Please help.....Diagnosis for DVT risk

[mlauren]

I have wondered this since last semester and never did come to a conclusion. Now here I am again needing to use this, because my patient needs interventions to prevent it and I don't know what ND to use. I have thought about this to the point where I feel like I'm losing my mind. So here are my thoughts and you tell me if I'm crazy.

First I thought Risk for Ineffective tissue perfusion rt immobility and patient being high risk for DVT (because of Crohn's and immobility together, plus he has had DVT before).

Then I thought Risk for decreased cardiac output rt increased pressure in the pulmonary arteries secondary to PE. I mean if the patient is a high risk for DVT, has had one before, why couldn't I use this? Because if he had a DVT he could get a PE, which could cause decreased cardiac output due to pulmonary hypertension, right? Or am I just going way too far with this one?

Lastly I started thinking Risk for Impaired gas exchange for sort of the same reason as the above. If he gets a DVT it could turn into PE and then definitely cause impaired gas exchange.

So what do you guys think? Am I crazy? I cannot figure out for the life of me which one of these would be correct. And I have tried talking to the only instructor who was available and she was no help at all.

[nurseprnRN, BSN, RN]

You know what? They are all correct, and for the reasons you have thought out. Nowhere is it written that only one nursing diagnosis is needed or applicable, or that several nursing diagnoses can't have the same origin. Good job of thinking these out. I love higher-order thinking; seeing it in students gives me hope to carry on :). Now go and figure out what the nurse would do when faced with a patient with such significant risks. Clue: Many, if not all, of your actions will involve vigilance and patient teaching about what you are on the watch for.

:flwrhrts:

[mlauren]

Well thank you. I was hoping I wasn't crazy :) at least I am understanding this