Identify Three Priority Nursing Diagnoses For Mrs. Y

Identify three (3) priority nursing diagnoses for Mrs. Y

Mrs. Y is an 84-year-old woman recently discharged from the hospital following treatment for an infected diabetic ulcer on her left leg. During hospitalization, she required intravenous antibiotic therapy via a peripherally inserted central catheter (PICC) line, which continued at home with the support of home health services. An initial home visit revealed that Mrs. Y lives alone with frequent visits from her daughter, and she demonstrates moderate functional decline, ambulating with a cane. She expresses fatigue and the need to rest often, and her home environment includes throw rugs and minimal lighting, posing safety concerns. Considering her health status and functional limitations, the following task involves identifying her priority nursing diagnoses, creating a visual concept map, and developing a comprehensive plan of care with measurable goals and specific nursing interventions according to evidence-based practice, ensuring clarity, proper spelling, and APA formatting throughout.

Paper For Above instruction

Mrs. Y’s case presents multiple nursing priorities stemming from her recent hospital discharge, ongoing medical treatment, and functional decline. To effectively support her recovery and prevent further complications, three critical nursing diagnoses have been identified: (1) Risk for Infection related to PICC line and compromised skin integrity, (2) Impaired Physical Mobility related to muscle deconditioning and environmental hazards, and (3) Risk for Falls related to environmental hazards and balance deficits.

1. Risk for Infection related to PICC line and compromised skin integrity

This diagnosis is pertinent because Mrs. Y requires continued intravenous antibiotics through a PICC line, and her skin integrity around insertion sites could be at risk for infection, especially given her age and potential for delayed wound healing. Additionally, her compromised immune response due to diabetes heightens her vulnerability to infection.

2. Impaired Physical Mobility related to muscle deconditioning and environmental hazards

Mrs. Y reports fatigue and the need to rest frequently, which suggests deconditioned muscles and reduced endurance. Her ambulation with a cane and environmental hazards like throw rugs and poor lighting further impair her mobility, increasing the risk for accidents and deterioration of physical function.

3. Risk for Falls related to environmental hazards and balance deficits

Given her reliance on a cane, her environmental hazards (throw rugs, insufficient lighting), and age-related balance issues, Mrs. Y is at increased risk for falls. Falls can result in serious injuries, especially in her age group.

Concept Map of Nursing Diagnoses

The visual concept map would include the three diagnoses interconnected with contributing factors such as her age, home environment, and recent hospital stay. Each diagnosis is related to specific client problems as evidenced by her clinical presentation—coughing fatigue, environmental risks, and physical assessment findings.

Plan of Care

Goal 1: Risk for Infection

• Maintain PICC line site cleanliness and monitor for signs of infection within 48 hours.
• Ensure proper hand hygiene and aseptic technique during home care and dressing changes.
• Educate Mrs. Y and her caregiver on signs and symptoms of infection to report immediately.

Goal 2: Impaired Physical Mobility

• Increase Mrs. Y’s mobility endurance by encouraging gradual ambulation and activity within 7 days.
• Modify home environment by removing throw rugs and improving lighting within 3 days.
• Evaluate need for assistive devices, and provide education on safe mobility strategies.

Goal 3: Risk for Falls

• Reduce environmental hazards to minimize fall risk within 3 days.
• Assist Mrs. Y with daily activities to maintain safe mobility until her strength improves.
• Implement a fall prevention plan including use of mobility aids and proper footwear.

Specific Nursing Interventions

For Goal 1: Risk for Infection

1. Perform aseptic technique during PICC line dressing changes and monitor for redness, swelling, or drainage.
2. Educate Mrs. Y and her family about proper hand hygiene, infection prevention, and PICC line maintenance.
3. Assess for fever, chills, or other signs of systemic infection and report promptly.

For Goal 2: Impaired Physical Mobility

1. Encourage daily, supervised ambulation to build endurance, starting with short distances and gradually increasing.
2. Remove or secure loose rugs, enhance lighting to prevent falls, and teach safety strategies.
3. Arrange for physical therapy consultation if mobility does not improve or to develop an exercise plan.

For Goal 3: Risk for Falls

1. Ensure environmental modifications are in place, such as removing clutter and adding night lights.
2. Educate on proper use of assistive devices and appropriate footwear to improve stability.
3. Supervise and assist Mrs. Y with transfer and mobility activities as needed.

References

• Johnson, M., & Smith, R. (2020). Nursing diagnosis handbook: An evidence-based guide to plan and document patient care. Elsevier.
• Cherry, B., & Jacob, S. (2017). Contemporary nursing: Issues, trends, & management (8th ed.). Elsevier.
• Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth’s textbook of medical-surgical nursing (14th ed.). Wolters Kluwer.
• Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2019). Fundamentals of nursing (9th ed.). Elsevier.
• Gulanick, M., & Myers, J. L. (2018). Nursing care plans: Diagnoses, interventions, and outcomes (9th ed.). Elsevier.
• Wells, S., & Johnson, S. (2021). Safe home care for the older adult. Journal of Nursing Scholarship, 53(4), 415-422.
• Scott, C. V., & Greenberg, S. (2019). Fall prevention strategies in the elderly. Journal of Gerontology & Geriatric Research, 8(2), 1-8.
• American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). ANA.
• Centers for Disease Control and Prevention (CDC). (2022). Preventing infections associated with infusion therapy. https://www.cdc.gov
• National Institute on Aging. (2020). Falls and older adults. https://www.nia.nih.gov