Q about "risk for" diagnosis

jerryh55 · Nov 25, 2004

Nursing instructor #1 tells me that my "risk for" diagnoses cannot be a three-part diagnosis because how can you have evidence of something that hasn't happened yet.
Nursing instructor #2 asks me where is the third part of my "risk for" diagnosis. I tell her the rationale that I was taught about how a 3-part diagnosis is not appropriate for "risk for". She insists that it's not so and I must have the "as evidenced by" statement.
Can someone please direct me to an authoritative source on this one?
Tanky!! These instructors are driving me up a wall with their contradictions.
Kat

Hey Kat, can't direct you somewhere to help, but did have my care plan bled on for having used as evidence by. Was told by 2 insturctors that a Risk For does not have the AEB part in it. Know this doesnt answer ur question, just wanted u to know how our instructors are.

Have A Great Day

Jerry

RN06 · Nov 25, 2004

Jerry, I too was told that Risk for Dx's don't have AEB. I don't know why your instructors is saying that.

Example, instructor once gave:

Risk for falls

R/T the use of assistive devices.

The patient hasn't fallen yet and you have no proof or AEB that he ever will, but the risk is there because he uses a walker.

Whereas

Impaired Skin Integrity

R/T decreased mobility

AEB Stage II decubitis ulcer to coccyx

The pt has impaired skin integrity

because of decrease mobility and you can "prove" it by AEB: the ulcer

Perhaps you should meet with both instructors. Maybe one can rationale why she is choosing to use 3 part statements, or she misunderstood you.

Hope I helped.

crb613, BSN, RN · Nov 25, 2004

I don't know where to send you to either but if it's a risk for how do you know when it happens(or what to look for) if you don't have an AEB? I have gotten 100% on all of my careplans except the 1st & it was 95%. I always use AEB on my at risk for's. I guess it depends on the instructor.

shel_wny · Nov 25, 2004

Risk for does not have an AEB at my school.

That's why it's a risk.

Euphrosyne7, MSN, RN · Nov 25, 2004

Hi

we have one instructor who insists that if it is a risk for, it MUST have AEB, and another who just wants the two part.

Also we have an instructor who told us that if we have a diagnosis, we can use r/t (a medical term) while others are saying we cannot use r/t (a medical term)...........

I think it all may depend on the instructor.....makes things a lot more confusing that's for sure.

I have not been able to find any specific references regarding any of these either...good luck

BBFRN, BSN, PhD · Nov 25, 2004

http://www.nanda.org/

Here's a link to the NANDA site- you might find what you need here.

Altra, BSN, RN · Nov 25, 2004

I hate to say it, but I think your instructor is combining/confusing the "related to" part of the dx and the AEB. How can you have evidence of something that hasn't happened yet? The "At Risk" diagnoses are applicable when there are factors/conditions present that put a person at risk for some adverse outcome, but the adverse outcome hasn't yet occurred, and the goal/outcome of the nursing interventions is to prevent the occurrence. The risk is related to impaired mobility ... whatever. But there is no evidence.

Sorry if I'm going in circles with this -- too much coffee already this morning. :rolleyes: :chuckle

kathy_79 · Nov 25, 2004

you suppose to have some explanation at your fundamental nursing book. there is no AEB for risk dx, you put only current status (include your subjective and ibjective data). this is risk for so there cannot be any signs of and symptoms of anything: ex infection. you susspect but there is no evidence, you want to write your interventions and rational how to prevent it, that is why it is "risk for...". i would fail my care plan now if i would put AEB for "risk for...". i can give you example from book which i use at my school craven "fundamental of nursing. human health and function."

ACTUAL nur dx: three part statement includes diagnostic label, related factors, defining characteristics, ex: acute pain r/t surgical trauma and inflammation AEB grimacing and verbal reports of oain.

RISK FOR nur dx: two part statement includes diagnostics label, risk factors, ex: risk for infection R/T surgery and immunosupression.

i hope it helps, :)

rnmi2004 · Nov 25, 2004

I just went to my Ackley & Ladwig Nsg Dx book to check the "Risk for" diagnoses (infection, injury, falls, etc.). None of these categories includes a "defining characteristics" section, which you normally would get the AEB from. Maybe you could show your instructor what the book says & see if you can get some agreement on this issue.

wonderbee, BSN, RN · Nov 25, 2004

I just went to my Ackley & Ladwig Nsg Dx book to check the "Risk for" diagnoses (infection, injury, falls, etc.). None of these categories includes a "defining characteristics" section, which you normally would get the AEB from. Maybe you could show your instructor what the book says & see if you can get some agreement on this issue.

I have that book, among others. I'll check it out. Thanks!

FuturenurseCA&O · Nov 25, 2004

At our school "risk for" is also 3 part:

Nursing diagnosis

R/T statment (cause)

Secondary to: (medical diagnosis)

AEB: objective/subjective data that leads you to believe there is a risk.

(other AEB statements are objective/subjective data that supports the diagnosis.)

Example:

Risk for infection r/t inadequate primary defenses (broken skin)

Secondary to: Diabetes Mellitus, Acute Renal Failure

AEB: Multiple lesions & scars on forearms, active wound on leg, compromised ambulation for ADLs, dehydration.

Oh! And make sure everything that you put as AEB is supported in your nursing assessment/database.

Hope that helps. In short, just like you can see a problem for a diagnosis, you can also see a risk for a potential diagnosis. That is what AEB is all about. But it is your instructor's call. If they don't want it in, don't put it in, but in all cases make sure your support for the risk is in your nursing assessment/database.

Toodles~

Futurenurse :)