Pediatric Nursing Diagnosis

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Hi everyone!

I am working on my care map (only one shot, this one has to be satisfactory or else) and I am desperate. I am thinking hard about what nursing diagnosis I could formulate.

It was a 7 week-old with MRSA empyema. Chest tube is out. Still on antibiotics and isolation. RR 80s.

Ok here is what I have so far:

Inefficient Breathing Pattern R/T inflammatory process secondary to pneumonia

And that is it :o. I know he is at risk for infection because of the chest tube site. But is it according to NANDA for pediatric patients?

Can the same nursing diagnosis for an adult be applied to a pediatric patient?

Thanks

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if the child has MRSA empyema, then would it really be "risk for infection"?

wouldn't the child really have the infection?

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i think gingersue is correct on this one. from what i understand... "risk for" nursing diagnoses are one of the last resorts because the patient has not yet developed the problem.

i'd personally go with:

  • ineffective airway clearance r/t increased production of secretions and increased viscosity.
  • impaired gas exchange r/t decreased functional lung tissue

good luck!

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i think gingersue is correct on this one. from what i understand... "risk for" nursing diagnoses are one of the last resorts because the patient has not yet developed the problem.

i'd personally go with:

  • ineffective airway clearance r/t increased production of secretions and increased viscosity.
  • impaired gas exchange r/t decreased functional lung tissue

good luck!

thanks a lot!!! i am not sure about the impaired gas exchange because his o2 sats are still at 100 on room air and his has good perfusion so ??? i really don't know what else to come up witt. i need 6 diagnosis so i got some works to do.

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wow, that is one tough kid! you're right, i'd leave the impaired gas exchange off since he's at 100% ra. you might want to take a look at some of these:

  • hyperthermia (if he had/has a fever) r/t increased metabolic rate/illness.
  • impaired oral mucous membranes (did the little guy have thrush? any impairments in his mouth?) r/t dry mouth from breathing (or decreased fluid intake if it was decreased).
  • fatigue r/t increased energy requirements and metabolic demands
  • deficient fluid volume (if the kiddo has lost weight) r/t insensible fluid losses (fever, diaphoresis), inadequate oral fluid intake (?)
  • imbalanced nutrition, less than body requirements r/t fatigue, poor sucking and breathing coordination, dyspnea

i hope this helps!

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Specializes in Pediatrics Only.

It was a 7 week-old with MRSA empyema. Chest tube is out. Still on antibiotics and isolation. RR 80s.

The biggest issue that I see here is the Resp. Rate in the 80's. This little guy should be 30-60, Max. Respiratory distress needs to be address ASAP. I'd formulate your nursing diagnosis for that factor, and make it #1.

Good Luck!

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Thanks everyone!!!

I have been racking my brain. :trout:He has no fever, no thrush, has actually gained a little weight and no secretions to worry about...so that cuts it down pretty good...

I am still working on it but here is what I have so far:

Ineffective Breathing Pattern R/T inflammatory process secondary to pneumonia

Impaired skin integrity R/T/ contact with diaper and secretions

(Has a diaper rash)

Pain R/t gastrointestinal discomfort (there I am not sure how to word it, but he basically has gas)

And I was thinking about adding a deficient knowledge for the mom, she smokes (claims she does outside but oh well) and dad, daughter and her had a staph infection so they should not touch the baby at all if that happens again.

Also maybe a risk for injury (further injury of the lungs if he gets sick again)

What do you think? Still have one diagnosis missing.

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just some ideas: in italics

Ineffective Breathing Pattern R/T inflammatory process secondary to pneumonia {is empyema the same as pneumona?} add "as evidenced by .... eg. respiratory rate

Impaired skin integrity R/T to contact with diaper and secretions {urine, moisture} as evidenced by...

(Has a diaper rash)

Pain R/t gastrointestinal discomfort {as evidenced by ... maybe abdominal distension, facial grimacing, crying}(there I am not sure how to word it, but he basically has gas)

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Specializes in Pediatrics, High-Risk L&D, Antepartum, L.

I can tell you that some instructors will allow a risk for infection even if a patient already has an infection. Their logic is that the person is still at risk for other infections.

So if a patient has MRSA and they are in the hospital on antibiotics...they have an increased risk for c-diff (as well as other things). Same thing if they have a foley.

So there are some that will take risk for infection for a patient with an infection on the idea that they are at risk for getting a new infection.

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