Relationships between diagnosis and co-morbidities

[sassychassy8503]

Hey! I am doing a clinical care packet (my first) and am a little confused about how to relate the co-morbidities to the diagnosis.

My client's main diagnosis is acute renal failure secondary to dehydration.

Her co-morbidities are:

Dementia, CAD, HTN, Hiatal hernia, Cardiomegaly, Steroid Dependent Rhuematoid Arthritis, Gout, GERD, Glaucoma, and depression.

I found a connection between most of them but I am having trouble with depression, glaucoma, GERD, and hiatal hernia... could someone please help with this or direct me to a source that could help?

Thanks! :)

[Bobylon]

Hey! I am doing a clinical care packet (my first) and am a little confused about how to relate the co-morbidities to the diagnosis.

My client's main diagnosis is acute renal failure secondary to dehydration.

Her co-morbidities are:

Dementia, CAD, HTN, Hiatal hernia, Cardiomegaly, Steroid Dependent Rhuematoid Arthritis, Gout, GERD, Glaucoma, and depression.

I found a connection between most of them but I am having trouble with depression, glaucoma, GERD, and hiatal hernia... could someone please help with this or direct me to a source that could help?

Thanks! :)

Just a (possibly worthless) thought, but is it not possible that there is no correlation between those you can't connect. It's possible for a pt to have multiple problems that have nothing to do with one another, no ?? Just a thought....I obviously may be wrong.

[Daytonite, BSN, RN]

co-morbidities is an interesting term. it is a way of dividing up medical diagnoses. i have only seen it used in relation to the coding of medical diagnoses, but i can see how it can be applied to nursing care. are you doing a care map? medicare and coders define co-morbidities as pre-existing conditions that affect the principle reason for admission and cause an increase in a persons hospital stay (affect their care during the admission). the way coders distinguish principle diagnoses from co-morbidities is based upon how much attention and treatment is being given by the doctor to any particular medical diagnosis.

now, your nursing program may be giving you similar instructions (i'm just guessing here). what is principle is/are the conditions you are focusing your care upon. that would probably be the acute renal failure, for sure. the dehydration was probably a result of the acute renal failure (arf) or vice versa. and unless you can show through pathophysiology that any of the other medical diagnoses led to the arf and dehydration, all the rest are not significant to the patient's care.

that may be a different story for the nursing care. while the acute renal failure takes up nursing time (ivs, meds, test pre). if symptoms of dementia lead you to nursing problems such as confusion or incontinence then nursing might consider the dementia to be a co-morbidity because nursing also spent a lot of nursing time attending to the confusion and incontinence. for nursing, dementia could be considered a co-morbidity.

that's about all the help i can offer you since you mention nothing else about the care rendered.

[sassychassy8503]

Thanks! That helped me better understand how to connect them together :)