Patient Care Essay

  1. Hi Everyone

    We've been given a patient scenario and have to select 2 priority nursing diagnoses, give a rationale for each and briefly discuss how you as an RN would address the patient's problems in general then discuss in detail how you would address the 2 priority problems you identified. It has to be roughly 2000 wds.

    The case study is a 26 year old man with Schizophrenia (Paranoid). Basically I have gone through the scenario and I identified the following problems which are impacting on the patient's health & wellbeing:

    * relationship problems with partner
    * non-compliance with medication (believes he is being poisoned)
    * delusions (other people tapping into his world via phone etc, partner infidelity, nurses are KGB agents)
    * anorexia

    I haven't done one of these before and would REALLY APPRECIATE any advice anyone can give me!! I'm finding the whole NANDA thing a bit confusing. I look up for eg Delusions and then it directs me to a list of terms... if I look those up I don't really feel as though they are really addressing the problem.

    Thanks so much everyone!! I will kiss your feet for ever!!

    Thanks guys,

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    About Aussie_Amy

    Joined: Oct '05; Posts: 13


  3. by   Thunderwolf
    The first piece of advice would be "what specifically are you asking for?"

    You provided a lot of info above, but ask generally and sort of vaguely for assistance. What assistance, I can't tell. It may be more effective here on this "One Thread" to have us members address "One" assignment problem/issue. When you post generally on something like this, you tend to get general feedback...which may not be all too helpful or answer your question(s). Your time is valuable. Post more specifically, you will then have all reading members "on the same page" with you. Please narrow down your request.

    Also, we have a Nursing Student Assistance Forum for students who need help with school assignments. I encourage you to use that forum for school projects. It is located here: Nursing Student Assistance Forums

    Just trying to be helpful.
    Last edit by Thunderwolf on Mar 24, '06
  4. by   CharlieRN
    Like the Wolf said. Too much info, too broad a subject. I suspect you are giving us what you were given. It may well be a case of needing to read your instructors mind. You are in a better position than we to know what his/her focus will be.

    That said. One way to narrow your field would be to focus on things that are generally held to be "nurses problems" as opposed to Doctor's problems, or Social worker's problems. Nurses are the folks who are on ground zero regarding getting the patient to take his meds. We are the ones who run the "medication education" groups. So Med compliance is a good nursing focus.

    Similarly nutrition is a primary nurse problem. It will be the nurses who document exactly what the patient's intake actually is. It will be nurses who have to try to make him eat when he is unwilling.

    Delusions and paranoia are primary symptoms of the diagnosed illness and therefore are to be delt with by the physician. Relationship issuses might be a social work or a therapy issue. All psychotic patients need to have someone in their lives that they will trust, but their partner may not be an inherently trust worthy person. Sick folks often have sick partners.

    Psych nursing is a vital part of the treatment team, but it is part not the whole.
  5. by   wilbur's mom
    Hi! Amy,
    How cool is this! Homework help from friends is the best kind. I am a NY nursing instructor. Don't bother to read my mind, it is so over stuffed, the contents vary from class to class. Do you need to write what would be a Care Plan and Case study? Do you use N.A.N.D.A. statements? If not, they might give you clues for your paper. We teach A.D.P.I.E., which is Assessment, NURSING Diagnosis, Planning, Implementation and Evaluation based on the ABC's of CPR. and make our students write 3 part statements that 1) State the Problem, 2) Related to 3) as evidenced by. For example,
    Pain related to s/p ORIF as evidenced by HR 130, facial grimacing and states pain "8" on the pain scale. And for a mental health patient, safety is a priority. sue.
  6. by   wilbur's mom
    Hi! Again,
    P.s. I think the list of terms you are referring to are Defining Characteristics and Supportive Data that need to be personalized to your patient. Assess which of those terms is applicable to this client. If they fit, then you can use that NANDA statement in your paper. I truly hope I haven't confused you more. I would help anyway I could, sue. p.p.s. Delusions and Paranoia are the Medical Dx, that the doc writes orders for, Safety, or "High Risk for Injury" related to that med. dx is what you the nurse write interventions for in the Plan of Care, i.e. Client will be kept under direct observation for the duration of the pschotic episode, behavior notes will be documented q15minutes. What you did is then evaluated to see "Did it work?" Was the pt. kept safe, so a goal statement could read... Injury or self harm was prevented, antipsychotic meds demonstrated good effect in 30 minutes.
    Clear as mud???? Good luck with your paper. Taber's Medical Dictionary might be helpful, too.