Published Apr 6, 2009
2bnurseshanley
6 Posts
70 yr old male c/o right sided abd. pain vomiting diarrhea.admit. to ER dx. test and colonscopy found malignant mass laproscopic colectomy done. mas was encapsulated but aggressive, chemo planned
past medical hx ~ iddm and htn
current medsnovolin nph, red insulin on sliding scale, atovolol
i need 10 nursing diagnosis and 1 teaching plan
can anyone help?????!!!!!
BuckeyeRN07
18 Posts
This patient has a LOT going on, which makes it somewhat easier to develop his care plans. What nursing diagnoses are you considering at this point?
MoopleRN
240 Posts
Keep in mind his past medical hx but address his current admission. He has something planned? What does he need to know about that?
uvlclark
5 Posts
This is what i could come up with. You could teach about any of these. DM would be a good one, teach about how his blood sugars will be effected by surgery and the importance of tight control to promote healing. Good luck.:wink2:
1-pain
2-impaired mobility secondary to surgery, pain
3-altered gas exchange secondary to surgery, pain, pain medication
4-risk for DVT secondary to surgery, impaired mobility
5-altered nutrition secondary to NPO status
6-risk for delayed healing secondary to IDDM
7-ineffective coping due to diagnosis
so far i have things like
pain
dehydration electrolyte imbalance
ostomy care
ostomy physio/psychological
changes in body image
anticipattory grieving
and i know there so much more but im having trouble coming up with more
and i would like to say thanks for responding cause i didnt think i was going to get any help lol ( i just signed up)
Keepstanding, ASN, RN
1,600 Posts
sorry, can't do your homework for you. we all paid our "dues"...so must you !
praiser :heartbeat
Roy Fokker, BSN, RN
1 Article; 2,011 Posts
You could defnitiely try the teaching angle given his meds/recent health conditions.
Here's something that used to help me come up with clues for nursing diagnoses when I was in school:
* If you were a patient diagnosed with cancer with chemo planned - what would you ask your doctor/nurse?
* Don't disregard nutrition/dietary and physical/occupational therapy.
cheers,
You're definitely on the right track - good job!
You may want to put any ostomy related care plans aside for the moment. He's had a colectomy, but there's no mention of an ostomy at this point (unless you simply overlooked adding that bit of info to your original post). Regardless of whether he has an ostomy or not, his elimination patterns are going to be different. Aside from the obvious (altered elimination :wink2: ) what else goes along with having a portion of your bowel removed?
Considering his history of IDDM and the current problems he's facing with this admission, is there anything he might need to know in terms of continuing to successfully manage his diabetes?
thats a great way of thinking thanks for the help
We've all been in your shoes, and I know I've been blessed with many helping hands as I learned the ropes.
Anything we can do to help a future colleague out (without actually doing the work for you :wink2: ) is worth the effort!
morte, LPN, LVN
7,015 Posts
1)potential for impaired nutrition less than optimal....rt being post op and losing part of his digestive tract
2)potential for dehydration rt post op and age and loss of part of his digestive tract
3)pain rt post op
4)impaired mobility rt post op and possibly, age
5)self care deficit
6)knoweldge deficit rt to op procedure and results
...if there is indeed a colostomy involved....
7)alteration in body image
8) grieving for loss of former self
and perhaps when you get to actually meet him you will find others.....some things i could suggest may have no bearing for this patient, if he is long term HTN and IDDM and these have to be careplanned, but, i would think they would tend to be at the bottom of the list.....keep in mind that the elderly often dont tolerate surgery particularly well....
VICEDRN, BSN, RN
1,078 Posts
altered body image due to ostomy
nutrition: less than body requirements (for the cancer)
risk for falls (post surgical patients)
enhanced readiness to learn (teaching needs)