Week 8: The Nursing Diagnosis

Nursing diagnoses are the terms in which your nurse will think.  A nursing diagnosis is the nurse’s clinical judgment about the client’s response to actual or potential health conditions or needs (American Nurses Association, 2015). When a nurse does an assessment on a patient, they then determine a plan of care based on your overall health status.  Some examples of nursing diagnoses that are under consideration for shingles are…

•   Impaired Comfort…
•  Acute Pain…
•  Social Isolation…
•  Risk for infection…
•  Readiness for enhanced immunization status… (Ackley, Ladwig, 2014). 

With these diagnoses, the nurse then determines if they are an actual diagnoses (this is occurring with the patient in the moment), or potential (the patient is at risk for this diagnosis). Then the nurse must figure out what the diagnosis is related to.  This essentially means, what is causing the diagnosis.  Then the nurse must make a plan to intervene on the diagnosis and determine what outcome is appropriate for the patient.  Then finally, the nurse will implement their intervention.  Below I have created a table that explains the process for one nursing diagnosis.  Keep in mind that for each patient, there can be an unlimited amount of nursing diagnoses to care for.

Nursing Diagnosis	Actual or Potential	Related to…	Plan and Outcome	Nursing Intervention
Risk for infection…	Actual…	Related to infectious particles inside of rash	Implement infection precautions.  Outcome is to limit the spread of infection.	Implement personal protective equipment to be worn by staff. Educate patient about the infectivity of the condition, and when they are no longer contagious. Teach patient how to properly wash hands. Place dressing over ruptured rash. Educate patient and family about Shingles vaccine.

(Ackley, Ladwig, 2014)

In this instance, risk for infection is the nursing diagnosis.  This is an actual diagnosis because the patient can spread the infection if the rash has not scabbed over.  This can put healthcare workers and family members at risk for contracting the virus if they are not careful.  This infectivity is related to having the active virus inside the pustules of the rash.  The nurse will plan to limit the spread of infection to others, in which the desired outcome is that nobody else becomes infected.  In order to achieve this desired outcome, the nurse will have to elicit many interventions.  Some of these interventions are located in the last column above. 

This link below is a case study for a patient with Shingles.  Here they show the nursing process along with the plan of care.

• http://wps.prenhall.com/wps/media/objects/737/755395/herpes_zoster.pdf

This link describes the nursing process which includes the nursing diagnosis that I have explained here.

• http://www.nursingworld.org/EspeciallyForYou/What-is-Nursing/Tools-You-Need/Thenursingprocess.html

REFRENCES:

Ackley, B., Ladwig, G. (2014). Nursing Diagnosis Handbook. Elseiver, 10^th Edition. Page 105.

American Nurses Association. (2015). The nursing process. Retrieved from http://www.nursingworld.org/EspeciallyForYou/What-is-Nursing/Tools-You-Need/Thenursingprocess.html