Please Help!!!

I was awful at the care plans so I don't know how helpful I will be but here goes:

I would make decreased cardiac output the primary since it's the most directly related to the MI. I would say that the Tissue Perfusion issue is a result of the decreased cardiac output, so I wouldn't think it would be necessary to mention it. I guess that's what your teacher meant...They're not really the same thing but they both have the same effects on the body, so there's not much sense in mentioning it twice.

Or...maybe you could say Decreased Tissue Perfusion related to decreased cardiac output secondary to MI.

I don't know if that would fly or not. Good luck.

Just get a good care plan book.

One for MI is probably in there. : )

You can also use other diagnosis such as risk for second mi as many people who have one will have another this can then lead you to help the person change their lifestyle exercise and diet changes to improve their chances of having a second mi

you could also use risk for diabetes as many people who have mi have underlying diabetes, has your patient been tested? if he does have diabetes then that opens up a whole realm of lifestyle changes you can help him with and a whole bunch of complications that you can help him prevent

i had my clinical instructor review my careplan for my client who had an mi on the 25th. she told me that ineffective tissue perfusion and decreased cardiac output where the same nursing dx:uhoh3:. ineffective tissue perfusion is my primary nursing dx. i was thinking of replacing decreased cardiac output with impaired gas exchange. my question is should i make the impaired gas exchange my primary:confused: ??

i think your clinical instructor better go back to school. ineffective tissue perfusion relates to the cellular process, which would be influenced by decreased cardiac output; but, is not exclusively caused by it. other factors that cause ineffective tissue perfusion would be shock states (of that cardiac shock is only one of the shock states)-therefore, the 2 diagnosis are not the same. looking at it another way-if cardiac output were to increase, you may just have a resulting increased tissue perfusion; but, not always (eg, hypovolemia). if the 2 were the same, you would see them parallel with interventions (which they do not always do).

impaired gas exchange would be appropriate if the patient has pulmonary edema r/t the decreased cardiac output-but, then again, your instructor might try to say that the diagnoses were the same. if you have a nursing diagnosis book, take a look and show her that related diagnosis are just that. a medical condition may result in more that one nursing diagnosis, which does not necessarily make them the same.

not sure if this'll help, but this is the care plan included

in my manual for a patient who has had an MI:

1. Alteration in tissue perfusion related to imbalance between myocardian

oxygen supply and demand.

2. Pain related to imbalance between myocardial oxygen supply and

demand.

3. Activity intolerance related to imbalance between myocardial oxygen

supply and demand.

4. Disturbance in self-concept related to possible changes in role,

vocation, and lifestyle.

ineffective tissue perfusion and decreased cardiac output are not the same diagnosis. don't worry you were right, some of these instructors swear they know what they're talking about, and sadly they don't. how could she/he say that they are the same. decreased cardiac output would be my first choice, then ineffective t.p. impaired gas exchange would be low on the list, seeing that m.i is a cardiac problem, not pulmonary. you're right not to fear!

Take it from a former careplan nurse.............decreased cardiac output and decreased tissue perfusion are not the same dx. Decreased cardiac output might increase the problem of decreased tissue perfusion, but its not the same. That being said, while we can come up with some generic dx that a person with MI might have, without further info we can't tell you which ones to use.