write a nursing diagnosis related to this patient condition

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please help....I just started nursing school. i got this scenario ....would appreciated if someone could explain and help me with this.

This patient was admitted to a hospital due to severe weakness. he is 25 yrs old male asian...O X 4. initial VS...98.3t, 112 pulse, 92/60 bp, 20 res, spO2 89% on room air. patient verbalizes pain to left upper abdomen 6/1-10. lab work CBC revealed hemoglobin level of 8.2. EGD. show bleeding gastric ulcer.

past med his...gastric ulcer, diabetes mellitus type II, HTN, drinks 4 glasses of wine/day, smokes 1 pack of ciga/day.

currently on med...Glucophage 1000 mg daily for Diabetes Mellitus and Pericardia XL 10 mg daily for HTN.

Please help find a nursing diagnosis related to this patient's condition.

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Well you could do something for his Oxygen....That's pretty low for someone that young with no respiration condition.

Acute pain

Anemia - Weakness, bleeding

Ineffective health maintanence - smoking, drinking, DM

He's got a Hx of HTN but is he on meds? His blood pressure is low even with a gastric bleed.

Do you have a nursing care plan book? I think the one I have is a nanda one.

This guy is a train wreck and a ton of plans can be made from him but I would first start with breathing, then pain...

Hope that helps.

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Your problem is blood loss from the ulcer.

Deficient fluid volume, etc. Lots of things can stem from this. NANDA is turned off in my mind for the moment.

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Next time you come on here asking for homework help please at least give your thoughts first. We're here to help, not do it for you. There are a lot of factors with this patient, low O2 sat, bleeding ulcer, pain, DM, drinking, you had to have some ideas for diagnoses yourself.

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Specializes in LDRP.

can someone tell me what a&O x4 is? ive only heard of x3.. am i being an idiot? haha.. and OP: Please at least put some effort into your homework and we can help guide you, but dont expect people to do it for you.

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Specializes in ER, progressive care.
can someone tell me what a&O x4 is? ive only heard of x3.. am i being an idiot? haha..

I'm also wondering about the A&Ox4!

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A&O x 4 = Alert and oriented to person, place, time, and recent events that led up to medical situation.

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Person, place, time, situation

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