State the client problem as a three-part nursing diagnosis

Reference no: EM133570870

Problem

A. Use the Braden Scale for Predicting Pressure Sore Risk Download Braden Scale for Predicting Pressure Sore Risk(also available on p. 1065 in your (eBook) textbook)

a. Review each area of assessment based on the case scenario
b. Score each area of assessment based on the case scenario
c. Compile the score from each of the 6 areas assessed

B. Identify a client care problem (actual or potential) based on the compiled Braden score.

C. State the client problem as a three-part nursing diagnosis.

D. Use the Nursing Care Plan Template Download Nursing Care Plan Template to develop a plan of care based on the Braden Scale results. The plan must include one actual or potential problem

Case Scenario:

A 24-year-old male admitted from the Spinal Center (rehabilitation center) has just returned from surgery after removal of his gallbladder (cholecystectomy). He is alert and oriented. He was hospitalized and NPO for 3 days prior to the surgery. His initial complaint was nausea and vomiting and "not able to eat for a while." The medical records from the rehabilitation center reveal he became paraplegic following a diving accident 6 months ago and was progressing well until about a month ago when he started refusing meals and complained of nausea. Review of the medical record reveals the following lab results-

1) WBC- 12, 000
2) RBC- 3.90
3) Hgb- 11.6
4) HCT- 45.0
5) Platelets- 160,000
6) albumin- 3.2

He is occasionally diaphoretic and needs assistance transferring from the bed to his wheelchair. He can reposition himself in the bed to some extent but generally needs assistance with this, especially since his recent surgery.

Reference no: EM133570870

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