![]() "risk for" means an anticipated problem and no evidence of the problem exists yet.The assessment and management of impaired skin integrity as part of wound care is a common nursing task. otherwise, use risk for infection r/t pressure of pins on skin surface. impaired skin integrity is defined as altered epidermis and/or dermis. If the result of your initial assessment is the patient has evidence of open skin around the pins of the external fixation device then that is impaired skin integrity r/t presence of fixation pins. support the deterioration of the patient's condition/problem.stabilize the patient's condition/problem.improve/remedy of the patient's condition/problem.outcomes (the result of our interventions), whether we like it or not, that made me wonder what that nurse does about the things they can't prevent or do any interventions for? sweep them under the rug, look the other way and pretend that they don't exist? do i want that person as my nurse? rns are problem solver, folks. i've read one reply you've gotten in particular that says a nursing diagnosis should focus "on things i can fix or prevent or otherwise intervene in". the care plan is then a determination of the person's nursing problems and strategies to do something about them. When you are doing a care plan it is like taking a snapshot of the patient except that instead of getting a picture you are determining their nursing problems. He is going to need fiber or something to keep his pooper moving too. FOOD! LOTS AND LOTS OF FOOD! All this business is going to increase his nutritional requirements right? Healing requires protein. Teach him how to cope with pain without meds.find that threshold. Teach him how to use his pain meds.break through meds, kickers etc. Even if he can't make a drastic position change.maybe he can make freq small changes in between your q1h or q2h position shifts. Teach your patient how to help you help him.or better yet.teach him how to help himself. You know what connects all of these together to make a master Dx? Teaching! Make sure to make teaching a priority. Powerlessness is eh.I wouldn't say that statement demonstrates "powerlessness." Is he feeling powerless or more like he is having a role performance alteration? Ineffective tissue perfusion is going to be a biggy. Risk for constipation is a good one too.boring but often over looked. ![]() My advanced med surg prof hated when we would us pain.he said, "DAMN IT! That's a given! Show me you guys are thinking!" lol Never stopped me from using it as filler though lol. Pain is good but boring.I think I used pain in every single care plan I have ever made in school. I used powerlessness because he states, "I don't know how I am going to make the house payments and take care of my wife." I also included ineffective tissue perfusion because we were given the information of overall pallor as well as a Hgb of 8.2 and a HCT of 29.6% I also have the nursing diagnosis' of acute pain, risk for infection, and risk for constipation. Nursing diagnosis should focus on things I can fix or prevent! That'll certainly guide my thinking from here forward. Thank you Bug Out! This was exactly what I was struggling with as far as going with the "risk for" or straight to the "impaired skin integrity". The Sx wound is intentional, are you going to take measures to undo the Sx wound? Infection, pain, tissue breakdown etc.Ĭan you fix the Sx wound? Certainly you can prevent infection but that is another direction. Granted his skin integrity is impaired from the Sx wound but I like to focus Nursing Dx on things I can fix or prevent or otherwise intervene in.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |