I am currently doing an assignment which asks for nursing interventions to be given with the priority of the issues in order. this is for the care of the patient within the first 24 hrs.
35 year old female post operative patient who has
minimal urinary output of 30-50ml/hr
a PCA in place which has shown high demands but inadequate pain control.
I am unsure which one would go first. From my research the minimal urinary output is acceptable post operative but could require nursing intervention. According to maslows hierarchy this would be considered priority over the pain. Pain would be patients priority.
I know how to treat both issues but don't know which one would be first.
The markers are expecting evidence based literature.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
tulip5 has given some great suggestions...but to best help you learn we need to know what you think. Here at AN we like students to tell us first what they think and guide them....not just give answers. Giving answers does not help the student grow and learn.
Oh... likely nursing diagnosis: (depending upon exact assessment data)
Impaired gas exchange RT respiratory depression (opiate/anesthetic) and splinting AEB (vital signs here), pt. not coughing deep breathing, c/o incisional pain, etc.
Alas, there is no such related factor as "respiratory depression" or "splinting" to allow you to make the diagnosis of "Impaired gas exchange" and no such defining characteristics as, "pt. not coughing deep breathing, c/o incisional pain, etc." either. Having incisional pain (nor the others) are no evidence of impaired gas exchange at the alveolar/capillary membrane, nor are they evidence of ventilation-perfusion imbalance (these are, BTW, the only related /causative factors approved for this diagnosis).
You cannot make that nursing diagnosis without that evidence or some random nonspecific related (causative) factor. You can't make it up.
I will leave it to you to go to page 214 in the NANDA-I 2012-2014 to see what the real ones are. You may or may not have evidence to support this diagnosis somewhere, but you haven't presented it here.
Also, it is not up to nursing to change medications. Certainly knowing meds, effects, and how to suggest things to a prescriber are useful, but ... nurses do not make those decisions. No point to encouraging a nursing student to think like an auxiliary physician when she is in school to learn how to plan and deliver nursing care for patients, not medical care.
Esme12, ASN, BSN, RN
20,908 Posts
tulip5 has given some great suggestions...but to best help you learn we need to know what you think. Here at AN we like students to tell us first what they think and guide them....not just give answers. Giving answers does not help the student grow and learn.