Ackley: Nursing Diagnosis Handbook, 10th Edition
Writing Assignment: NCP: Planning, Implementation & Evaluation
Due to Evolve dropbox by 10/29/14@ 11:59 PM
Nursing Process Case Study - Mrs. Ross (Wound Care)
Case Scenario
“It isn’t fair. I’ve worked so hard all my life, I don’t deserve this,” thought Mrs. Ross as she looked down at her right leg where a large wound gaped open. Two weeks ago, she had a femoral-popliteal bypass, which got infected. The wound was opened up and was healing slowly by secondary intention. It was painful, raw, and frightening. She put a hand on her chest and raised the head of the bed higher so she could catch her breath and stare out the window.
Nursing Assessment Including Client Story
Mrs. Ross is
Select interventions from Section III (beginning on p. 119) that are appropriate for Mrs. Ross.
Nursing interventions: (list 5)
Perform a thorough assessment of the client, including risk factors.___________________________________________________________________
Assess and treat for depression and anxiety.___________________________________________________________________
Use careful aseptic technique when caring for wounds.___________________________________________________________________
Promote early ambulation and deep breathing.
___________________________________________________________________
Assess for presence of medical condition and treat appropriately befor surgert___________________________________________________________________
Second Nursing Diagnosis
Write a nursing diagnostic statement for one of the nursing diagnoses by combining the nursing diagnosis label with the r/t factors.
a.The label is the title of the nursing diagnosis as defined by NANDA (found on the inside cover of your Ackley & Ladwig textbook.
b. A r/t statement describes factors that may be contributing to or causing the problem that resulted in the nursing diagnosis.
NANDA label: Risk for suicide ______________________________________________________
Related to (r/t) factors: history of prior suicide attempt ______________________________________________
The complete nursing diagnostic statement is: