chantel2382

Hi! I am also a new grad on PCU. I'll be finishing up my preceptorship in just two weeks! (Scary) I will tell you one of the biggest hurdles for me on this unit has been understanding cardiac rhythms and since all of our patients are on telemetry monitors and the vast majority are cardiac patients I've found that this is a major deficit on my part. I make a point to go into the monitor room to view all my rhythms rather than to just call and ask what they are. I'm also looking into taking a more in depth rhythm class! Good luck to you!

Thank you for this great article! I'm a new nurse who is about to finish up my preceptorship on PCU and then I will be flying solo. I haven't had to deal with a code situation yet (twice we got the patient to ICU before they coded!) but I know it is inevitable and my biggest fear is that I will freeze and/or be incompetent even though I know I've been trained for it! This article put my mind at ease a little bit!

IN answer to your earlier question, the care plan book that I am using is Nursing Care Plans by Gulanick/Myers. This is the one the professors recommended.

Thank you!!

Oh man, you know my first instinct was to choose Risk for Infection and then I questioned myself. Just shows how completely inexperienced I am at this. Thank you so much for your feedback. I think I am in for a shock next semester when I have to do multiple care plans in a week because this ONE is taking me days to complete!

Thank you for your response and taking the time to write all that!! I think I forgot to mention that in the previous post!!

Hi, Thanks for responding back to me. I thought I had considered the assessment data before I formed my nursing diagnosis and interventions. I didn't include the assessment data in my original post but I do have it. This is the full case study, KT, who is 8 years old, and her family have returned from a weekend camping trip. KT presents to the emergency room department with lower abdominal pain with nausea and vomiting. She is very tired and irritatable. Vital Signs: Temp=101.8 P=102 R=22 BP=90/56 The ER doctor ddoes a thorough history and physical examination. KT has moderate to severe tenderness in the right lower abdomen when the doctor pushes there. She has rebound tenderness. Rebound tenderness is pain that is worse when the doctor quickly releases his or her hand after gently pressing on the abdomen over the area of tenderness. An ultrasound of the abdomen is done which indicates KT has appendicitis. She is scheduled for surgery. All of the above is the information I used to make my nursing diagnosis. Broken down into objective and subjective data I specifically focused on the vital signs, the complaint of lower abdominal pain with nausea and vomiting, the tiredness and irritability and the findings of the doctors examination. All of this led me to the nursing diagnosis of Acute pain. I am thinking that assigning this particular 8 year old a couple of chores to do isn't really feasible in this situation considering 1. she is ill and in pain and about to have an appendectomy and 2. She's in the emergency room. Most of what you wrote I understand and we have covered most of that in class. I guess I was just looking for some feedback on how to effectively individualize the NANDA interventions to a child who is sick.

Hello, I am in the "intro" semester of the ADN program and we just got our first care plan assignment based off of a case study. My patient is an 8 year old girl who presents to the emergency room with lower abdominal pain and is diagnosed with Appendicitis and is scheduled for surgery. We are to come up with 2 nursing diagnosis, one medical and one psychosocial, a short term goal and long term goal for each diagnosis and 5 interventions for each diagnosis. For my medical diagnosis I think I am going with Acute pain r/t diagnosis of appendicitis A.E.B. pt reports pain in lower abdomen, rebound tenderness in rt lower quadrant and elevated pulse rate. I was hoping to receive some feedback as to wether this is worded correctly. I'm also having some trouble coming up with Goals and interventions. I have a nursing care plan book, but my knowledge is so limited since this is just my intro semester that I am not sure how to individualize the interventions listed for acute pain to be appropriate for an 8 year old. This is what I have for goals and interventions. I was wondering if it was possible to get some feedback on what I have come up with so far. I've spent hours(believe it or not) working on this already and I feel like I have done it all wrong. Not sure if I'm stressing for no reason or what but it's important for me to have this done correctly. ANY help or advice/feedback would be greatly appreciated, especially advice on individualizing these interventions! Short term goal: Patient will verbalize pain as a 3 or less on a scale of 0-10 within 30 minutes of receiving ordered pain medication. Long Term goal: Patient/caregivers will describe how unrelieved pain will be managed by date of discharge. My interventions are 1. Assess pain characteristics including quality, severity, location, onsent, duration and precipitating or relieving factors. 2. Give analgesics as ordered by M.D., evaluating effectiveness and observing for any signs and symptoms of untoward effects. 3. Assess the patients expectations for pain relief. 4. Assess the patients willingness or ability to explore a range of techniques aimed at controlling pain. 5. Eliminate additional stressors or sources of discomfort whenever possible. Thank you!!!