Question

Consider the psycho-social impact on the family with a child with heart disease.

please list 2 priority nursing diagnoses and the priority outcomes expected?

Describe the interventions you would do and rationales to achieve these goals.

Answer 1

The psycho social impact on family due to child's disease include higher levels of stress, anxiety and depression.

The priority nursing diagnosis in a child with heart disease are :

1) Decreased cardiac output to meet metabolic demands of the body related to structural factors of heart defects evidenced by fatigue, decrease peripheral pulse.

DESIRED OUTCOME:Child will demonstrate an ability to tolerate activity and maintain the cardiac ability.

NURSING INTERVENTIONS :

1.Assess the patient 's condition (check heart rate, blood pressure)

Rationale :Provides baseline data for further intervention.

2.Note skin colour, temperature and moisture.

Rationale: cold, clammy and pale skin is secondary due to low cardiac output and oxygen desaturation.

3.Provide adequate rest periods.

Rationale : Rest decreases metabolic rates, decreases myocardial and oxygen demand.

4.Provide comfortable position to the child(semi fowlers position).

Rationale: Facilitate lung expansion.

5.Administer oxygen as prescribed.

Rationale :The falling heart rate may not be able to meet the oxygen demand.Oxygen saturation need to be maintained.

Nursing Diagnosis 2:

Ineffective family coping related to situational and developmental crisis of family and child evidenced by anxiety and posible hospitalization.

DESIRED OUTCOME : Family will cope more effectively.

Nursing interventions :

1) Assess the family 's level of perception in coping with child' s illness.

Rationale: Provides baseline data for further assessment.

2.Observe for unexpected behavior in parents(anger, tension, disorganization)

Rational: This will help to understand the coping behavior of parents (how they cope with child's care).

3. Encourage expression of feelings and provide factual information about child's condition.

Rationale: Reduces anxiety and enhance family 's involvement in child' s care.

4.Assess the need for information and support.

Rationale : Provides information about need for interventions to relieve anxiety and concerns.

5 Clarify any misinformation and answer questions regarding disease process.

Rationale: Avoid unnecessary anxiety resulting from inaccurate knowledge and belief.

6.Refer family for additional support and counseling if indicated.

Rationale: Referral provide more assistance in coping.