HELP! My first concept map!

Nursing Students Student Assist

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Ok I am a first semester nursing student and I have my first concept map due tomorrow. The scenario is....

A 55 yr old man came into the ER with syncope episodes and weakness. Patient lives at home alone. Patient had difficulty voiding in the last few days. After assessment the physician consulted urology.

The patient has a medical background of HTN, BPH, chronic constipation, and DM.

Patient is alert and oriented, breathing regular unflavored on room air, king sounds crackles throughout all loves. Normal sinus rhythm on monitor, pulses palpable, last BM yesterday, patient stated did not urinate but once yesterday and it was dark in color. Patient is unsteady.

Labs in admission BUN 21, Cr 1.6, Na 135, K 3.8, Cl 100, Ca 8.5, Hct 28, Hgb 8

VS: HR 100, BP 135/60, RR 18, Temp 98.7, POx 93% on room air

Urology has completed a TURP. Patient urinary output at 1000 was 100mL with scant blood clots

Meds: Flomax 0.4 mg daily, Lactulose 15mL daily, Lisinipril 40 mg daily, Metformin 500 mg

My problem is the nursing diagnosis. I have came up with one, impaired urinary elimination, but can't find another. The diagnosis for my concept map is syncope/weakness. I really want to say one diagnosis is risk for injury but my teacher doesn't lol "risk for..." diagnosis so I can't use those. Someone please help me! Thanks in advance!

Oh my....my phone wrongly auto corrected me....it is supposed to say "Patient is breathing regular UNLABORED on room air, LUNG sounds crackles throughout all LOBES" sorry about that...

LUNG sounds crackles throughout all LOBES

What could be causing that?

Possible fluid in the lungs. Maybe pneumonia...

Specializes in Nephrology Home Therapies, Wound Care, Foot Care..
Possible fluid in the lungs. Maybe pneumonia...

And what NURSING diagnosis would match up with that?

Specializes in retired LTC.

Not only pneumonia, but what else can cause lung fluid backup?

Oh, this guy is so ripe full of nsg diagnoses!

One clue - think nephrology before urology.

Specializes in Public Health, TB.

What is his glucose? Hx dm, taking metformin...

Fluid balance? Has he been NPO?

Did he have a spinal for the TURP?

Pain?

Pulse ox is not the only determinate for adequate tissue perfusion, hint, hint

Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Moved to Nursing Student Assistance. Keep at it! :)

Just a thought, the Lisinipril may be contributing factor as well.

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