Readiness for enhanced family processes r/t?

Esme12, ASN, BSN, RN · Feb 13, 2013

Anticipatory guidance for what? Since care plans are all about the assessment......there is not enough information here to help you. What is the enhanced family process...tell about your patient and their family.

Let the patient/patient assessment drive your diagnosis. Do not try to fit the patient to the diagnosis you found first. You need to know the pathophysiology of your disease process. You need to assess your patient, collect data then find a diagnosis. Let the patient data drive the diagnosis.

What is your assessment? What are the vital signs? What is your patient saying?. Is the the patient having pain? Are they having difficulty with ADLS? What teaching do they need? What does the patient need? What is the most important to them now? What is important for them to know in the future. What is YOUR scenario? TELL ME ABOUT YOUR PATIENT...:)

The medical diagnosis is the disease itself. It is what the patient has not necessarily what the patient needs. the nursing diagnosis is what are you going to do about it, what are you going to look for, and what do you need to do/look for first. From what you posted I do not have the information necessary to make a nursing diagnosis.

Care plans when you are in school are teaching you what you need to do to actually look for, what you need to do to intervene and improve for the patient to be well and return to their previous level of life or to make them the best you you can be. It is trying to teach you how to think like a nurse.

Think of the care plan as a recipe to caring for your patient. your plan of how you are going to care for them. how you are going to care for them. what you want to happen as a result of your caring for them. What would you like to see for them in the future, even if that goal is that you don't want them to become worse, maintain the same, or even to have a peaceful pain free death.

Every single nursing diagnosis has its own set of symptoms, or defining characteristics. they are listed in the NANDA taxonomy and in many of the current nursing care plan books that are currently on the market that include nursing diagnosis information. You need to have access to these books when you are working on care plans. You need to use the nursing diagnoses that NANDA has defined and given related factors and defining characteristics for. These books have what you need to get this information to help you in writing care plans so you diagnose your patients correctly.

Don't focus your efforts on the nursing diagnoses when you should be focusing on the assessment and the patients abnormal data that you collected. These will become their symptoms, or what NANDA calls defining characteristics. From a very wise an contributor daytonite.......make sure you follow these steps first and in order and let the patient drive your diagnosis not try to fit the patient to the diagnosis you found first.

nurseprnRN, BSN, RN · Feb 13, 2013

When you look at your NANDA-I 2012-2014 (free 2-day shipping for students from Amazon, and every student should have one even if the faculty forgot to put it on the bookstore list), what do you find there for defining characteristics? Have you assessed at least one in the family in question? (Hint: The only right answer is "Yes" ? ) That's your "As evidenced by," the data you assessed that enabled you to make the diagnosis.

There may or may not be a "related factor" in the NANDA-I.... I will leave you to find that out. If there isn't you don't need to give one. Order it today and you'll have it by Friday.

What the heck is "anticipatory guidance," and how do you think that fits into this diagnosis? I'm not seeing anything like that in the NANDA-I.

love_heal_yoga · Feb 20, 2013

Thank you both for the wonderful feedback.

Esme12, sorry my initial question was short on detail. I was mainly just wanting to know the technical aspect of whether or not to include a r/t factor in my "Readiness for..." diagnosis. The assignment was to conduct a family assessment of a hospitalized pediatric patient, in addition to providing nursing care. Based upon the family assessment alone, I was to create a nursing diagnosis. The actual care plan for the family is a later task, and will be combined with specific nursing diagnoses for the hospitalized pediatric patient.

I identified the family as operating in the stage of an adult family based upon family assessment data, such as:

-The family has four children between the ages 6-12.

-The family seemed to cope well with the recent hospitalization of a child

-The parents both work full time; both parents had flexibility with taking leave to care for the hospitalized patient

-The family manages another child's chronic illness well

-The communication between parent and the hospitalized child was supportive; the communication with the nurse (in my case, the student nurse) was on a professional level.

I also needed to identify the needs of the family and that is where I included the term anticipatory guidance. Honestly, this term is very new to me, so I could be using it wrong. I used anticipatory guidance as a need, because I did not identify one for the family, otherwise. My understanding of anticipatory guidance is that it is used to provide families guidance on upcoming developmental needs and family education on health-maintenance and prevention.

I have read tons of Daytonite's posts. They are extremely helpful and have calmed my nerves about the task of writing a nursing care plan. I will utilize those and your feedback, as well. Thank you.

GrnTea your post just made my night! If only I knew to the answer to adding "R/T," or not. I will begin saving pennies for that book or just suggest my school's library to carry it. :) Thanks again!

nurseprnRN, BSN, RN · Feb 20, 2013

OK, thanks for the update. Good work.

The definition is, "A pattern of family functioning that is sufficient to support the well-being of family members and can be strengthened." That would seem to include the "anticipatory guidance" thang.

That diagnosis has no related-tos. You're good with just listing your defining characteristics (the "as evidenced bys" you found on your assessment). In your case, from the list you give above, some of them might be, "Family adapts to change; family functioning meets needs of family members; family resilience is evident; family roles are flexible for developmental tasks; relationships are generally positive; communication is adequate; energy level of family supports activities of daily living; activities support the safety of family members..." There are more on the list, but from your description I think some of these might work (you would have to say why you thought the ones you chose worked for this family).

The book is $27, cheap ? If you have a Kindle you can get it for half that.

nguyency77, CNA · Feb 28, 2013

If it's a wellness nursing diagnosis, I think it has to be only one part.