Scythinian

Congrats on your test! One thing I've learned in my program is that the devil is in the details. All the advice I've seen in this thread is awesome, but one thing I'd like to add is to not over think or "force" an answer to be right. Catching yourself trying to justify an answer with weak reasoning can save you sometimes. My personal habit: draw like crazy. I'm very visual so flow charts and arrows and diagrams really help organize my thoughts if a question has me boggled. It also helps organize what leads to what and where things are going or coming from. Also: Take advantage of whatever tutoring or preparation sessions available to you through the school or program! Usually they're headed by students who have already been in your shoes and can really help get your thinking set in the right order. When in doubt, go to your professors. Nobody can give you guidance like they can.

second baby (first child now ~8) breastfeeding--first was breastfed also knowledge of infant care seemed adequate when i interviewed her. patient mentioned reading a few books "as a refresher" plus a family planning class before the delivery. i think that's where i'm hung up in all this. i'm trying to focus on the actual mom rather than the entire dynamic that was just created with the addition of a new baby. oh! light bulb! interrupted family process! caregiver role strain! full time nursing student husband, maternity leave, recently moved to the area. those are all pretty big considerations now that i think about it.

The pitting edema seems to be related strictly to the pregnancy. Considering the patient had delivered just shy of 8 hours before I arrived the edema doesn't seem abnormal. Her labs showed that only her WBC was slightly elevated (21.6k/mm^3). You may be onto something with the deficit knowledge part: her husband is a nursing student and father a doctor. Maybe she was coached to know the right things to say and is only parroting without the actual understanding of what it all means? My care plan book and my little nursing diagnosis books are focused more towards the generic med surg or psychiatric patient with a scant bit on the maternal and infant aspect of things. When it comes to the diabetes what risk would you suggest looking at? Because she has a history of having her glucose so well controlled for the life of me I can't think of a risk. Perhaps risk for impaired wound healing? Glucose stores being depleted thanks to surgery, stress from delivery, disliking hospital food could all sensibly contribute to the impairment of the healing process I think. I appreciate the help! Keep it coming if you've got an idea! My assignment isn't due for another couple days so I have time to tinker and mull things over.

I'm in an OB clinical currently and from my experience thus far I have to say that while I put on the appearance of being man enough, the image of a duck on the water comes to mind. Calm above the surface but inside my heart is racing. I'll manage just fine and get everything done just as well as any of my female counterparts though.

If a "tote" bag is the recommended thing then a good canvas messenger bag won't do you wrong. I've got one myself and I couldn't tear it up if I tried. Mine is an older one from fossil that ran me about $50 and I've had it about 5 years now. A good old fashioned backpack does the job just fine too. Just make sure it has enough pockets without being too many and you lose stuff lol.

Absolutely. My clinical instructor is pretty strict on expectations and with all the data I have I'm afraid I'm missing what would be the priority above all. Imbalanced nutrition is what I was leaning towards to begin with since it covers all of her current concerns.

Hello all! First time poster because I need some help figuring out a primary nursing diagnosis for a postpartum patient who, despite crawling through a chart and noting every detail, has no issues which I can specifically pin down. My assignment is to develop three diagnoses, one of which is the primary that we develop a complete plan of care for. This is where I've got some trouble. Pertinent info Severe obesity both ante and postpartum (BMI 38+) Type 1 insulin diabetic +2 pitting edema, bilateral Save for those three conditions the delivery was a textbook planned c-section (term), patient displays adequate knowledge of and access to resources for postpartum care of self and infant, and no history of mental illnesses that would suggest need for further assessment. Diabetes was managed to a T via insulin injections throughout pregnancy. I was thinking something revolving around imbalanced nutrition requirements (excess) or something specific to her diabetes but for the life of me I can't find a list of nursing diagnoses specific to diabetes. Any help would be greatly appreciated!