Nursing Diagnosis, trouble with

[locklane]

I am really struggling with nursing diagnosis...can anyone help me fix these if they are incorrect?? thanks

activity intollerance related to limited mobility as evidence by tiredness when trying to aambulate and failure to complete the full amount of her physical training.

Denial related to threat of unpleasant realitiy as evidence by client's statetments of going to "get married" and wearing a false engagement ring.

Risk for disturbed body image related to immobility (ADL's).

Readiness to ambulate (walk)

[Daytonite, BSN, RN]

activity intollerance related to limited mobility as evidence by tiredness when trying to aambulate and failure to complete the full amount of her physical training.

• webpage with nanda information and interventions: activity intolerance
  
• "tiredness when trying to ambulate" implies the patient tries and fails and "failure to complete the full amount of her physical training" is vague. be more specific: "becomes tired and must sit down after ambulating ___ feet" and "only able to complete ___ minutes of physical therapy before tiring and having to stop and rest."
  
• if you look at the defining characteristics on the website above you will see heart rate and blood pressure response changes listed. if you have this kind of evidence, include that as well.

denial related to threat of unpleasant realitiy as evidence by client's statetments of going to "get married" and wearing a false engagement ring.

• proper name of this diagnosis is ineffective denial because the patient is using the denial so that it is leading to abnormal responses and/or physical health issues. the evidence to support this is bizarre and inappropriate behavior to the context of the situation and/or signs and symptoms of psychosomatic illness.
  
• this is anxiety manifested inappropriately and/or at inappropriate times.
  
• "statements of going to "get married" and wearing a false engagement ring" are certainly how the patient is in denial, but what are her signs and symptoms as a result of doing this? this is a behavioral diagnosis that focuses on a specific behavior that perpetuates the denial. does she act giddy as she talks about going to get married (not)? does she talk happily about her ring? focus the aeb items on her inappropriate behavior. does she wear herself out getting ready for the church and have to go to bed because she is so exhausted? does she tell you she has a stomach ache because she is so nervous about the wedding? that is how she is perpetuating the denial and it is turning into physical complaints.

risk for disturbed body image related to immobility (adl's).

• disturbed body image
  
• i'm trying to get a picture of how being immobile can cause somebody to have a problem with how they perceive their body. can you explain your thinking here because this sounds really bizarre to me. immobility is not a related factor for disturbed body image.
  
• this might be another one of her ineffective denials. her perception of her body is going to look like when she is immobile could be a manifestation of ineffective denial because it seems psychosomatic to me.

readiness to ambulate (walk)

• impaired physical mobility
  
• there is no such diagnosis. readiness to ambulate would mean the patient can't walk which makes them impaired physical mobility.
  
• the "readiness for enhanced. . ." diagnoses are wellness diagnoses and are only used for people who have no nursing problems and want to improve their health even more. that doesn't sound at all like this lady!
  

[locklane]

Thank you, this has helped a lot! I will continue to review your post, as it is very helpful (still working on it!) : )