cmarcus

I think it went well. The nurse manager scheduled me to shadow one of their nurses next week, so I am hoping that's a good sign :) Thanks for asking!

I have an interview for a Nurse Residency position in the Trauma Unit at a level 1 trauma hospital on 5/27. Any advice for what to expect?? I have an interview with the HR dept. first and then with the hiring manager afterwards. It's my first interview for a Nursing job so I'm a little nervous because I don't really know what to expect. Thanks in advance for your input/help!

They can cause immunosupression

He was on solumedrol. Thank you!

So, how would you put that into a nursing diagnosis? The presence of a foley, 2 PICC lines, intubated?

Yeah, that makes sense. His skin was fine, no breakdown. He had just been admitted the evening before. He was in end-stage COPD so I could go towards powerlessness r/t progressive nature of disease? I feel like my prof. would say he wouldn't be at risk for infection because we were performing peri care Q8H. Thanks for your help, I appreciate it!

Sorry I was replying on my phone the last time. His vent settings: Peep- 5.0 I:E- 1:2.7 FiO2- 30% VT- 550 RR-12 and he was on assist control. The doctors were contemplating on placing a trach because he had been intubated so many times in the past. We were letting his lungs rest. He was on fentayl, vanco, normal saline and propofol drips. Our goal was to get him back to his baseline ABGs which was what I would consider a somewhat controlled resp. acidosis. I chose ineffective airway clearance because he still had the wheezing and decreased breath sounds, I went with impaired gas exchange because of his abnormal ABGs. While I was there his O2 sats never dropped below 93%. I had a hard time choosing a third diagnosis for this patient. I went with risk for infection because he had decreased ciliary action and stasis of secretions and he was a little malnutritioned. I didn't chose ineffective breathing pattern because he was on the vent which was giving him at least 12 respirations per minute.

He had decreased breath sound and wheezing. He had the barrel chest. As for the ABGs his latest was a pH of 7.41 PCO2 67 121 bicarb 42.5. He has HTN, afib, CAD, he had an MI in 06, hypercapnia. He had been in the ICU five times in the past six months every time he had been intubated. He was on DVT prophylaxis, he did have a foley, he was on propofol he had 2 PICC lines. If you would talk to him he could respond to you knew where he was and who he was.

So a little background on my patient. He came in through the E.D. SOB, 3L NC O2 as 90% they gave him a breathing treatment his O2 went to 100%. He has a history of COPD and has been intubated several times in the passed. He was put on Bipap but his LOC decreased and they decided to intubate. When I had him he was in the ICU, intubated, ABGs were all out of whack, as to be expected. His O2 sat was running from 93-100 he still has wheezes and decreased breath sounds. Many of the Nursing diagnosis that I have found are for COPD patients that are not currently on mechanical ventilation. Right now I am trying to figure out 3 top diagnosis and then prioritizing them. I have- Ineffective airway clearance r/t expiratory airflow obstruction, bronchoconstriction AEB wheezing, difficulty breathing, impaired gas exchange r/t ventilation perfusion inequality AEB abnormal ABG values, reduced tolerance for activity, risk for infection: risk factors: inadequate primary defenses, chronic disease process, malnutrition. He had a chest x-ray and there was no pneumonia just overinflation and presence of chronic lung disease. Do you guys have any advice on better nursing diagnosis/ better prioritization?

My pt was a 2 m/o in the NICU barely weighed 2.5 kg he was born at 28 weeks. I am having trouble with a developmental nursing diagnosis. I have so far risk for delayed development r/t prematurity AEB?? Not sure if I am even on the right track any help will be beneficial. Thanks!

All we were given to go off of was that we are to make a nursing care plan with a full page single space of nursing diagnosis for a woman during stage 1 of term labor & lady partsl birth. Pt would be considered normal and low risk. Priorities cannot be hemorrhage, inverted uterus, ruptured uterus or anything life threatening. I have basics like acute pain, powerlessness, anxiety and fatigue. But how would I prioritize these? We have to pick three priority and then a first priority and write a care plan on that. I have the NANDA diagnosis book and used those. Thanks in advance for your help!

Thank you! You definitely helped me narrow down the most important. Yeah it would definitely help if they gave us more information about the patient, but no such luck. Thanks again! I appreciate the help for sure!

I'm in my first semester of my junior year. The only book I have for nursing diagnosis is the Nursing Diagnosis Handbook by Ackley and Ladwig. It's not a real life infant and literally the only information we were given about the infant was that he was a full term male from birth to 48 hours. We know nothing about mother/baby relationship, nothing about the mother etc. This is only my second care plan and we have to have a full page of nursing diagnosis then narrow it down to 3 priority and then pick the top priority and write a care plan off that.

All we were given to go off of for our nursing dx is it is a term newborn male from birth to 48 hours old. I need help finding 3 priority nursing diagnosis. I was thinking along the lines of inadequate thermoregulation r/t immaturity of neuroendocrine system, Risk for respiratory distress syndrome r/t inadequate surfactant and risk for hypoglycemia r/t cold stress. Thanks in advance for your help!