nursingstu14

Thanks Esme12 and GrnTea! I really appreciate your help. Im really stressed out and I'm a crying roller coaster. I didn't pass my first exam i got a 79%. Eighty and above is considered passing and the majority of my classmates passed. I felt like a failure/ incompetent. I feel lost even though Im reading and researching. Im not really understanding but for now I just have to try my best and keep going. So, thank you SO MUCH for clearing things up for me. I needed the help! Ill let you guys know what i come with :)

@GrnTea: i was responding to Esme12 about it being a real patient or not. Now, about what you responded I wasn't trying to choose diagnoses first and support second. From what information I was given I decided to have risk for skin integrity as my nursing diagnoses. I decided on that just because i believe its the best I can do based off from the background info provided. I wasn't given VS or anything of that sort so i cant really get much from what the case study included. Im trying my best. Im new to this and reading all the text books in trying to find good nursing interventions. I hope i didnt offend you in any way. I hope you dont think Im just trying to get answers. I really have no one to help me and I found this website and so far its helping me. I did however and take your advice and purchased the NANDA-l Nursing Diagnoses to help me. THank you.

This is not a real patient.

@psu_213 : I agree with you too now diuretics.I was confused about that i was just reading it from my care plan book. During anaphylactic reaction certain interaction of chemicals with receptors on the surface of blood vessels causes the vessels to leak fluid into surrounding tissues, causing fluid accumulation, redness, and swelling. On the smooth muscle cells of the airways and digestive system, they cause constriction. On nerve endings, they increase sensitivity and cause itching.

yes, i do know where this is going thank you VERY MUCH! The case study has no information about pain or risk for infection and no further info on her surgery...

I do have a nursing all in one care plan book but it doesn't really give much information on edema. In the book they have it more as a side effect or symptom to a greater disease...=/ thanks for your advice though =)

Yes, she's having an allergic reaction to the medication cefazolin. And sorry for not mentioning it but cant do anaphylaxis either. So, heres the whole case: A 69 yr old Mexican American woman is admitted for total knee replacement surgery. Following surgery, an order was written for cefazolin sodium (Ancef) 2 gm intravenous piggybank every 8 hrs for 24 hrs. She received her first dose after surgery. Thirty mins after the medication was started, the patient calls the nurse and reports "itching all over" and difficulty breathing. The nurse notes facial edema and audible wheezing. The skin is red with large swollen blotches over her arms, trunk and back. Patient states, "I had this happen to me before when I took a drug called amoxil. The doctor said i am allergic to amoxil." I believe she is experiencing swelling to the face because of the allergic reaction from the medication not from sodium in her diet. So, it doesn't make sense when i wrote for one of my interventions to be nutrition therapy. I chose that for when she goes home she would be educated in what not to eat so swelling doesn't get worse. Maybe the sodium in her med order is adding to the swelling too. Cefazolin is meant for bacterial infection so maybe she has an infection which is contributing to her swelling. But that wouldnt cause swelling to her face because its her knee....Swelling is the body's reaction to an injury, which in the patients case is her knee surgery. =/ im not sure what to say. risk for dehydration?? Im sorry if i miss it. I don't really know. Im completely new to this i have no medical background what so ever? Im researching all of this as I'm going in my textbooks and internet.

I cannot use the diagnoses of airway obstruction since its the most obvious diagnoses (according to my professor). That is the reason why i chose risk for impaired skin integrity. Thanks though =) Since she has facial edema, excessive fluid retentions of the face, Im thinking for an intervention would be drug therapy on removing the excess fluid retention. My rationale would be if diuretics were prescribed it will increase kidney water and sodium excretion. Another intervention could be nutrition therapy, which can involve restrictions of both fluid and sodium intake to control fluid volume. And since she has itching and red swollen blotches an intervention can be some sort of ointment/medication to reduce the itching which will prevent the patient from scratching and making her blotches worse. If patient continues to scratch they can tear skin which will increase chance of skin infection/ integrity. What do you guys think?

Hi I am only in my second week of nursing school and I am having trouble with my first case study. I have a case study about a patient who is having an allergic reaction to a medication. She is experiencing facial edema, red swollen blotches over her arms, trunk and back, itching, and difficulty breathing. Im suppose to have a nursing diagnoses and 3 interventions with rationales. The nursing diagnoses i decided to do is risk for impaired skin integrity but i don't really know what interventions to choose. For one intervention i was thinking to reduce sodium intake but i am not sure. My books I have dont have much on facial edema. Please help me. Ill take any tips. Thanks.