emlam

HI CT Pixie, I just took an exam and the question asked for the Priority nursing diagnosis for a HIV pt. with oral candidias... A. Risk for infection B. Disturbed body image C. Risk for imbalanced nutrition D. Risk for skin impairment I answered the question based on PRIORITY, which was what was actually happening at the moment (answer chosen: Disturbed body image, original answer: Risk for infection) , than what the pt. will be at Risk For. I keep doubting myself, not knowing what my teacher really was asking.

So, my classmate is correct with her b/p as the highest priority then? I was thinking about the puncture site as a choice but could not find a rationale from my text to back up the choice.

A group of classmates and I are having a debate on what is the nursing assessment highest priority after a patient with bacterial meningitis having a lumbar puncture done. Assuming the CT scan displayed no obstruction. 1. blood pressure 2. urine output 3. puncture site care 4. headache Many believe the headache is the highest priority because the LP can produce headache intensity. Some believe b/p because of the meningitis and cushing's triad.

Thank you! I did. One of the outcomes was "patient will be on suicide observation q15 minutes, she will follow a no-suicide contract and identify at least two people they can contact that can provide emotional support by..." Mental Health care plan was a bit tougher for me than Maternal Newborn. My care plan was not patient-focused enough. But, overall, the instructor liked how I had it set up :)

THANKS ESME for your assistance! I got a 96% on my careplan. My teacher did not care much for the No Contract Suicide.

I LOVED YOUR COMMENT! Thank you so much for this! I always felt that I had to pick one or a few specialties to work in, because everybody always asked...what do you want to do as a nurse when you graduate. Deep down, I want to learn EVERYTHING, not to say that I know it all, but to give everything/Every Opportunity a chance and to say that I have accomplished something. I strive to learn new knowledge! It always worried me that I was too open and will have problems finding a job because I am not picky! My main goal is to be their for the patients! It makes me happy when they receive great care from somebody that cares!

Group work is not fun! I will agree that they suck! But, the outcome of it is TEAMWORK...Can you work as a team and succeed? Communication, organization, leadership, seeing differences, etc... My experience was joining a class (group communication: BSN requirement) a day late. The instructor randomly groups and I was placed in the fewer members group to make it even. Knowing that they already did the introduction/ice-breaking ordeal, I felt a bit awkward, lost/confused at my 1st meeting, their 2nd meeting. We had to create a Nursing In-Service that could be picked up by any person wanting to move the project forward. Therefore, the In-service had to be broken down, detail by detail in a binder and later presented to the class (for 1 grade for all!!!) I admit, I try to be an over-achiever student because I want to do the best I can to learn and succeed. I don't just do "half-bootie" just to pass. Well, somehow, I ended up being the LEADER! Picking up certain people's slack because they either didn't meet mine and/or group members criteria or they didn't care as much or in your case "forgot." I guess what I am trying to say in this confusing comment is that Group work sucks, especially when your grade depends on it. Yet, if you are as assertive as you want to be, you can try try to get things done the way you want to. If there was a chance to repeat what happened, could you have sent the assignment to the teacher instead of waiting for the "forgetful group-member." I know that sounds bad to intrude on other's responsibilities, but my grade is important to me, I sometimes gotta do what I gotta do :) Overall, it's good that you vented out your frustrations, but Group work isn't as bad as it is...(I think? ). In addition about my group project: I ended up purchasing additional material for our project, create ppts, flyers, almost everything on my own and we got a 20/20! Did I think it was fair for the slacker to get the 20? NO! but he did! The other groups got B, C, and C- for their project! I did learn that the teacher always knows what's going on within groups! She knew that everybody in my group was counting on me and that it wasn't fair, but she couldn't do anything (???) About your Quiz thing....I have to take a quiz by myself prior to taking it with a group because once I figure out why I chose that answer, I can rationalize or rethink my answer!

For my care-plan teaching...my teacher wants me to do Safety risk r/t depression aeb previous suicide attempts! Trying to find rationales for that seems difficult. I need 3 outcomes 3 interventions & rationales (with 3 subcategories?) 1a 1b 1c, 2a 2b 2c, etc and 3 evaluation of outcomes Currently I have staff maintains a safe environment for patient (make sure pt. swallows all medication, remove any harmful objects, restricting patient visitors from bringing in any harmful objects)

Love your ideas Esme! I will focus more on my care-plan teaching tomorrow after my Ob exam! Today will be study day :) The nurses report (electronic) never stated why pt. had weakness in legs. My original plan was to teach the pt. not to commit suicide, but my teacher kept saying there was more than just suicide. The teaching will be within an 8 hour shift. Just thinking from the top of my head I would look into teaching the pt. 3 of these options Risk for suicide r/t depression and previous attempts of suicide Long-term goal: Patient will remain safe while in the hospital, with the help of nursing intervention and support by discharge - Remove any objects that she could use for harming herself - have one-on-one monitoring or suicide observation (q15 minutes visual check of mood, behavior, and verbatim statements) - keep accurate of timely records, document clients activity q15 minutes (what they are doing, with whom, etc...) - Construct a no suicide contract (ex: when they begin to feel overwhelmed by pain or depression - "I will speak to my nurse/family member when I first begin to feel the wish to harm myself" - Encourage pt. to talk about her feelings and problem-solve alternatives I feel like my mind is stuck in a little box and I am limiting my options...could I somehow relate stress management for the patient teaching? Nursing outcome: Pt. will identify two stress management or (relaxation techniques) to decrease suicidal ideation Intervention (whatever rationale I end up finding) Nurse will teach the importance of using relaxation techniques to decrease suicidal ideation ---I want to make sure if I could use the above statements because I may have misunderstood my teacher---

She has weakness of legs. It's her 2nd husband (remarried) Pt. pleasant, good eye contact, good recalls of timeframes and events, affect bright and mood congruent. Went to both group activities, socialable with other patients. She was in a cheerful, giggly mood when I met with her. Mood 10/10. Denies HI, feels safe, sleeps well I appreciate you highlighting/bolding the key factors...it helps me to understand the relationship with the diagnosis :) Now, I need to find 1 diagnosis that I can care-plan teach. Could I use? Risk for suicide r/t depression and recent suicide attempt

It is due Friday morning! I try to be an overachiever student by doing things in advance, but it's the getting lost part that gets me finishing the assignment a little later. I have been erasing, rewriting, erasing, rewriting, erasing, and rewriting diagnosis...I just don't like what I have....THANK YOU FOR THE SUGGESTIONS ESME! I was thinking of you when I posted because you helped me last time.

Also, I forgot to add...my teacher does NOT want anything dealing with Ineffective coping

Actually, I think I am more interested in KNOWLEDGE DEF. R/T STRESS MANAGEMENT! :) My teacher told me that there was more than risk for suicide/injury, but I could not put my finger to it.

Apologies in advance for the long novel but I wanted to give a brief & concise description of my patient. I just had my Mental Health Clinical and am practicing on writing a problems list with diagnosis and then I have to pick one diagnosis for a care-plan. I think I am making it more difficult than it should but, that's because I push myself to learn more! :) First half of this semester I was in Maternal Newborn Clinical Rotation and my instructor loved the diagnosis and care-plan that I typed up...Thanks with the help on Allnurses!!! Unfortunately it took me about 3 days to type it all up but fortunately my teacher loved it! With that being said, it should be a breeze for me to type up Mental Health...but it is/was not! I am not sure if I am satisfied with my diagnosis because I am still learning. Also, I don't know which 1 to focus on creating a care plan for. Majority of the assignment is made-up (for practice) but the patient that I was dealing with for a brief moment is a... 39/F admitted for Benzo OD, daughter found her. Pt. has 4 kids (1 is sort of adopted), 23 F with 3 kids, 19 F in college, two 23 M (working and in school, one is adopted). Pt. takes care of the 23 year old and grand children in own home. Pt's home was foreclosed, resulting in the family having to move out and then (unknown reasons) was able to move back into the foreclosed home. Pt. c/o of having to reorganize and unpacking the items at home and is not ready to return to that and the responsibilities. What led to the SA was after having an argument with her husband (not the father of the 3 kids), she pushed him, he pushed her back, she OD'd. Diagnosed with anemia, MDD, and GAD. Past history: first husband (father of children) was shot in the head 30+ times in front of their home in Puerto Rico (Pt. from there), she did not witness it, but the police showed her a picture for identification without any warnings...all she remembered was his teeth and his blood distorted face, but it was his teeth that she recognized. I'd say she was around her late teens or early twenties when it happened. Also, her mother continues to ask her to visit her in Puerto Rico, but Pt. states "There is nothing for me to do there, everybody that I use to know is either dead or in jail. I have no one to visit. My mom was just in WI. visiting me, so i don't have to go see her." In order by Priority (I will abbreviate some words just for here) **1. Risk for injury R/T depression and anxiety AEB previous history of attempted suicide. 2. Imablanced nutrition less than body requirements R/T lack of interest in food AEB lost five-pounds in four days 3. Disturbed sleep pattern R/T stress AEB patient reported difficulty concentrating and functioning the following day because of interrupted sleep. 4. Grieving R/T recent home foreclosure AEB patient's statement "I just can't handle losing my home and having my children being unstable." 5. Low self-esteem R/T depression AEB patient feels like a failure 1. Knowledge deficit R/T constipation AEB patient statement (ps) "is it normal for me to not have to poop in four days?" 2. KD R/T medication compliance AEB ps "I take my medications whenever I can remember to take them. I don't even notice anything changing" 3. KD R/T stress management AEB ps "when I feel stressed, I just isolate myself, but it seems to make things worse for me." 4. KD R/T MDD AEB ps "I don't know what depression is. It's annoying because my doctor just tells me to take medications for it." 5. KD R/T GAD AEB Patient Statement (PS) "I don't know how to control my anxiety!" I am leaning towards Risk for Injury as a care plan. Thanks in advance in taking your time in reading this and giving your input. I want to make sure I am well prepared at comprehending and creating care plans.

I've actually learned that my school started counting the absences and tardies because Financial Aid will not pay for students missing class, since the contract is for students to attend class and Fafsa will offer aid.