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Discussion

nursing diagnosis

hi, while doing a nursing care plan on a patient with CML, one of the nursing diagnosis that we were looking on is: ineffective breathing pattern related to decreased energy or fatigue as manifested by shortness of breath. I was not pleased with the related to factor, however, when i checked my nursing nanda list it was there as a related to factor but knowing the pathophysiology of o CML, i still cannot buy the related to factor. Please i need some help.:nono:

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You can't buy that fatigue can lead to ineffective respirations? Take a close look at someone in respiratory distress......TRUE distress, like an asthmatic or a CHF-er......in the ER or ICU. These pts can get so worn out that it's more work to breathe than they have the energy for.

  • Author

Hi TazziRN, thanks for replying, but i am not understanding what u are trying to say

  • Author

Isn't fatigue a symptom and not a related to factor when looking at actual problem in a nurnsig diagnosis

Merged for continuity

Isn't fatigue a symptom and not a related to factor when looking at actual problem in a nurnsig diagnosis

many r/t factors, are still symptoms.

ineffective breathing pattern r/t fatigue, is perfectly appropriate...

whether the fatigue is the result of anemia, pain, immobility, doesn't matter.

you're only addressing the complications from the cml.

leslie

  • Author

i am more convince now. Thanks very much.

Moved to nursing assistance forum for more support

  • Expert

Extreme fatigue is a symptom of chronic myelocytic leukemia. With CML I think I would use the nursing diagnosis of Fatigue related to disease in the blood forming cells of the bone marrow as manifested by lethargy and tiredness.

Shortness of breath is more likely a result of tissue hypoxia related to anemia. Rather than Ineffective Breathing Pattern I think I would consider using Ineffective Tissue Perfusion, cardiopulmonary related to decreased hemoglobin concentration in the blood as evidenced by shortness of breath if there is evidence of anemia. Do you have evidence of the patient being anemic (low in RBCs)? If not, then my question would be what else could be causing the shortness of breath? Another reason might be Activity Intolerance or some pathology going on in the lung, such as an atelectasis or pneumonia.

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