Please help me. Im a new student and Im kind of freaking out

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I need homework help pretty please. Im in my 2nd week of nursing school and we are learning about NANDA and making diagnosis.

The question is:

Write a possible nusing diagnosis based upon the following situation:

A 52 year old patientis admitted after episodes of severe vomiting.

Thats it...I feel like I dont have enough information. Or am I overthinking this? Can anyone help please:crying2:

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Specializes in Ante-Intra-Postpartum, Post Gyne.

at risk for metabolic imbalance r/t severe vomiting

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Specializes in med/surg, telemetry, IV therapy, mgmt.

you have enough information. a diagnosis can only be made based upon assessment information. assessment yields abnormal data. assessment consists of obtaining as much of the following as possible and then sorting out what is abnormal:

  • a health history (review of systems) - you have been told the patient is 52 years old and has had episodes of severe vomiting. vomiting is abnormal.
  • performing a physical exam - unable to do this since it is a case scenario and no physical exam information was given
  • assessing their adls (at minimum: bathing, dressing, mobility, eating, toileting, and grooming) -no adl assessment is provided
  • reviewing the pathophysiology, signs and symptoms and complications of their medical condition -since no medical disease or condition was given there is no medical disease or condition to look up, however, you should look up and read about vomiting and what it is, what causes it, and how it occurs. vomiting is a symptom of many medical conditions. its importance to us as nurses is that we treat patient's responses to their medical diseases and conditions and vomiting is certainly a response to something going on with the patient. we also need to consider complications that can occur as a result of a continued symptom.

    [*]reviewing the signs, symptoms and side effects of the medications/treatments that have been ordered and that the patient is taking - in reading about vomiting you need to find out how physicians treat vomiting, the symptom. how do nurses treat vomiting? you need this information for the care plan.

after completing your study of vomiting and nausea you should have an idea of what this patient faces if the vomiting is not controlled. that is the nursing problem (nursing diagnosis). the task is to turn it into a nursing diagnosis. a nursing diagnosis is merely a label (a tag). nanda has already compiled a list of nursing diagnoses for us. it is a matter of becoming familiar with what is on the list. there are currently 206 diagnoses but the problem is that nanda only provides the list if you pay them for it. previous years listings can often be found for free but do not contain the few diagnoses that have been recently added. if you have a current copy of taber's cyclopedic medical dictionary you will find a list of the diagnoses along with their definitions, defining characteristics (signs and symptoms) and related factors (causes and etiologies) in the appendix. about 80 of the most commonly used diagnoses along with their definitions, defining characteristics (signs and symptoms), related factors (causes and etiologies) and some nursing interventions are contained on these two websites:

diagnosing is putting a name to a problem or potential problem. in this case, the problem is vomiting. vomiting also has some specific symptoms and if you have ever vomited and you read what they are you will recognize them: increased salivation, a sour taste in the mouth after an episode of vomiting and, most especially, nausea. if the vomiting continues, what will happen? make a list of those complications. the major complications of vomiting are dehydration and fluid and electolyte imbalances. there are nursing diagnoses for these.

  • actual problem: nausea r/t (unknown reason, probably gastric irritation) aeb vomiting
  • potential problem: risk for deficient fluid volume r/t fluid lost through vomiting
  • potential problem: risk for imbalanced nutrition: less than body requirements r/t inability to ingest food

what must be done to stop the vomiting? some things depend on doctor's orders; some things can be done independently by a nurse. these will be your nursing interventions.

see https://allnurses.com/general-nursing-student/help-care-plans-286986.html - help with care plans for more information on how to construct a care plan.

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Thanks for anwswering. And thanks for giving me an explanation. I actually understand the process a lot better now. Thanks for the help :yeah::bow:

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Specializes in Rehabilitation; LTC; Med-Surg.
Thanks for anwswering. And thanks for giving me an explanation. I actually understand the process a lot better now. Thanks for the help :yeah::bow:

Yes, Daytonite has her stuff together! I've learned more from her about nursing priority and diagnosis than I did in the classroom!

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I agree with Zanatu. I am just starting nursing school now, and this site has taught me so many things. It is because of people like you that make it amazing! In other words thanks and you rock! =)

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Just thought I would let you know, I will be posting alot of questions for you during the next three semesters . . .I have learned more in 5 minutes of reading your posts than 2 years of school! THANKS!!!

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There is a NANDA list out there, I just wish I could remember where to find it. You know that irks me because as a LVN we're not allowed to make a nursing dx, but yet, through out nursing school we had to do it. I hate having to do a dx anyway. That was my weakness anyway.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

"as a lvn we're not allowed to make a nursing dx" what is your objection to using them? you must know them to use them. as nurses we can't "make" medical diagnoses yet we still use them all the time! in order to use medical diagnoses we need to learn about them so we understand what we are talking about. if you don't know and understand a nursing diagnosis it would be silly to try and use it around people who do know what it means.

a laminated sheet with just a list of the current diagnoses can be purchased from nanda (http://www.nanda.org/). see the right side of the home page. they also sell the taxonomy (definitions, defining characteristics and related factors of each and every nursing diagnosis) which i use as a reference all the time when i am answering nursing diagnosis questions on allnurses although that information is also printed in the appendix of current editions of taber's cyclopedic medical dictionary. the fact that taber's has included so much nursing diagnosis information in its appendix should be telling everyone how important nursing diagnosis is to the healthcare field. ignore this if you want. find some good reasons to explain why you hate doing nursing diagnosis and why it is your weakness when potential employers ask you about it at job interviewers and hope they are still interested in hiring you. nursing care plans are required to be in every patient's chart when a facility receives any medicare or medicaid money (which is just about 95% of u.s. hospitals and nursing homes)--that is a federal law.

any nursing diagnosis lists you find on the internet are old and do not include current additions and changes that are made on a regular basis. there are currently 206 approved nursing diagnoses. here are several nanda lists that i know of. however, be aware that the lists are just the labels (names) of the diagnoses and tell you nothing about their definitions. you need taxonomy information to get the definitions, defining characteristics and related factors of each diagnosis:

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My objection is that it was my weakness, I hated doing them because I felt like I was always picking the wrong one. I know there could be several to choose from and we would have to choose the best one that fits. Some of the ones that I came across I was like whattttttttttttttt, but I survived nursing school. Now I have to do it again for the RN program, and will be using them even more.

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Specializes in med/surg, telemetry, IV therapy, mgmt.
my objection is that it was my weakness, i hated doing them because i felt like i was always picking the wrong one. i know there could be several to choose from and we would have to choose the best one that fits. some of the ones that i came across i was like whattttttttttttttt, but i survived nursing school. now i have to do it again for the rn program, and will be using them even more.

you want to be an rn by the title of your screen name. rns are problem solvers. that is what rn school trains us to do. nursing diagnoses are names placed on nursing problems. before nursing diagnoses we just wrote out what the nursing problem was or we just listed the signs and symptoms of the nursing problem. what nursing diagnosis has done is merely standardized the list of diagnoses so we are all using the same ones and meaning the same thing when we use them. it eliminates confusion that exists when one nurse calls a set of signs and symptoms something that another nurse has named differently. just as doctors learn the process of how to diagnose, there is a process we also need to go through to learn to correctly diagnose nursing problems as well. there is no mystery about this. the nursing process is how we do that. if you have always been picking wrong diagnoses it is because you are new at the procedure. this is a (mental/cognitive) skill and like any skill it takes practice, practice, practice. it also requires you to be familiar with using the tools. who was an expert at riding a ride or driving a car on the first, second or third attempt? initially, you must assess the patient and that is a skill that takes a great deal of time to develop proficiency in. you can never have enough data. determining the diagnosis of problems comes next and it is based on sorting out the abnormal data that was collected. this implies that we must be aware of which data is normal and which data is abnormal. like putting together a puzzle picture, the abnormal data becomes the signs and symptoms of nursing problems (nursing diagnoses). at first, nursing diagnosis references like the taxonomy information that has the defining characteristics for each diagnosis is needed to help us in identifying and naming the nursing problems (nursing diagnoses). with time and experience you start to know what nursing problems (nursing diagnoses) you have when you see the symptoms in the patient. for example, weight loss, routinely refusing breakfast and taking 3 forks of dinner and stating, "i've had enough to eat" are clearly symptoms (defining characteristics) of imbalanced nutrition: less than body requirements. before nursing diagnosis or places that do not use nursing diagnoses will just call it "poor intake".

before using such a strong word as hate or accusing yourself of being weak give yourself a chance to be a student that must go through the steps of learning. be kinder to yourself.

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people learn something every day, and a lot of times it's that what they learned the day before was wrong.

bill vaughan

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Thank you for the kind and informative words, but nursing dx has always been my weakness. I know I'm going to be exposed to it more especially in RN school, and I will have to overcome it. It will be something that I will see on a daily basis even as a LVN. As you say, practice, practice, and practice. Thanks again

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