Problem 1 - Clinical Nursing Skills and Techniques

Question

A patient who wears contact lenses in both eyes is scheduled for hand surgery and will have her hand in a cast for 6 weeks. What is the priority nursing diagnosis for this patient? 1 Anxiety 2 Self-health management 3 Imbalanced nutrition: less than body requirements 4 Disturbed personal identity

Step-by-Step Solution

Answer

The priority nursing diagnosis is 2: Self-health management.

Step 1: Understand the Context

The patient in question will have impaired use of her hand for six weeks due to the surgery. This impairment may affect her ability to carry out daily activities normally performed using hands, influencing her ability to manage her basic health needs, including managing contact lenses.

Step 2: Analyze Each Option

- **Anxiety (1):** Though the patient might experience anxiety, it is not specific to the condition of having impaired hand use. - **Self-health management (2):** This diagnosis addresses the patient's ability or need to carry out self-care, such as placing and removing contact lenses, which is directly impacted by her surgery. - **Imbalanced nutrition (3):** This diagnosis is not directly related to hand surgery or contact lens wear. - **Disturbed personal identity (4):** This is not relevant to the situation of having a temporarily impaired hand function.

Step 3: Determine the Most Relevant Diagnosis

Considering the situation, the patient's ability to manage her contact lenses independently with one hand in a cast for six weeks will be the most affected. Thus, Self-health management (Option 2) is the priority nursing diagnosis since it directly relates to her condition of wearing contact lenses and her new physical limitation.

Key Concepts

Self-health Management

Self-health management refers to an individual's capability to manage their own health needs effectively. For patients undergoing surgery or dealing with physical impairments, this aspect becomes crucial.

• Ability to perform daily activities independently.
• Managing personal care, like hygiene and medications.
• Acknowledging and attending to specific health needs.

In the scenario of the patient with her hand in a cast, self-health management becomes a priority because she will face challenges in maintaining tasks she typically performs with her hands. For instance, putting in or removing contact lenses requires the use of hands, and being one-handed during recovery can be challenging. Adjustments and perhaps assistance will be needed to maintain her normal routine. Hence, emphasizing self-health management ensures that individuals continue to meet their health requirements, preventing complications during recovery.

Patient Care

Patient care is at the heart of nursing practice and involves ensuring that patients receive comprehensive care tailored to their needs, especially during recovery periods.

• Providing emotional support and reassurance.
• Monitoring patient’s physical condition and progress.
• Educating patients about managing their health effectively.

In the case of the patient with the hand surgery, patient care would entail assessing her ability to handle other essential tasks aside from managing contact lenses. It involves developing a tailored care plan that accounts for her physical limitations while ensuring she stays informed about her condition and the importance of adhering to her care regimen.

Post-Surgery Care

Post-surgery care is critical to successful recovery and preventing complications. Ensuring that patients understand and adhere to post-surgical instructions is vital.

• Wound care and hygienic practices to prevent infections.
• Pain management through medications and therapies.
• Rehabilitation measures to aid the recovery of function.

For a patient with a hand in a cast, post-surgery care includes keeping the cast clean and dry, managing pain, and possibly engaging in exercises suggested by healthcare providers to maintain mobility in the rest of the body. The goal is always to promote healing and restore full functionality.

Nursing Assessment

Nursing assessment is the process where nurses collect information about a patient’s physiological, psychological, and sociological status. This comprehensive evaluation is crucial before tailoring a care plan.

• Gathering data through observation and physical examination.
• Interviewing the patient and reviewing medical history.
• Prioritizing nursing diagnoses based on assessments.

In the context of the patient facing hand surgery, nursing assessment would involve understanding her daily activities, specifically those affected by impaired hand functionality, like her contact lens management. It helps in identifying her primary care needs, allowing the nursing team to focus on intervention strategies that address her self-health management challenges.