Teaching plan diagnosis

[THELIVINGWORST, ASN, RN]

I am waiting for my instructor to email me back about my teaching plan. I was wondering if you guys think this is appropriate.

"The patient that I chose was admitted for dyspnea and SOB but was recently diagnosed with lung cancer. I was wondering if I am on the right track with my teaching plan.

What I have so far is Knowledge Deficit RT pneumonia and lung cancer disease processes aeb complaints of SOB and dyspnea.

I think that she needs to be educated on the possible sequelae of lung cancer and why she is at a higher risk of pneumonia and aspiration."

I don't want to start writing if this isn't appropriate. I do not have a NANDA book right now.

Thanks in advance

[nurseprnRN, BSN, RN]

1) "Related to" in care planning means "caused by." She doesn't have a knowledge deficit because she has pneumonia and lung cancer cancer.

2) "AEB" means "as evidenced by." These are the things that demonstrate your reason for making the diagnosis or conclusion. For example, "I think my 3-year-old nephew got into the pudding as evidenced by the chocolate all over his hands, face, and clothing." SOB and dyspnea doesn't tell you that she has a knowledge deficit.

3) Get the book. Free 2-day shipping for students from Amazon-- order it today (Monday), have it by Wednesday. Do not put this off any longer.

A nursing diagnosis statement translated into regular English goes something like this: "I think my patient has ____(nursing diagnosis)_____ . I know this because I see/assessed/found in the chart (as evidenced by) __(defining characteristics) ________________. He has this because he has ___(related factor(s))__."

"Related to" means "caused by," not something else. In many nursing diagnoses it is perfectly acceptable to use a medical diagnosis as a causative factor. For example, "acute pain" includes as related factors "Injury agents: e.g. (which means, "for example") biological, chemical, physical, psychological."

To make a nursing diagnosis, you must be able to demonstrate at least one "defining characteristic" and related factor. Defining characteristics and related factors for all approved nursing diagnoses are found in the NANDA-I 2012-2014 (current edition). $29 paperback, $23 for your Kindle at Amazon, free 2-day delivery for students. NEVER make an error about this again---and, as a bonus, be able to defend appropriate use of medical diagnoses as related factors to your faculty. Won't they be surprised!

If you do not have the NANDA-I 2012-2014, you are cheating yourself out of the best reference for this you could have. I don’t care if your faculty forgot to put it on the reading list. Get it now. When you get it out of the box, first put little sticky tabs on the sections:

1, health promotion (teaching, immunization....)

2, nutrition (ingestion, metabolism, hydration....)

3, elimination and exchange (this is where you'll find bowel, bladder, renal, pulmonary...)

4, activity and rest (sleep, activity/exercise, cardiovascular and pulmonary tolerance, self-care and neglect...)

5, perception and cognition (attention, orientation, cognition, communication...)

6, self-perception (hopelessness, loneliness, self-esteem, body image...)

7, role (family relationships, parenting, social interaction...)

8, sexuality (dysfunction, ineffective pattern, reproduction, childbearing process, maternal-fetal dyad...)

9, coping and stress (post-trauma responses, coping responses, anxiety, denial, grief, powerlessness, sorrow...)

10, life principles (hope, spiritual, decisional conflict, nonadherence...)

11, safety (this is where you'll find your wound stuff, shock, infection, tissue integrity, dry eye, positioning injury, SIDS, trauma, violence, self mutilization...)

12, comfort (physical, environmental, social...)

13, growth and development (disproportionate, delayed...)

Now, if you are ever tempted to make a diagnosis first and cram facts into it second, at least go to the section where you think your diagnosis may lie and look at the table of contents at the beginning of it. Something look tempting? Look it up and see if the defining characteristics match your assessment findings. If so... there's a match. If not... keep looking. Eventually you will find it easier to do it the other way round, but this is as good a way as any to start getting familiar with THE reference for the professional nurse.

So... think about nursing diagnosis the way it works, and see how you could rework your observations about her knowledge, her presenting symptoms, your assessment of her knowledge deficits as evidenced by ( by what? things she says? misconceptions she communicated to you?) and her needs into a knowledge deficit teaching plan.

[THELIVINGWORST, ASN, RN]

Thank you for the response! I actually spoke with my instructor and I changed it to

Knowledge deficiency RT new diagnosis of lung cancer and pneumonia aeb pt stating that she doesn't "know what the connection is between my cancer and pneumonia. I don't know what happens when someone gets lung cancer".

Sidenote: I have no money, if I could buy the book I would.

[Esme12, ASN, BSN, RN]

The book isn't expensive like $22.00 and Amazon gives student discounts...you are going to be using this book A LOT. without it you can't do care plans or any case studies...this book should be on your MUST have list.

[THELIVINGWORST, ASN, RN]

The book isn't expensive like $22.00 and Amazon gives student discounts...you are going to be using this book A LOT. without it you can't do care plans or any case studies...this book should be on your MUST have list.

I've literally got $50 for the next week. My school paid for my books but I couldn't keep my first semester books so I really can't.

I'm going to borrow it from the library I guess.

[Esme12, ASN, BSN, RN]

((HUGS))....I know things are tough....here is a link to the list of diagnoses from NANDA itself.....NANDA LIST: Complete List of Nanda of Nursing Diagnosis 2012-2014 and here...... nursing diagnoses 2012 - 2014.pdf‎ I know Amazon rents the REALLY cheap.

[nurseprnRN, BSN, RN]

For what it's worth, just having the list of the diagnoses and even the definitions, while far better than nothing, is not enough to assure that you're getting it right. We see students all the time who pick a sexy-sounding nursing diagnosis off a list, but without knowing the NANDA-I required defining characteristics and assessing their patients for them, they don't get it right very often.

Christmas is coming...perhaps Santa would advance you the book because you've been a very good girl this year? Worth an ask.

[THELIVINGWORST, ASN, RN]

Thanks guys ? I've got the resources for the book on evolve and it's got a list of diagnosis with defining characteristics and outcomes with interventions for them but I was mostly confused on how to word a teaching diagnosis with RT and aeb.

I decided to assess the pts knowledge of her diagnosis and the treatment for it. Since she couldn't explain her diagnosis and what caused it and subsequent pneumonia, my diagnosis wa related to unfamiliarity with new disease process aeb pt stating a lack of understanding etc etc.

[Stella_Blue]

I agree. I probably use my nursing dx book more than any other book Ive ever bought in nursing school except maybe my drug book. I bought it in my LPN program 2 years ago and am using the same one now in my bridge. They just released a new edition and Ill probably go ahead and buy that one too. I really suggest you invest in one. Your care plans will thank you!

[THELIVINGWORST, ASN, RN]

What's ironic about this is that I LOVE patient teaching. It's my favorite part of nursing because "knowledge is power" lol

[THELIVINGWORST, ASN, RN]

@GrnTea just wanted to tell you that I borrowed the newest Ackley book from one of my coworkers. Thanks for all the advice!