Teaching Nursing Diagosis

Posted
by thatgirl_sadie thatgirl_sadie (New) New

For my foundations class I have to come up with a teaching nursing diagnosis with a related to statement for a diabetic foot care. I was thinking about doing knowledge deficit, but I don't know what the objectives should be or the actual diagnosis.

This is the example that my teacher gave us: Dx: Knowledge deficit (Turn, Cough, Deep Breathe) r/t ineffective airway clearance secondary to postoperative pneumonia

Anything wil help! Thanks!!

AliNajaCat

AliNajaCat

1,035 Posts

Sigh.

"Related to" doesn't mean the same in nursing diagnosis as it does in regular English. In nursing diagnoses, "related to" mean "caused by" or "because of" or "due to." You are related to your brother, but your pain is related to your surgical incision. Lions are related to cheetahs, but deficient knowledge (page 257 in your NANDA-I 2015-2017 -- get it NOW) is related to alteration in cognitive function, alteration in memory, insufficient information, insufficient interest in learning, insufficient knowledge of resources, and/or misinformation presented by others, by definition.

Therefore, although somebody may, indeed, have deficient knowledge about his ineffective airway clearance and what to do about it, his deficient knowledge is not caused by his pulmonary illness. How do I know that? Because in the approved related factors for Deficient Knowledge, "pulmonary illness" (indeed, any illness) does not appear.

If your faculty wanted to recognize that the patient wasn't taking good care of himself because he had deficient knowledge about his disease process and self care maneuvers, then one possibility might be, perhaps, Ineffective health management related to insufficient knowledge of therapeutic regimen as evidenced by (those are the Defining factors, the things that when you see them you say, "Aha! That's how I know that's the diagnosis!" just like a low blood count indicates the diagnosis of anemia) perhaps "Pt states he never learned about coughing and deep breathing/cannot accurately demonstrate use of an incentive spirometer/did not understand teaching by RT due to language barrier."

Does that help?

Now, there is no such thing a a "teaching nursing diagnosis" per se. There are nearly infinite numbers of things nurses can teach to patients, and diabetes patients have a list of things they need to know as long as your arm.

I'll let you in on a little secret that your faculty (I HOPE) learned when she took her teaching / curriculum classes in grad school. Learning involves three different factors (called domains): cognitive, which is the factual content itself, the learning of data or facts; psychomotor, which is learning the hands-on, manipulative skills; and affective, which is basically the attitudinal component, the "why should we care?" part.

If I were looking at a diabetic who needed to learn something, I would look at all three of those in my prescribed actions (nursing plan, not medical plan of care) after I figured out my diagnosis.

So, using the above example, what can you think of that your patient needs to know, and why doesn't he know it? Then your interventions are aimed at removing his barriers to learning. And how you know he learned it is .... well, whatever you think. "Pt accurately states risk factors for... and reasons for ... Gives accurate return demonstration of .... States that in the future he will ..."

Go get 'em.