Help with post-op CABG nursing diagnosis

  1. I need some help with my diagnosis for a patient who has undergone his fourth cabg, has had four previous mi's, and is now on his third post-op day and still on the vent. he is being kept sedated with diprivan because of agitation and pulling tubes and i am having to up his dosage because of his tolerance level. he currently is on 50mcg/hr. vent settings are on simv and fio2 is at 50. the main reason for the vent at this time is post-op hypoxemia. he is also diabetic and has an insulin drip. htn is also a problem and i am titrating cardene for that. please help!!! i need 15 diagnoses!!
  2. Visit mandyc8047 profile page

    About mandyc8047

    Joined: Mar '11; Posts: 4; Likes: 2
    RN; from US
    Specialty: LTAC


  3. by   Hygiene Queen
    Try this:
    Find a list of nursing diagnoses.
    Start at the top and ask yourself: does this apply and can it possibly apply.
    If you are unsure, investigate that diagnosis more closely.
    There really aren't that many to go through and it goes quicker than you think.
    You may be surprised at the ones that would apply that you might not have thought of without looking at a list.
    This method worked for me.
    Good luck!
  4. by   ImThatGuy
    15?! What doof assigned that? Let's see what I can ramble on with...

    Risk for decreased cardiac output (it's the heart afterall lol)
    Pain (that **** hurts)
    Ineffective breathing pattern (cause it hurts)
    Impaired spontaneous ventilation (cause it hurts)
    Risk for infection (don't want any endocarditis)
    Risk for injury. (kinda easy to split that wound back open)
    Knowledge deficit (what lay person really knows that much about CABG)
    Disturbed body image (that scar ain't cute)
    Situational low self-esteem maybe (heart surgery humbles people)
    Acute confusion (probably delirious)
    Imbalanced nutrition less than body requirements perhaps (often they get to eat whatever they want just so they'll eat - maybe not - look into it)
    Risk for deficient or imbalanced fluid volume
    Ineffective coping perhaps (like I said some of them just seem detached and depressed for a while)
    Impaired role performance (takes a while to recover)
    Interrupted family processes (see previous)

    That 15?
  5. by   solneeshka
    CABG is supposed to be a palliative treatment (technically). This guy's had 4 of them?! Sounds like what he needs is hospice care...