Nursing diagnosis

KrCmommy522, BSN, RN · Nov 15, 2017

Why does it have to be an elimination diagnosis? If you give your thoughts on where you are at with potential diagnosees and your thought process, there are lots of wonderful people here at All Nurses that are always willing to help - you just have to show your work. They don't want to do your work for you! But, now that I see your screen name and the post, I think I already posted an answer to this question in the nursing student's assistance forum.

alexischill · Nov 15, 2017

I did give my thoughts and process. There was nothing wrong with the patients elimination before or after the surgery. I do still, however need a diagnosis for their elimination. I didn't ask for anyone to do the work for me. I stated that any help would be great. Thanks

KrCmommy522, BSN, RN · Nov 20, 2017

I'm sorry. You misunderstood me. I wasn't saying that you specifically were asking for people to do the work for you. Just that sometimes people get on here and post a question and just want people to figure out everything.

In this post, the only information you gave was a patient who had acute appendicits who had an appendectomy and that the patient had no elimination problems before or after surgery.

Why does it have to be an elimination diagnosis?

Esme12, a senior moderator on this site, gives a great speech quite often whenever a student asks about a nursing diagnosis (I got it myself when I first became a member here and asked for help with a nursing diagnosis). Esme12 makes a lot of good points. You can do a search for nursing diagnosis help, and I'm sure you will find what she tells people in most of the posts. But here are a few things Esme12 states:

Let the patient/patient assessment drive your diagnosis. Do not try to fit the patient to the diagnosis you found first. You need to know the pathophysiology of your disease process. You need to assess your patient, collect data then find a diagnosis. Let the patient data drive the diagnosis.

Don't focus your efforts on the nursing diagnoses when you should be focusing on the assessment and the patients abnormal data that you collected. These will become their symptoms, or what NANDA calls defining characteristics. From a very wise an contributor daytonite.......make sure you follow these steps first and in order and let the patient drive your diagnosis not try to fit the patient to the diagnosis you found first.

What I mean by your thought process is....what do you have so far? What diagnoses are you thinking? Why are you thinking those diagnoses (what occurred with or what did you see with your patient that is making you think those diagoses?)

What I mean by more information is what all came from the assessment of your patient? - was the surgery open or laparoscopic? When was the patient's last BM? What did the BM look like? (small, large, brown, solid, watery, etc.) How many BM has the pt has since surgery? Are bowel sounds active, hypoactive, or hyperactive? Are they present in all 4 quadrants? Is the patient on pain meds? If so, what kind and how often?

From these questions, you might get that I am thinking of constipation or a risk for constipation as a diagnosis for your patient. Why would your patient have constipation or be at risk for constipation? What causes constipation?

I saw that you posted another nursing diagnoses question for a patient with acute appendicitis who had an appendectomy. I responded to that question and this one before I realized they were both from the same person. In the other post you are asking about a "risk of injury r/t invasive procedure" diagnosis and what to put for as evidenced by. ...So, do you need an elimination diagnoses as well or any diagnosis for your patient?

The more information you give, the more help I can provide. It's hard to help you with a nursing diagnosis without any assessment of your patient other than the fact that you need an elimination diagnosis, that your patient had acute appendicitis, had an appendectomy, and your patient had no elimination problems before or after surgery. That's not much information to go on to come up with a nursing diagnosis.

alexischill · Nov 20, 2017

Well, that is all of the information I got and that is what I stated. If that is not enough to help me, then that's all that needed to be said.

I'm sorry. You misunderstood me. I wasn't saying that you specifically were asking for people to do the work for you. Just that sometimes people get on here and post a question and just want people to figure out everything.
In this post, the only information you gave was a patient who had acute appendicits who had an appendectomy and that the patient had no elimination problems before or after surgery.
Why does it have to be an elimination diagnosis?
Esme12, a senior moderator on this site, gives a great speech quite often whenever a student asks about a nursing diagnosis (I got it myself when I first became a member here and asked for help with a nursing diagnosis). Esme12 makes a lot of good points. You can do a search for nursing diagnosis help, and I'm sure you will find what she tells people in most of the posts. But here are a few things Esme12 states:
What I mean by your thought process is....what do you have so far? What diagnoses are you thinking? Why are you thinking those diagnoses (what occurred with or what did you see with your patient that is making you think those diagoses?)
What I mean by more information is what all came from the assessment of your patient? - was the surgery open or laparoscopic? When was the patient's last BM? What did the BM look like? (small, large, brown, solid, watery, etc.) How many BM has the pt has since surgery? Are bowel sounds active, hypoactive, or hyperactive? Are they present in all 4 quadrants? Is the patient on pain meds? If so, what kind and how often?
From these questions, you might get that I am thinking of constipation or a risk for constipation as a diagnosis for your patient. Why would your patient have constipation or be at risk for constipation? What causes constipation?
I saw that you posted another nursing diagnoses question for a patient with acute appendicitis who had an appendectomy. I responded to that question and this one before I realized they were both from the same person. In the other post you are asking about a "risk of injury r/t invasive procedure" diagnosis and what to put for as evidenced by. ...So, do you need an elimination diagnoses as well or any diagnosis for your patient?
The more information you give, the more help I can provide. It's hard to help you with a nursing diagnosis without any assessment of your patient other than the fact that you need an elimination diagnosis, that your patient had acute appendicitis, had an appendectomy, and your patient had no elimination problems before or after surgery. That's not much information to go on to come up with a nursing diagnosis.

KrCmommy522, BSN, RN · Nov 21, 2017

Well, that is all of the information I got and that is what I stated. If that is not enough to help me, then that's all that needed to be said.

Wow. I have tried to help you. I have been nothing but nice so there is no need to be rude to me. I just said if you had more information I could help more.

The more information you give, the more help I can provide.

I also provided you with information for your elimination diagnosis to help you

was the surgery open or laparoscopic? When was the patient's last BM? What did the BM look like? (small, large, brown, solid, watery, etc.) How many BM has the pt has since surgery? Are bowel sounds active, hypoactive, or hyperactive? Are they present in all 4 quadrants? Is the patient on pain meds? If so, what kind and how often?
From these questions, you might get that I am thinking of constipation or a risk for constipation as a diagnosis for your patient. Why would your patient have constipation or be at risk for constipation? What causes constipation?

Well, that is all of the information I got and that is what I stated.

I just was asking for more information so I could help you come up with a good diagnosis that would fit your patient and as evidenced by to go with the diagnosis. How am I supposed to know that the only information you were given was that the patient had acute appendicitis, had surgery to have it removed, and had no elimination problems before or after surgery? I couldn't know that because you DID NOT state that, you said this:

I had a patient with acute appendicitis and they had surgery to have it removed. I need to come up with a nursing diagnosis for elimination for the patient and I'm a bit lost. The patient had nothing wrong with their elimination before and after surgery so what would be a diagnosis I could potentially put? Any help would be great

You said YOU had a patient, so I figured you would have done a head-to-toe assessment on that patient and read their chart. Even in my first semester of nursing school I had to do head-to-toe assessments on my patient and read my pts chart. If this is just information your instructor gave you and asked you to come up with an elimination diagnosis that is a different story. But you DID NOT state that what you gave was the only information you had.

I took time out of my day to try and help you. I gave you a suggestion for an elimination diagnosis and possible causes for that diagnosis. I also tried to help you with advice on coming up with nursing diagnoses. It is your choice to take it or leave it. But you come on here asking for help, I offer help and have been nothing but nice, and you've been nothing but rude.

Toadette, MSN, RN · Nov 21, 2017

I did give my thoughts and process. There was nothing wrong with the patients elimination before or after the surgery. I do still, however need a diagnosis for their elimination. I didn't ask for anyone to do the work for me. I stated that any help would be great. Thanks

I think that KrCMommy gave good direction for the question you posed. I will just add that if your assignment is to specifically give an elimination diagnosis that you should look at the appendectomy procedure, recovery, and common medications (including their side effects) that are given after this procedure. Do any of these factors lead you to a nursing diagnosis for elimination?

Good luck with your assignment.

alexischill · Dec 11, 2017

I do not understand why you are writing a book here. I wasn't being rude at all. I'm not sure how saying "Well, that is all of the information I got and that is what I stated. If that is not enough to help me, then that's all that needed to be said" is being rude. I gave all of the information that I knew right from the beginning. YOU, would know that because that is what I stated from the very beginning. Obviously if I had more information, I would have provided it so it would be easier for everyone to understand. You assuming that I want people to do the work for me from the getgo when I simply asked a question is rude quite frankly. If you think that ive been nothing but rude then that sounds like a personal problem. I never asked for you to help me personally. So now you don't have to "help" me anymore. Thanks :)

chare · Dec 11, 2017

I do not understand why you are writing a book here...

It should be noted that she did not ask these questions to demonstrate how smart that she is, or to put you on the spot. Rather, and this should always be remembered; your patient, and her or his assessment findings guide your plan of care and nursing diagnosis. Without these assessment findings you can not develop nursing diagnoses.

...I wasn't being rude at all. I'm not sure how saying "Well, that is all of the information I got and that is what I stated. If that is not enough to help me, then that's all that needed to be said" is being rude...

While that might not have been your intent, your post most assuredly came across as rude.

...I gave all of the information that I knew right from the beginning. YOU, would know that because that is what I stated from the very beginning. Obviously if I had more information, I would have provided it so it would be easier for everyone to understand...

If you spent any part of a shift with this patient, you should have been able to answer most, if not all of the questions that KrCmommy522 asked you.

...You assuming that I want people to do the work for me from the getgo when I simply asked a question is rude quite frankly...

Actually, it isn't, and I'm fairly certain that this wasn't intended to be rude.

However, you would be amazed at the number of posters that come here, post a question without any indication of having made any attempt of their own, don't participate in the thread when asked what they have done so far, and when someone does post the answer never thank them for having done so.

...If you think that ive been nothing but rude then that sounds like a personal problem. I never asked for you to help me personally. So now you don't have to "help" me anymore. Thanks :)

Based upon this response, I doubt she will. And, it is likely that few others will either if they have seen this post.

Best wishes to you as you continue through school.

alexischill · Dec 11, 2017

I understand that many people may seek for others to give them answers on here, but to assume that I would do that or anyone else is rude especially when I said "any help would be great". I didn't ask for any sort of answers from anyone. I thought she was rude from the beginning. No one should be assuming anything about anyone's intentions. We are all different people. If I am being rude by asking a question and being honest then I guess I'm rude. If she does not want to help me, great! If no one else wants to help either, that's great too! That's the beauty of this. No one is forcing you to answer. If you or anyone else feels I am being rude, then help the next person. It's that simple :)

KrCmommy522, BSN, RN · Dec 13, 2017

It should be noted that she did not ask these questions to demonstrate how smart that she is, or to put you on the spot. Rather, and this should always be remembered; your patient, and her or his assessment findings guide your plan of care and nursing diagnosis. Without these assessment findings you can not develop nursing diagnoses.
While that might not have been your intent, your post most assuredly came across as rude.
If you spent any part of a shift with this patient, you should have been able to answer most, if not all of the questions that KrCmommy522 asked you.
Actually, it isn't, and I'm fairly certain that this wasn't intended to be rude.
However, you would be amazed at the number of posters that come here, post a question without any indication of having made any attempt of their own, don't participate in the thread when asked what they have done so far, and when someone does post the answer never thank them for having done so.
Based upon this response, I doubt she will. And, it is likely that few others will either if they have seen this post.
Best wishes to you as you continue through school.

Thank you very much! I appreciate everything you said!

KrCmommy522, BSN, RN · Dec 13, 2017

I understand that many people may seek for others to give them answers on here, but to assume that I would do that or anyone else is rude especially when I said "any help would be great". I didn't ask for any sort of answers from anyone. I thought she was rude from the beginning. No one should be assuming anything about anyone's intentions. We are all different people. If I am being rude by asking a question and being honest then I guess I'm rude. If she does not want to help me, great! If no one else wants to help either, that's great too! That's the beauty of this. No one is forcing you to answer. If you or anyone else feels I am being rude, then help the next person. It's that simple :)

Here's another book! Haha!! :roflmao: I just feel like there was misunderstanding from the start! :banghead:

The reason I felt it was rude for you to say "Well, that is all of the information I got and that is what I stated. If that is not enough to help me, then that's all that needed to be said," was because you hadn't stated that was all the information you had been given. Only that you had shown your thought process and that there were no elimination problems before or after surgery. So, to say that is all the information you go and that you had stated that was kind of rude. Then, to say "if that is not enough to help me, then that's all that needed to be said" was rude because I was trying to help. Where in my posts did it imply that I wasn't? I took the time to provide you with information that I felt was very helpful for coming up with nursing diagnoses from Esme12. I then shared with you my thought process that led to a possible elimination diagnosis you could use (which is exactly what you needed). How was that not helping?

I also apologized for the misunderstanding in what I had said.

I was not trying to be rude at all. In my initial post, I was simply trying to get more information on where your thought process was and what exactly you needed so I could help you the best way possible. I added in the part about showing your work and that the people at AllNurses don't want to do work for others because, unfortunately, it seems to happen too often. I ended my post there because I realized I had already posted something for your question on another thread. So, I was hoping that would be enough to help or at least to find out it wasn't so I could see exactly what you needed and hopefully be able to help you. I didn't mean at all to imply that wanted other people to do your work for you, which is why in my second post I apologized because I felt what I said was misunderstood. I immediately started off my second post apologizing because I did not mean to imply YOU were the one wanting people to do your work for you. As I thought I had explained.Your post said you still needed an elimination diagnosis.

So, I then went on in that second post to use Esme12's explanation of coming up with a nursing diagnosis. I thought it might help you. I added that it wasn't a lot of information to go on because your initial posting did not state that you were only given the information and had not actually assessed the patient (I don't know if your instructor gave you some kind of case study and wanted a diagnosis or what). I just assumed you had cared for and assessed the pt, which I should not have just assumed. I did, however, give a possibility for an elimination diagnosis - constipation or risk for constipation - and I stated the reasons why (using the questions that led me there, which was just me trying to show the thought process that would lead you to such a diagnosis).

Your third post then stated that was all the information you had and that you had stated that, but you hadn't. When I said the thing about providing your thought process, you replied by saying that you had given your thought process and that there was nothing wrong with the pts elimination before or after surgery. Only then did I realize that you had been given the information and apparently did not care for and assess the patient yourself. If you would have stated that in the beginning I would have not asked questions about the assessment.

In the end, I was never trying to be rude. Nor was I ever trying to imply that you wanted others to do your work for you. I only meant to imply that it unfortunately happens on here sometimes, and the fact that the more information people have the better they are able to help. When I realized that is what I implied, I apologized.

I'm sorry you felt I was being rude. I was only trying to help and give you some information I thought was helpful regarding coming up with nursing diagnoses from Esme12 as well.