Risk for delirium?

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We were talking in class the other day about "risk for delirium" and our teacher said it would make a great diagnosis. I happen to have a patient that fits the bill we discussed in class, but in both my diagnosis books, I can't find a risk for delirium dx...So what do I do if I can't find a resource?

I have 2 posts running, kind of silly, I know. She has redness on her sacrum. I looked in her chart and there was no mention of confusion. There was no family for the one day I was with her, but I spoke with another student that had her a few weeks ago and she didn't notice confusion.

My book has risk for electrolyte imbalance?

Is it possible to have impaired memory and acute confusion together?

Of course. I do it every day. :)

Look at the defining characteristics and related factors in the NANDA-I 2012-2014 and you'll see why.

Your book should have "RIsk for electrolyte imbalance," but that's not the same as having electrolyte imbalance. Does she or does she not?

You DO have that book, right? Free 2-day delivery from Amazon, or instant on your Kindle or iPad. Cheap.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I have 2 posts running, kind of silly, I know. She has redness on her sacrum. I looked in her chart and there was no mention of confusion. There was no family for the one day I was with her, but I spoke with another student that had her a few weeks ago and she didn't notice confusion.

My book has risk for electrolyte imbalance?

Is it possible to have impaired memory and acute confusion together?

I know you do...but to combine them now neither would make sense. Right, since she has an electrolyte imbalance you have to look at what the present imbalance can do....in this instance may be able to still say she is at further risk Of worsening) because of her ongoing diagnosis of renal disease and nutrition issues.
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I think she is risk for electrolyte, she has chronic kidney disease.

The books I have are Nursing Diagnosis Handbook 9th edition by Ackley and Nursing Care Plans by Myers. They were suggested by our school.

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Esme, risk for electrolyte imbalance r/t her chronic kidney disease and malnutrition...? These are her last 2 CMP's, the later actually shows improvement in sodium and potassium:

CMP 4/13/14: Na low @ 135, Potassium high @ 5.3, BUN high @ 49, Creatinine high @ 1.8, Albumin low @ 2.2, GFR abnormal @ 29.7

CMP4/14/14: BUN high @ 53, Creatinine high @ 2, Albumin low @ 2.3, Bilirubin high @ 1.3, AST high at 41, GFR abnormal at 26.3

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I use the 10th addition. But I also use the one TRUE guide to NANDA....the book itself. It is cheap around $20.00 on amazon with free shipping to students....Nursing Diagnoses: Definitions and Classification 2012-14

That may really help you "see the light"

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Ha, I need any light I can take right now!! I'll check it out!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I am ever confused on the hiding (not recommending) of this valuable resource. Just because it isn't listed doesn't mean you can't use it! I think they rent it for like $18.00.

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I know it sounds sad, but I'll have to wait for a little more extra income to buy it. 3 kids and nursing school has done a number on my wallet! But it's on my list on Amazon to buy!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Not odd at all....things are tight everywhere. Besides we are here to help.

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You can't make a diagnosis of "risk for electrolyte imbalance" if it already exists, any more than a physician can make a medical diagnosis of "risk for anemia" in an already-diagnosed anemic person. :)

Do what Esme suggests: What follows from electrolyte imbalance? What nursing diagnoses may declare themselves then?

And for heaven's sake, please understand that while the handbooks and care planning books reference the NANDA-I approved diagnoses because they must, since these are the only approved and validated nursing diagnoses, NANDA-I understandably does not give those publishers permission to reprint their entire work. So they are of necessity incomplete and not up to date besides (NANDA-I is updated q 3 years-- the last issue was 2009-2011, now 2012-2014, and the next edition will be 2015-2017). Diagnoses are added and subtracted for new evidence in each issue, so if you are using an out of date book, its nursing diagnoses are out of date too.

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As to Esme's (and my) continuing perplexity about why nursing schools hide the NANDA-I's light under a bushel, I believe it's because the faculty remembers the last really difficult edition, 2006-2008 (and prior ones), which was confusing, had a completely useless index, and was unnecessarily loaded with academic-speak and therefore very inaccessible to the average undergraduate-- and maybe a lot of faculty. I can see why someone who went to nursing school and suffered the pain of learning to plan nursing care with such a "resource" wouldn't remember it being of any utility and therefore be loath to assign it to students. This is not your auntie's NANDA, though.

Since the 2009 edition it has undergone a complete transformation. We wouldn't insist on students getting it stat all the time if it hadn't. It will really, really help you start to think like a nurse if you fool around in it and read individual pages now and then (one-two pages per diagnosis, easy-peasy).

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Specializes in Hospitalist Medicine.
As to Esme's (and my) continuing perplexity about why nursing schools hide the NANDA-I's light under a bushel, I believe it's because the faculty remembers the last really difficult edition, 2006-2008 (and prior ones), which was confusing, had a completely useless index, and was unnecessarily loaded with academic-speak and therefore very inaccessible to the average undergraduate-- and maybe a lot of faculty. I can see why someone who went to nursing school and suffered the pain of learning to plan nursing care with such a "resource" wouldn't remember it being of any utility and therefore be loath to assign it to students. This is not your auntie's NANDA, though.

Since the 2009 edition it has undergone a complete transformation. We wouldn't insist on students getting it stat all the time if it hadn't. It will really, really help you start to think like a nurse if you fool around in it and read individual pages now and then (one-two pages per diagnosis, easy-peasy).

We brought up the question of why we don't have the NANDA-I book in Fundamentals (we have a "Nursing Diagnosis Handbook") and the prof basically told us what you said. It's too complicated to read and understand for beginning level students. I should make a point of showing her that I get much more out of the NANDA-I book than I do from the diagnosis handbook. Especially now that I've got clinical paperwork that backs it up :)

I could see that having a confusing edition would make you not want to use it again. Good to know that they made helpful changes.

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