" diagnosis you might want to let NANDA know.

[Blue Cat]

I meant that I thought nursing instructors usually don't want us to use a "risk for" dx and want us to focus on an actual dx that the patient already has. But I think part of critical thinking is to think ahead and assess what the patient is at risk for as well as their current dx's.

Thanks for the input : )

Blue

[ashleyisawesome, BSN, RN]

maybe just simply risk for infection r/t decrease in normal flora...

if you instructor is alluding to the fact that she wants a dx related to the possibility of c. diff, and the patient does not already have it, i would assume it would have to be a risk for dx...

[Blue Cat]

Just to update, I turned it in today and she was happy with the careplan. Thanks for the feedback. It's so hard to know if we are on the right track sometimes.

Blue

[SnMrsSmiley]

there is the actual dx that has three parts.... then there is the potential DX that has two parts.

i think that is what she wanted. We have to do our careplans like that anyway