oh yes, another nursing diagnosis question

[Leaky1021]

Hi everyone, I'm hoping someone can help me out with this...

My patient is a 66-year old male admitted with abdominal pain, nausea, vomiting, and diarrhea x3days. He has a history of end stage COPD. Barium enema was positive for diagnosis of diverticulitis and his WBC count (20.01) indicates he has an infection brewing in there. After 3 days of antibiotic therapy, his white count is back to a more normal 6.62 and his symptoms have stabilized.

The patient needs to have a bowel resection for prevent future flare ups and possible bowel perforation, however his pulmonologist has advised that with his COPD history, he may likely not survive anesthesia or be unable to come off the ventilator post-op.

I am charged with coming up with 1 NANDA prioritized nursing diagnosis with 4 interventions and 2 collaborative diagnoses.

So far I've come up with:

Priority: Risk for infection related to compromised bowel circulation secondary to chronic diverticular disease

Interventions:

- Educate patient on signs and symptoms of infection related to diverticulitis

- Instruct patient to take entire course of prescribed antibiotics

- Encourage increased fluid intake of 2000-3000 mL per day

- Instruct patient to eat a high fiber, low fat/low residue diet

I'm not 100% certain what exactly a collaborative nursing diagnosis is, but I came up with:

- Impaired elimination

- acute pain

Any guidance or feedback would be greatly appreciated! Thank you

[Daytonite, BSN, RN]

So, in other words, he has to live with the diverticulitis and everyone keeps their fingers crossed that he never gets a bowel obstruction, right? This diagnosis of diverticulitis is new, isn't it? Then, your diagnosis, rather than being Risk for infection, should be Deficient Knowledge, Diverticular Disease R/T lack of information AEB [statements by patient that he knows nothing about this condition and/or wants to know more]. You include interventions to teach him about the types of foods he needs to avoid, signs and symptoms of a flair up of diverticulitis, signs and symptoms of a bowel obstruction and when to get to the ER for help.

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A collaborative nursing diagnosis would be a complication of the disease (such as infection or bowel obstruction) that would occur and requires the collaborative help of other healthcare personnel in order to treat. The nursing diagnoses would be Risk for Infection, Acute Pain.

[Leaky1021]

Daytonite,

Thank you so much! You are such an amazing help!

[Natingale, EdD, RN]

daytonite is so quick lol - i was going to add if you read the whole diagnosis backward it should make sense so something like acute pain related to inflammation of the diverticula secondary to diverticulitis...read it backwards, you get diverticulitis which is inflammation of the diverticula --leading to pain.

or ineffective airway clearance related to copious secretions secondary to TB or pneumonia. see how if you read it backwards you get an ah ha moment

[Leaky1021]

Natingale,

Thanks! I never thought of it that way...it certainly makes writing diagnoses much easier!