Question

Please help

71 y/o male has problem with Peripheral arterial disease. Hypertension. Type 2 diabetes. Coronary artery disease, and  amputation right BKA.

Please answer these w=question base on his problem

1. Nursing Process - Nursing Diagnosis:

Identify 3 physiological nursing diagnosis based on above assessed patient needs and nursing considerations. Develop two nursing diagnoses below. Must have at least one problem addressing patient’s admitting diagnosis.

Identify one (1) psychological nursing diagnosis based on above assessed needs.

2. (Nursing Diagnosis #1)

State rationale for choosing this diagnosis

Nursing Process: Planning and Intervention: Goals and Interventions: Develop one goal and four interventions for each diagnosis. One intervention should include patient education.

Goal (S.M.A.R.T.):

Evaluation: Please describe how your patient met/did not meet goal:

3. (Nursing Diagnosis #2)

State rationale for choosing this diagnosis

Nursing Process: Planning and Intervention: Goals and Interventions: Develop one goal and four interventions for each diagnosis. One intervention should include patient education.

Goal (S.M.A.R.T.):

Evaluation: Please describe how your patient met/did not meet goal:

Answer 1

Nursing Diagnosis

Physiological nursing diagnosis

1. Decreased cardiac output related to vasoconstriction/ increased peripheral vascular resistance secondary to hypertension as evidenced by BP (-), patient complaining about blurred vision.

2. Acute pain related to decreased myocardial bloodflow as evidenced by reports of pain.

3. Impaired physical mobility related to loss of a limb( right lower extremity) and pain evidenced by reluctance to attempt movement.

Psychological nursing diagnosis

4. Situational low selfesteem related to loss of body part evidenced by preoccupation with the missing body part and not looking at the stump.

Nursing Diagnosis *1

Decreased cardiac output related to vasoconstriction / increased peripheral vascular resistance secondary to hypertension as evidenced by BP( ), patient complaining about blurred vision.

Rationale for the diagnosis

Assessment: subjective data( patient complaining about blurred vision and severe headache) and objective data( Patient's BP is 210/ 115, history of hyperlipidemia and hypertension)

Goal

Patient's BP will be SBP 120-130 and DBP 80-95 within 24 hours/ patient will verbalize an absent in blurred vision and headache.

Interventions

1. Assess the patient's BP every hour and headache and blurred vision every four hour.

2. Provide calm and restful surroundings, minimize environmental activity and noise.

3. Administer Antihypertensive medications as per physician's order.

4. Educate the patient on how to consult with his doctor before stopping a medication.

Evaluation

Patient BP is reduced to SBP 124 and DBP 85 and he verbalized an absence of headache and blurred vision.

Nursing Diagnosis*2

Acute chestpain related to decreased myocardial blood flow as evidenced by the reports of pain.

Rationale.

Assessment: subjective data( patient complains about chest pain ) objective data( pain scale of 8/ 10, placing fist over midsternum, B.P - 180/ 100 mm of Hg).

Goal

Patient will be free from pain complaint after 8 hours of nursing intervention.

Interventions

1. Assess reports of pain in chest, shoulder and neck and arm.

2. Place patient at complete bed rest during angina attacks

3. Monitor heart rate and blood pressure

4. Administer anti- anginal medications as prescribed

5. Instrruct to notify nurse immediately when chest pain occurs.

Evaluation

After 8 hours of nursing intervention , the patient reported no complaints of pain. Pain scale 0/10.