please help with nursing diagnosis for sick sinus syndrome

[stephiebrowneyes]

Hi, I am a first semester nursing student and I am writing my first paper. I need help with nursing diagnosis. My pt is a 92 year old male who has been healthy his whole life. He came into the ER and was diagnosed with sick sinus syndrome and a couple months later he was admitted for surgery to have a pacemaker inserted. My focus is on the sick sinus syndrome not the pacemaker insertion. I dont have any experience with nursing diagnosis and I am having trouble finding ones that fit. Please help!

[Daytonite, BSN, RN]

Which diagnoses do you have that aren't fitting? Nursing diagnoses are based upon the symptoms that the patient has. What are the patient's symptoms? I have some experience with this since I have SSS myself and had a pacemaker insertion.

[stephiebrowneyes]

He was tired and lightheaded...his admitting diagnosis was premature beats.

[herring_RN, ASN, BSN]

Decreased cardiac output?

Oops "alteration in"

[Daytonite, BSN, RN]

when you are care planning you deal with the patient's response to the medical disease, not the medical disease itself. however, you do need to look up information about this sick sinus syndrome so you know what it is and what its pathophysiology is (you need that to formulate the etiology part of your nursing diagnostic statement). the online merck manual includes some pathophysiology of most diseases although if you have a textbook of pathophysiology you will probably get a more in depth explanation. follow the steps of the nursing process to develop a plan of care. . .

step 1 assessment - assessment consists of:

• a health history (review of systems) - 92 years old, healthy his whole life, admitted with premature beats
  
• performing a physical exam - tired and lightheaded
  
• assessing their adls (at minimum: bathing, dressing, mobility, eating, toileting, and grooming)
  
• reviewing the pathophysiology, signs and symptoms and complications of their medical condition - look up the pathophysiology and signs and symptoms of sick sinus syndrome
  
  • http://www.fpnotebook.com/cv/ekg/scksnssyndrm.htm
    
  • http://www.mayoclinic.com/health/sick-sinus-syndrome/ds00930
    

  [*]reviewing the signs, symptoms and side effects of the medications/treatments that have been ordered they are taking - what medication and treatments were ordered?

step #2 determination of the patient's problem(s)/nursing diagnosis part 1 - make a list of the abnormal assessment data

• tired
  
• lightheaded
  

step #2 determination of the patient's problem(s)/nursing diagnosis part 2 - match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use

• decreased cardiac output r/t impaired electrical conduction aeb fatigue and lightheadedness
  

step #3 planning (write measurable goals/outcomes and nursing interventions)