Sunday, March 1, 2015

Nursing Diagnoses

Nursing diagnoses differ from medical diagnoses. Simply put by NANDA (North American Nursing Diagnosis Association); "A medical diagnosis deals with disease or medical condition. A nursing diagnosis deals with human response to actual or potential health problems and life processes." (1)

Nursing diagnoses are statements explaining the problem with relation to the source and if patient interaction has taken place, the addition of evidence (signs/symptoms) to support is preferred. For example, a person medically diagnosed with asthma could have a nursing diagnosis of ineffective airway clearance related to bronchial constriction, as evidenced by increased mucus and wheezing. Many medical diagnoses are one word pathologies. Nursing diagnoses are statements which include more depth, making the problem individualized to each patient. 

When considering diagnoses for atrial fibrillation there are several possibilities. The following are just some of these.

1. Activity intolerance related to decreased cardiac output

2, Decreased cardiac output related to altered electrical conduction

3. Fear related to threat of death, change in health status.

4. Risk for ineffective cerebral tissue perfusion related to decreased cardiac output.    

5. Ineffective health maintenance related to deficient knowledge regarding self-care with disease.

The 5th example can be universal to all conditions and I hope this blog is a source which provides the necessary knowledge to be effective with health maintenance for AF.

Ineffective health maintenance:

Actual or potential goals
Related to
Plan and outcome
Nursing intervention
·         Patient will explain in simple form what AF is and the risks involved
·         Patient will explain how anticoagulant therapy is crucial for health maintenance and the risks involved with not taking it as well as side effects possible from taking it
·         Patient will identify the lifestyle changes that will promote health maintenance for a person living with AF



·         Denial of disease
·         Disbelief in effectiveness of therapies
·         Cognitive impairment
·         Complicated grieving
·         Deficient communication skills
·         Diminished motor skills
·         Inability to make appropriate judgments
·         Ineffective coping
·         Insufficient resources (finances, equipment, etc…)

·         Discuss fear of or blocks to implementing health regimen
·         Follow mutually agreed on health care maintenance
·         Meet goals for health care maintenance

·         Educate about atrial fibrillation
·         Use teach back methods to confirm teachings have been understood
·         Provide resources for patient reference and ease of access


References:

1.     (2015, March 1). Retrieved February 26, 2015, from http://kb.nanda.org/article/AA-00266/0/What-is-the-difference-between-a-medical-diagnosis-and-a-nursing-diagnosis-.html
2.     Ladwig, G., & Ackley, B. (2011). Guide To Nursing Diagnosis (3rd ed., p. 52, 405). Maryland Heights, Missouri: Elsevier.