Pediatric Nanda Diagnoses

Posted
by Bacoobs Bacoobs (New) New

I am in my 3rd year of nursing and currently on a pediatric acute care cardiology unit where most of the patients suffer from congenital heart diseases. I am to complete a care plan but I'm having a little trouble with developing diagnoses for peds patients.

I have one: At risk for post operative pain related to Norwood-Sano procedure (or open heart surgery..not sure which one to use) as evidenced by a pain score of 7 out of 10 using the FLACC Behavioural Pain Scale.

I guess I am just not sure how to write a diagnosis specific for peds patients. Any suggestions? Thanks so much for your help!:)

smartin13

smartin13

Has 5 years experience. 152 Posts

During my peds rotation and a pediatric burn hospital we used regular NANDA diagnosis, they aren't specific related to client age.

The diagnosis you have should not be a risk for if your client has actual pain, it should be acute pain. Some others that come to mind anything that has to do with the cardiac condition your client has such as decreased cardiac output, or something about growth and developement such as delayed growth and development or risk for delayed growth and development. Hope this helps

Bacoobs

Bacoobs

2 Posts

Yes that does help me. Thank you so much. So instead of at risk for pain it should just read acute pain related to etc..

Also, I do recognize that peds patients are at risk for delayed growth and development and also I was thinking of decreased cardiac output but then I am unsure of what to relate it to and evidence it by...because my patient is 3 weeks old. And then I am unsure how to develop some goals and how I will achieve them. I only need 2 so I am just looking for one more.

Would another one be Delayed growth and development related to impaired mobility as evidenced by ...? This is where I get stuck. How are we able to tell a 3 week old had delayed growth and development when only in the hospital for a few weeks and going home with no complications?

Am I just confusing myself?

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience. 4 Articles; 14,603 Posts

the nanda diagnoses with a few exceptions are to be used universally for all patients. there are a handful specific to maternity (breastfeeding) and growth and development and that it is.

what i can tell from your questions is that you do not understand the nature of a nursing diagnosis. first of all, it is merely a name--a label. we are really referring to nursing problems. nursing problems are derived from the patient's response to the disease or condition they are experiencing and in identifying that problem we use a name called a nursing diagnosis to shorten the identification and definition of the problem to make it easier for us to refer to. however, what we end up doing is developing nursing strategies (nursing interventions) to do something about these problems. nanda has spent a great deal of time and energy over the years to help make the identification of nursing problems easier for us by putting all the information concisely into a taxonomy. it is unfortunate that many times nurses do not know about this taxonomy or they weren't paying attention in class when it was lectured on. every nursing diagnosis has a definition, related factors (the r/t part for the nursing diagnostic statement) and defining characteristics (the aeb part for the nursing diagnostic statement, or signs and symptoms) in the taxonomy. this taxonomy must be purchased from nanda or can be found in many current care plan books, in the appendix of current editions of taber's cyclopedic medical dictionary, and for 80 of the most commonly used diagnoses on these 2 websites:

the construction of the 3-part diagnostic statement follows this format:

p (problem) - e (etiology) - s (symptoms)

  • problem - this is the nursing diagnosis. a nursing diagnosis is actually a label. to be clear as to what the diagnosis means, read its definition in a nursing diagnosis reference or a care plan book that contains this information. the appendix of taber's cyclopedic medical dictionary has this information.
  • etiology - also called the related factor by nanda. this is what is causing the problem. it is the reason the problem exists and reasons can be many and varied. ask yourself "why did this happen?" or "how did this problem come about?" "what caused this to become a problem in the first place?" and dig deep. consider the medical diagnosis, the medical treatments that were ordered and the patient's ability to perform their adls. pathophysiologies need to be examined to find these etiologies if they are of a physiologic origin. it is considered unprofessional to list a medical diagnosis, so a medical condition must be stated in generic physiological terms. you can sneak a medical diagnosis in by listing a physiological cause and then stating "secondary to (the medical disease)" if your instructors will allow this.
  • symptoms - also called defining characteristics by nanda, these are the abnormal data items that are discovered during the patient assessment. they can also be the same signs and symptoms of the medical disease the patient has, the patient's responses to their disease, and problems accomplishing their adls. they are evidence that prove the existence of the nursing problem. if you are unsure that a symptom belongs with a nursing problem, refer to a nursing diagnosis reference. these symptoms will be the focus of your nursing interventions and goals.

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i was thinking of decreased cardiac output but then i am unsure of what to relate it to and evidence it by...because my patient is 3 weeks old. and then i am unsure how to develop some goals and how i will achieve them.

first of all, you will already know your "as evidenced by" information from your assessment of this patient before you even began searching for a nursing diagnosis (nursing problem). the signs and symptoms you encountered in your assessment should have raised red flags that there was a
decreased cardiac output
problem based on the definition of this nursing diagnosis
(inadequate blood pumped by the heart to meet metabolic demands of the body,
page 139,
nanda international nursing diagnoses: definitions and classifications 2009-2011
)
as well as what you know about the patient's medical diagnosis [hypoplastic left heart syndrome?].

your goals are always going to be reflective of what you predict is going to happen
as a result of any nursing interventions that will be done
. so, they depend on what those signs and symptoms are that the patient has. just as a doctor treats a patient's symptoms, we nurses do the same when it comes to our nursing interventions so you need to have those "as evidenced by" symptoms, or defining characteristics, of the nursing diagnosis clearly delineated for this patient because you will be ordering nursing interventions for them and your goals will need to reflect the successful results of those interventions.

how are we able to tell a 3 week old had delayed growth and development when only in the hospital for a few weeks and going home with no complications?

i guess you haven't had a growth and development class yet. the developmental milestones for children have been known for a long time and can be found in textbooks and on a number of websites. they are clearly laid out for a newborn and one month old. you need to assess the infant for them. see the pediatric weblinks on this thread to find some of the websites that have these developmental milestones for you to see:
https://allnurses.com/nursing-student-assistance/medical-disease-information-258109.html
-
medical disease information/treatment/procedures/test reference websites