Nursing Dx. for Right hip infection

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Can some ine please HELP. I am a first semester nursing student and I need help coming up with 4 nursing dx. on a patient.

Patient is an 83 y/o female, c/c is right hip pain with possible infection. She had surgery 3 wks ago and went to rehab, and since Sunday of last week she's been complaining of worsening pain in the right hip with serous drainage. She does have staples in Right hip.

Hx: diabetes, anemia, htn, constipation, kidney stones, myasthenia gravis, depression, CAD with stentand CABG, back surgery, lumbar surgery, and appendectomy.

Medications: aspirin 325mg, calcium carbonate 1000mg, docusate sodium 100mg, enoxaparin 40mg, glipizide 2.5mg, insulin, lisinopril 20mg, metformin 500mg, zofran 4mg, protonix 40mg, potassium 10mEq, mestinon 180mg, vancomycin 250ml, coumadin 2mg, clonidine 0.2mg, & narco 7.5/325.

Labs: H&H low, RBC low, BUN high, Na+ low, RDW high, eosinphil and basophil high, Osmo-Cal high

She ambulates very well, but fatigues easily and is very weak. She can't lift her right (without help) and always showed signs of pain (facial grimmace) and holding her right hip. Vitals were stable throughout the day Except for her B/P it was high. Constipation is no longer a problem b/c she had 4 BM the day I cared for her. Had MRI and it showed pressure on right L2 nerve, and fluid within the adjacent subQ tissues and intertrochanteric bursa.

The only thing I'm really having trouble with, is coming up with a Nsg.Dx. that I have not already used. These are the ones I have used this semester:

> Acute Pain

> Impaired Physical Mobility

> Activity Intolerance

> Disturbed Body Image

and I know 2 of these fit my patient but I am unable to use them again. I have looked at 3 other Dx. but I am not sure if they are right. They are:

> Impaired Skin Integrity r/t inflammatory process

> Knowledge Deficit r/t wound care

> fatigue r/t increased energy needs from muscular involvement

If someone could please help me, I will be very appreciative. In the meantime I will continue to look for Nsg.Dx. Thanks

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My first thoughts are infection, risk for bleeding, anxiety

~Simmy

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I was thinking Infection also, but since infection was in the Med.Dx. I wasn't sure if I could use it. Is there such a nsg.dx. as Acute blood loss anemia, b/c I was also thinking of something along the line of Anemia because of the lab values.

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What nursing dx book are you using?

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May I ask if you know why they have her on 3 blood thinners. Are they trying to get her to therapuetic coumadin level. I work in geriatrics and seeing how the elderly bruise easily, that just sent up a red flag for me.

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To Nurse Simmy, I have several nursing dx. books. I am also using my Med.Surg book and they don't have alot on postoperative anemia information. I was really leaning toward a nsg.dx. that had to do with anemia. What you think

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To Vmoh18, I really have no idea as to why they are giving her 3 different blood thinners but she didn't receive any coumadin while I was there. Since you work in geriatrics, does the nsg.dx. that I have written above sound like reasonable diagnosis according to the patients information.

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Those are reasonable diagnosis. You can use infection since it says possible infection in the medical diagnosis. She is also at risk for further infection because she is a diabetic since sugar feeds bacteria. She is also at risk for injury r/t her med use (BP meds and oral diabetic drugs) and from her surgery(mobility issues). These are just a few we would use on the unit I work at.

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Regarding the anemia you could use altered tissue perfusion r/t low RBC,H&H. although I don't know her vitals. There is evidence of this with the fatique's easily

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