Care plan help please for cultural diagnosis

[TMM_RN]

I am a 1st semester nursing student and still struggling with construction of care plans. I am working on a big care plan that consists of cultural, psychosocial, spiritual, physical, and teaching/helping nanda diagnosis. Each diagnosis needs one short term goal and one long term goal. I need help with my cultural diagnosis and my goals for the pyschosocial diagnosis --Risk for loneliness r/t limited mobility aeb physical handicap and restricted to bed.

My patient is:

-74 year old Hispanic woman

-hx-diabetes, breast and cervical cancer, alzheimer's

-admitted for UTI and back pain

-stage 2 pressure sore on coccyx

-limited mobility due to reduction deformity secondary to resection of her femur and severe back pain as a result of vertebral compression fractures

-lives with daughter who is at work all day

-home health nurse visit mon-fri for 4hrs/day

-widowed 6 years ago

-misses home in El salvdor

I don't know what other info is needed but the help would be greatly appreciated.

[Daytonite, BSN, RN]

as far as i know, there are no specific cultural diagnoses. the nursing diagnoses are very generic. if you are to make a diagnosis "cultural" you need to do it through your assessment and nursing interventions that are customized to the patient's cultural practices.

regarding your psychosocial diagnosis: risk for loneliness r/t limited mobility aeb physical handicap and restricted to bed.

(1)

limited mobility

is not exactly how i would state the risk factor for this diagnosis.

limited mobility

sounds like a physical problem and there is

impaired physical mobility

to cover that, a very different diagnosis. this is a

psychosocial

diagnosis. what you really mean is that the patient is

physically isolated

from contact with other people meaning she can't physically get to other people in order to visit and socialize with them. this is happening because of her medical problems, right?.

(2)

risk for

diagnoses are potential problems that do not yet exist, therefore, there cannot be symptoms of their existence. so, this patient cannot have a

physical handicap

or be

restricted to bed

yet. these things will only happen when, and if, she does develop the problem of loneliness. also, again, if this is a psychosocial diagnosis, why are you listing physical symptoms? these are not symptoms of loneliness.

(3) did you look up or research loneliness? loneliness can be feeling excluded, unloved, alienated from others, having no one to share concerns or experiences or that the person is alone. symptoms of loneliness are low self-esteem, thinking that no one likes you, blaming others for having no contact with others, becoming withdrawn, frightened, anxious, depressed, sad, unhappy, avoidance of others, negativity, isolation, self-consciousness or anger. those are psychosocial symptoms and what makes this a psychosocial diagnosis.

(4) the goal of any

risk for

diagnosis is to prevent the problem, or symptoms of it, from occurring. your interventions will always be:

• strategies to prevent the problem from happening in the first place
  
  
• monitoring for the specific signs and symptoms of this problem
  
  
• reporting any symptoms that do occur to the doctor or other concerned professional
  
  

(5) you should write this diagnosis as:

risk for loneliness r/t social isolation

• st goal:
  within one week one telephone call or personal visit with an el salvadoran volunteer will be arranged for the patient.
  
  
• lt goal:
  patient will express no feelings of sadness, depression or anger about living away from her home in el salvador.
  
  

[TMM_RN]

Thanks alot!!!!! :yeah:After reading your reply that does make a lot of sense now. I am slowly learning how to think like a nurse and trying to put everything together. They don't teach you that ya know!!!

[Daytonite, BSN, RN]

I know. Because I'm not involved in the academic world I haven't seen any textbooks that actually lay this stuff out like that either. I keep looking.