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Silly Nursing DX question

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by elby812 elby812 (Member)

elby812 specializes in Cardiac.

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Perhaps a silly question...We've just began doing these so please bear with me.

Can you have two etiologies in P.E.S. format?

As in, Risk for infection r/t open laceration on on left leg and impaired healing due to diabetes mellitus.

And am I right in thinking because this is a risk for dx there is not an a.e.b part to it??

Thank you! I've been going through my care planning book but I think its just confusing me more.

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DutchgirlRN has 33 years experience as a ASN, RN and specializes in OB, M/S, HH, Medical Imaging RN.

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Risk for infection r/t open laceration on on left leg and impaired healing due to diabetes mellitus.

And am I right in thinking because this is a risk for dx there is not an a.e.b part to it??

Thank you! I've been going through my care planning book but I think its just confusing me more.

I would think if there are no current s/s of infection that it would have to be a risk for dx.

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Your questions aren't silly. You are learning. These were hard for me too at first. You would want to put risk for infection r/t break in first line of defense (skin). Also, be careful about using the medical dx such as "DM" in your nursing diagnosis. Thats a big no no. Although, honestly I can't tell you what to put in place of that...and I don't have my care plan book with me right now. I don't know about having two. I just finished my first semster of ADN program and we only did one. We don't start doing two til next semester. I wouldn't put that on there unless you do the a.e.b. part, interventions, rationale, ect for each nursing diagnosis. Hope that helps some.

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elby812 specializes in Cardiac.

123 Posts; 1,923 Profile Views

Thanks guys for the help. Really appreciate it!!

I think I'll just go with using one etiology and see what the professor says.

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Daytonite has 40 years experience as a BSN, RN and specializes in med/surg, telemetry, IV therapy, mgmt.

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Your nursing diagnostic statement will be Risk for Infection R/T inadequate primary defenses (broken skin) and chronic disease. You may or may not include the broken skin in the statement. However, remember that the skin is a primary defense to the invasion of bacteria into the body. When the surface of the skin has been broken, a primary body defense has been compromised. That is one etiology. Diabetes is a chronic disease. We know that people with diabetes have circulation problems and difficulty with wound healing. That is a second etiology that establishes a risk for infection. This is why it is important to know the pathophysiology of what is underlying your patient's problems. If you want to include the diabetes in your nursing diagnostic statement a way you can do that is like this (if your instructors will allow it): Risk for Infection R/T inadequate primary defenses (broken skin) and chronic disease secondary to diabetes mellitus.

The answer to your initial question is, yes, you can have more than one etiology when you form a nursing diagnostic statement (P.E.S. format). Just be sure that both etiologies are causes of the anticipated infection in the patient. Your nursing interventions are basically to prevent and/or monitor for the signs and symptoms of infection in this wound.

For your reference, the risk factors ("related to" etiologies) that NANDA lists for the diagnosis of Risk for Infection are as follows and I've highlighted the ones pertaining to your patient:

  • Chronic disease
  • Inadequate acquired immunity
  • Inadequate primary defenses (broken skin, traumatized tissue, decrease in ciliary action, stasis of body fluids, change in pH secretions, altered peristalsis)
  • Inadequate secondary defenses (decreased hemoglobin, leukopenia, suppressed inflammatory response)
  • Increased environmental exposure to pathogens
  • Immunosuppression
  • Invasive procedures
  • Insufficient knowledge to avoid exposure to pathogens
  • Malnutrition
  • Pharmaceutical agents (e.g., immunosuppressants)
  • Rupture of amniotic membranes
  • Trauma
  • Tissue destruction
  • page 124, NANDA-I Nursing Diagnoses: Definitions & Classification 2007-2008 published by NANDA International.

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elby812 specializes in Cardiac.

123 Posts; 1,923 Profile Views

Wow, thank you Daytonite! Very helpful!

I guess this will just easier the more I practice....

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