ALCANGEL1

"It's been a long week."

I did.

I also wanted to put impaired gas exchange but that is caused by the fluid so can you put excess fluid volume as one nursing dx and impaired gas exchange as another?

Ok so the pt. was admitted with a dx of respiratory distress. Pt. has a history of renal failure, diabetes and hypertension. Pt. states she is a little out of breath especially when moving. She is overweight but does some exercise. She has a high BP, HR and RR. She has an SaO2 of 91%. She has a very high BNP which indicated heart failure. She also has a high creatinine level. She has crackles and edema. She needs assistance to walk and gets winded when walking short distances. She has some redness on her coccyx which is probably a pressure ulcer. When a person has CHF the heart is not pumping blood around the body like it should be and therefor tissues and organs are not getting the blood they need and oxygen is not being delivered. I am really trying to figure this out instead of trying to just pick care plans one of my books lists. I have Carpanitos handbook of nursing diagnosis and nursing care plans by gulanick and myers.

Its a fictional person given to me by my school so no i was not able to assess these things myself it would be a whole lot easier if it was an actual person

I am need to come up with three nursing dx and I need to prioritize them and I am having problems. The patient has severe CHF, chronic renal failure, diabetes. The pt. also has some redness on a spot where they could get pressure ulcers. I picked 3 nursing diagnoses and put them in this order 1. Excess fuluid volume r/t CHF and renal failure as evidenced by edema, crackles, dyspnea, elevated BP, HR 2. decreased cardiac output r/t CHF as evidenced by increased HR, crackels, increased RR, dyspnea, edema 3. Activity intolerance r/t CHF as evidenced by getting winded when walking a short distance Is that the order that you would put those three nursing dx in? Would you change any of them and perhaps remove 1 and add impaired skin integrity? Thank you.

Kylie I found your school email address on the school directory or at least I think it is you so I sent you an email. Alexandra

-Kylie002 I saw your post and I am in the final stages of setting up 1 bedroom rental in Amherst. I am also in the nursing program and thought maybe we should communicate further. Can you please let me know what your email address is. Alexandra

I got accepted and sent the enrollment form in today! I am a 24yo female with a BA in Psychology. Anyone interested in sharing an appt in or near Amherst?