Published Apr 23, 2018
kristen5500
1 Post
I have a 76 yr old female patient with shortness of breath, fainting spells, a resting pulse rate of 30 BPM, and a blood pressure of 125/82. I cannot figure out a diagnosis for this patient! Please give any advice or information on what the patient's pathology may be! Thank you! (this is just a simulation we are doing in class, there is no actual patient in danger!)
MilliePieRN
190 Posts
One of the vital signs is obviously far out of normal range. Which one?
AnnieNP, MSN, NP
540 Posts
What do you think would make someone faint?
nursej22, MSN, RN
4,449 Posts
Are you looking for a medical or nursing diagnosis?
student_B, ADN, RN
23 Posts
You should be able to find plenty of nursing diagnoses on this patient, think ABCs! Look through a NANDA or nursing diagnosis handbook and prioritize the most life-threatening/emergent bodily functions.
Also, escape rhythm r/t 3rd degree block? Trying to think of interventions beyond calling RR or code (also not sure which if pt is still A+O). I enjoy learning from other students questions:specs:
Esme12, ASN, BSN, RN
20,908 Posts
To help you the best I like to ask students what semester they are and is this a real patient? We also ask all students to tell us what they think first so we know how to best answer. We don't give answers. AN is interested in helping students be the best nurse they can be.
Care plans are all about the patient assessment. A care plan is the "recipe card" on the care of the patient so that everyone will know how to care for the patient. It is also used by schools to teach nursing students to think like a nurse.
So what was your assessment of this patient? What did their lungs sound like? What was the O2 sat? When did the symptoms begin? What made the symptoms better/worse? What meds was the patient on? Was this patient on the heart monitor? What was the patients medical history?
What about the vitals signs is significant on this patient?
Resting HEART RATE: 30 (THIRTY) beats per min. Was this the palpated pulse? Did you listen to the Apical pulse?
B/P: 125/82. Was this an auscultated B/P. Was an automatic B/P cuff used? Did you take orthostatic vital signs?
Tell me about your patient.
Neo Soldier, BSN, RN
416 Posts
With this info I can say
Decreased tissue perfusion
decreased cardiac output
activity intolerance
kaylee.
330 Posts
How much perfusion can be going on at hr of 30? Symptoms are related to decreased perfusion, and since they are having sx with the rate they are likely unstable. So your ndx will be about emergent concerns, not coping or education. Just in case you were going to go there. The emergent ones are the easier care plans because there are clear cut sx and steps to ensure pt safety and life! Hope i didnt give the whole thing away.
thatgirl2478
103 Posts
why is it that very few students actually follow up on their requests for help? granted, it's only been 2 days so maybe the OPs get busy... but I've noticed this as a general trend. :)
LilyRN99
151 Posts
Also, non emergent diagnosis could be risk for falls and risk for injury. There are also some respiratory NANDAs. If you have a medical diagnosis you can google something like heart failure NANDA. Personally, I like nurselabs.com for care plan help.
Wuzzie
5,222 Posts
Because someone will eventually come along and start giving them the answers (AEB this thread).