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what are the prioity nursing diagnosis. Patient Profile J.K. is a 57-yr-old white woman who was...

what are the prioity nursing diagnosis.

Patient Profile

J.K. is a 57-yr-old white woman who was is referred to the neurosurgery service for management of her temporal-parietal glioblastoma (see Assessment Case Study in Chapter 55 (Links to an external site.) on pp. 1302, 1304, and 1307 (Links to an external site.)). She was diagnosed after presenting with persistent headaches, a seizure in her HCP's office, and left side upper visual field loss and neglect. Her MRI/MRA demonstrated a temporal-parietal glioblastoma that extends into the occipital lobes. She is scheduled for surgery to debulk the tumor. J.K. lives alone and holds a management position. She is concerned about her ability to return to work after her surgery.

J.K. returns from surgery to the neurosurgery unit drowsy but following commands. During the night J.K. is noted to have a pronator drift of the left arm, her pupils are equal and respond to light, but she has also developed left-sided weakness of both arm and leg and difficulty with answering questions.

Medications: dexamethasone 4 mg q6hr, famotidine, metoclopramide, ondansetron (Zofran), codeine, and levetiracetam (Keppra) since her admitting seizure.

Subjective Data

  • Left arm and leg are weak and feel numb
  • She is trying to answer questions but looks confused and cannot follow commands.

Objective Data

  • BP 150/90 mm Hg
  • right gaze preference
  • Left homonymous hemianopsia
  • Left arm weakness (3/5) greater than leg weakness (4/5)
  • Decreased sensation on both left arm and leg
  • Has speech but not clear. Difficulty with word finding and following commands
  • A diagnostic CT scan demonstrates a hemorrhagic stroke into the site of the tumor bed, and temporal-parietal and anterior occipital areas extending into the thalamus.

2. Based on the assessment data provided, what are the priority nursing diagnoses?

Solutions

Expert Solution

Ms J.k is suffering with post surgery complications , her prior problems are, weekness, difficulty in speaking, follow commands,left sided weekness, homonymous hemianopsia(Is condition which a person sees only one side right/left side ), decreased sensation,...

So based the these conditions we can frame the nursing diagnosis

Nursing Diagnosis

  • Activity intolerance related weekness as evidenced by post surgery complications .
  • Impaired physcical mobility related to sedatives as evidenced by difficulty with answering questions
  • Impaired verbal communication related to reduction of ceribral circulation as evidenced by difficulty in speaking and follow commands.
  • Risk for injury related to partial vision as evidenced by physcical examination
  • Fear and anxiety related to present situation as evidenced by trying to asking questions.

These are the priority nursing diagnosis you can applicable for Ms JK

Nightingale answered 2 years ago
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