dovelove

Also, I had another question off the care plan subject. One of my questions asks if it is ever acceptable to use 3cc syringe for larger doses of insulin? I have searched the internet for feedback and it is vague. I was taught never to use anything but an insulin syringe for insulin. I answered no.

ThanK you everyone for the input. I have ordered the nursing diagnosis book and will continue to stream line the plans and reach out.

Yes fluid volume deficit was the first care plan I wrote with him----then I addressed the confusion next as well as this poses a risk to his safety ---then i went with pain as this can aggravate confusion and then the infection risk related to his very compromised state and active tissue trauma. It is the nutritinal status that stumps . This will affect his healing process and confusion.

Graduated in 1995 worked 3 years in Peds/NICU----- yes I see all those things as well and I believe I have addressed them, if not please advise- I have 4 full care plans addressing his confusion, dehydration, pain, risk for infection. It is the etiology, goals and interventions that are throwing me on his nutrition status ---- Should I do a diagnosis on nutrition? I think immobility, peripheral perfusion and the skin break down are also important... it could go on and on really--- I was told to be thorough. I am using two text books: Nursing care plans, :Gulanick,meyers, Nursing diagnosis: application to clinical practice and lots of internet stuff. But it is the individualization to this patient that I struggle with.

Hello I am taking an Rn refresher course and I have to write a careplan for the following pt. Male 69 yo with admitting DX of dehydration and pressure ulcer over a fractured R hip. He reported that he fell at home where he remained on the for for 30+ hours before he was discovered and admitted to the hospital. Admission nursing assessment T 36.5; BP 80/50; pulse 98;respirations 24: wt 116 height 5' 8". Clothes are dirty with urine . Pt grasps your arms and pulls at the bedrails yelling," Let me up, my cat is out there!" he cannot tell you where he is or why his hip hurts. When you ask him to tell you today's date, he again wants to get up and feed the cat that is in the other room. My Nursing dx include: Fluid volume deficit r/t inadequate intake manifested by hypotension tachycardia mental changes Acute confusion R/t unknown causes manifested by fluctuation in cognition and psychomotor activity Pain r/t tissue trauma manifested by report of pain and restless behavior Increase risk of Infection r/t tissue injury ( Not sure of how to word the manifested by part) Nutrition less than body requirements r/t inadequate intake manifested by ,10% IBW I am really having trouble with this one ---especially inerventions as he is in such a confused state and he may be pre-op NPO so not sure what to do here for goals or interventions. Other DX i was thinking of were,: Immobility impaired r/t tissue trauma medically orderd restricted movemnet impaired skin integrity r/t risk for altered tissue perfusion self care deficit not sure what to do with his psychosocial dx Social isolation?? What i really am struggling with is that there is this patient is a bit of a puzzle--it is sort of a chicken and the egg question. Did the fracture, pain, fluid /food status, cause his confusion or is his confusion the cause of his pathophysiology. Not knowing this is making the interventions and diagnosis, goals and interventions difficult. I have been out of Nursing so long and this is becoming so frustrating----any help would be appreciated.