Trouble with relating medical dx to nursing dx

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Hi, if anyone can give me a little direction it would be appreciated.

My medical diagnosis is right arm suppurative thrombophlebitis.

However the patient has been on the floor for 10 days and has no pain and is an IV drug user and wants to leave the hospital desperately ... the patient needs to finish their IV antibiotic therapy first however.

My supporting subjective and objective data consist of the patients statements about wanting to leave, and observations of the patients pacing, leaving the floor at every opportunity.

I want to use a nursing diagnosis of: deficient knowledge r/t lack of interest in learning aeb patients statement of "I want to leave"... something like that...

What I don't get is, does the supporting evidence have to relate to thrombophlebitis or no?

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Specializes in Complex pedi to LTC/SA & now a manager.

No but the r/t - AEB MUST be listed as a related factor in the nanda-I 2012-2014. I don't have my book right now but I can check when I get home.

Is this the most relevant nursing diagnosis for your patient?

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hi, thank you for your response! i believe it is, i am just looking in my book and the other nursing diagnoses listed for thrombophlebitis are ineffective peripheral tissue perfusion, which doesnt really apply because they have no edema, normal cap refill, normal skin color.. the other ones are acute pain (they are not in pain), and risk for impaired physical mobility (not applicable because the thromboplhebitis is in their arm).

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another question: would an appropriate "teach" intervention be to discuss safe iv drug injection with the patient? this is more of a harm reduction approach, i just dont know if its appropriate as a nurse to deliver such info.

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Specializes in Complex pedi to LTC/SA & now a manager.

Page 204 of NANDA-I

Deficient knowledge : absence or deficiency of cognitive information related to a specific topic

Defining characteristics:

-exaggerated behaviors

-Inaccurate follow- through of instruction

-Inappropriate behaviors (hysterical, hostile, agitated, apathetic)

-Reports the problem

Related factors:

-cognitive limitation

-information misinterpretation

-lack of exposure

-lack of recall

-lack of interest in learning

-unfamiliarity with information resources

There is also a nanda-I of noncompliance that may be better suited than knowledge deficit

Impaired mobility does not only refer to walking. NANDA defines impaired mobility as : limitation of independent, purposeful physical movement of the body or one or more extremities

Defining characteristics include limited ability to perform fine motor skills (hands/arms are fine motor) and limited ROM r/t discomfort, musculoskeletal impairment, neuromuscular impairment, pain

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thank you very much! i will look up noncompliance and see if that is more suitable

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Specializes in Hospice.

Your nursing dx are not supposed to "match" your medical dx. It is only what YOU can do as an intervention for that pt based on what YOU see, not what his medical dx is. That is how I was taught as well as many of the famed crusty old bats here will tell you.

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Specializes in Cath/EP lab, CCU, Cardiac stepdown.

Your nursing diagnosis should be based on your assessment. If you can't back it up with your assessment then it's not good. Do not pigeon hole yourself into making diagnosis based on medical diagnosis. If they're not showing the signs (assessment) then the nursing diagnosis at best would be at risk, which usually isn't a priority. So do not ever feel the need to relate back to the medical diagnosis unless you have your own assessment to back it up.

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What did your assessment show? What did the nurse spend most of her time doing with the patient? Why is the patient hospitalized and not getting antibiotics via PICC at home?

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Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.
Your nursing dx are not supposed to "match" your medical dx. It is only what YOU can do as an intervention for that pt based on what YOU see, not what his medical dx is.

This is what I was taught. Well said Lorinrn2b!

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It is absolutely appropriate to teach about safe iv drug use, there are needle exchange programs, disinfecting with bleach etc. You can find articles to teach not only the patient, but yourself for future patients. The drug epidemic will only worsen abd we need to be prepared.

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another question: would an appropriate "teach" intervention be to discuss safe iv drug injection with the patient? this is more of a harm reduction approach, i just dont know if its appropriate as a nurse to deliver such info.

There was a patient at clinicals who was an IV drug user (heroin) and was in the hospital due to a nasty infection from injecting with a dirty needle. The RN actually went in and taught him how to cleanly inject himself...her whole point being that he was going to do it, let's make sure he knows how to do it RIGHT so he doesn't land back in hospital with another infection. You deal with and address your patient's needs.

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