Pre op nursing diagnosis help PLEASE!

[Roxanne_SN]

i have a case study due and i'm stumped!

question: "pre operatively what are three priority nursing diagnosis for this patient"

the patient, a 5 year old girl with turners syndrome and coarctation of the aorta, is scheduled for an end to end anastomosis.

should my nursing diagnosis reflect the pre-op period itself (example nursing dx include):

deficient knowledge related to preoperative and postoperative events

anxiety related to change in health status

risk for infection and injury related to exposure to nosocomial infection and use of preoperative medication

or should it reflect the signs and symptoms requiring surgery in the first place? (which i have all the aeb and supporting s/s for)

decreased cardiac output related to obstruction of system blood outflow

excess fluid volume related to heart failure and pulmonary vasculature overload

risk for infection related to pulmonary vascular congestion and chronic illness

i can't figure this out. any help or insight would be greatly greatly appreciated!

[nurseprnRN, BSN, RN]

all of them are present in the preop period. excellent start. so, you get to pick the ones that are the most important (both at the moment and because of preparing for surgery) and defend your choices. this is a five-year-old, remember, so don't forget the parents when you plan her preop care.

one other hint on nursing diagnosis in general. "related to" means "caused by." pulmonary vascular overload does not cause excess fluid volume, it's a result of it. chf does, but only if you think it's because of decreased renal blood flow and inadequate urine output. so for those you might be looking at something like ineffective gas exchange related to pulmonary edema because she has ("as evidenced by" means "because i know/can see she has") fluid overload/congestive heart failure, wet breath sounds, decreased spo2, increased work of breathing, activity intolerance, etc. that make sense?

[Esme12, ASN, BSN, RN]

also think maslows hierarchy of needs and weel as the childs groth and development stage

[color=#003333]play age: 3 to 5 years[color=#cc6666]ego development outcome: initiative vs. guilt

[color=#cc6666]basic strength: purpose

during this period we experience a desire to copy the adults around us and take initiative in creating play situations. we make up stories with barbie's and ken's, toy phones and miniature cars, playing out roles in a trial universe, experimenting with the blueprint for what we believe it means to be an adult. we also begin to use that wonderful word for exploring the world—"why?"

while erikson was influenced by freud, he downplays biological sexuality in favor of the psychosocial features of conflict between child and parents. nevertheless, he said that at this stage we usually become involved in the classic "oedipal struggle" and resolve this struggle through "social role identification." if we're frustrated over natural desires and goals, we may easily experience guilt.

the most significant relationship is with the basic family.

erik erikson stages of development