Take a look at my nursing dx!

[whiteoleander5]

I need some feedback. Thanks. :typing

1) Ineffective Tissue Perfusion R/T decreased hemoglobin blood concentration AEB swelling of legs and constant fatigue.

2) Fatigue R/T red blood cell deficiency and prolonged sadness AEB frequent napping, and excessive grogginess.

3) Chronic Pain R/T radiation tissue damage AEB client's pain scale rating of 10/10.

4) Hopelessness R/T deteriorated physiological conditions AEB decreased appetite, sleep pattern disturbance, and decreased response to stimuli.

5) Risk for Constipation R/T decrease in appetite, and client's statement "I have a bowel movement once every three days."

[whiteoleander5]

*Any help would be appreciated....*:bowingpur

[Daytonite, BSN, RN]

what kind of feedback are you looking for? you have provided no information about the patient so i can't tell if you diagnosed correctly or not.

the body system must be specified in the title of the diagnosis, ineffective tissue perfusion, according to nanda guidelines. check with your instructors about using "depression" instead of "prolonged sadness" with fatigue. depression is a listed related factor in the taxonomy. can't you be more patient specific on the symptoms of the hopelessness? they came right out of the taxonomy word for word. risk for constipation r/t decrease in appetite, or do you mean to say something like "not eating enough to form bulk"?

[whiteoleander5]

what kind of feedback are you looking for? you have provided no information about the patient so i can't tell if you diagnosed correctly or not.

the body system must be specified in the title of the diagnosis, ineffective tissue perfusion, according to nanda guidelines. check with your instructors about using "depression" instead of "prolonged sadness" with fatigue. depression is a listed related factor in the taxonomy. can't you be more patient specific on the symptoms of the hopelessness? they came right out of the taxonomy word for word. risk for constipation r/t decrease in appetite, or do you mean to say something like "not eating enough to form bulk"?

pt was admitted with anemia. she has bilateral edema on her legs, fatigue (she was napping all day), hx cervical cancer resulting in tissue damage of her gi tract from radiation treatment, and severe depression.

i'll have to find out about using the term "depression", they tell us not to use medical dx as our etiology... although, that sounds much better than "prolonged sadness".

ineffective peripheral tissue perfusion r/t decreased hemoglobin blood concentration aeb swelling of legs and constant fatigue.

hopelessness r/t deteriorated physiological conditions aeb decreased appetite, reluctance to get oob, and frequent daily napping.

thanks daytonite:wink2:

[Daytonite, BSN, RN]

the nanda taxonomy does use the term depression, but i would clarify with your instructors since some might consider it a medical diagnosis. but be prepared to point out that the taxonomy does use it.

ineffective peripheral tissue perfusion r/t decreased hemoglobin blood concentration aeb swelling of legs and constant fatigue.

ineffective tissue perfusion specify type: renal, cerebral, cardiopulmonary, gastrointestinal, peripheral

http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=55

this peripheral edema. . .is it because of the anemia or is it because of the previous treatment for the cervical cancer? how long ago was the radiation? was there surgery as well? were there any lymph nodes removed with surgery? the reason i ask is because if they did surgery and lymph node removal before radiation, it may be the cause of the swelling now and the anemia may just be a contributing factor. we had a lady in ltc who had had radiation therapy 10 years prior for cervical ca and had developed non-healing fistulas and edema of the pelvis and lower extremities. i am 12 years post radiation to the jaw and am having circulation problems. radiation, as the years progress, causes the blood vessels in the bone to shrivel up so that the blood supply to that area that was radiated is compromised.

i would not include fatigue as evidence of impaired perfusion. ineffective peripheral tissue perfusion is a physiological problem about hypoxia and fatigue is not really a true symptom of hypoxia.

fatigue r/t red blood cell deficiency and prolonged sadness aeb frequent napping, and excessive grogginess.

fatigue

http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=19

chronic pain r/t radiation tissue damage aeb client's pain scale rating of 10/10.

chronic pain

http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=41

hopelessness r/t deteriorated physiological conditions aeb decreased appetite, reluctance to get oob, and frequent daily napping.

hopelessness

decreased appetite - can you say something like "refuses to eat more than __% of meals" or "frequently refusing foods she always said she liked".

sleep pattern disturbance - "staying in bed ___ hours a day"

decreased response to stimuli - "doesn't pay attention to things going on around her", "self absorbed with own thoughts"

risk for constipation r/t decrease in appetite, and client's statement "i have a bowel movement once every three days."