You will be admitting a client, Todd, from the emergency department (ED). According to the ED report, Todd’s admitting medical diagnosis is chronic renal failure. He is married, 58 years old, and employed, and he has a long-standing history of type 2 diabetes mellitus (DM). During the past 3 days, he reports that he has developed swelling and decreased sensation in his legs and difficulty walking, which he describes as “slight loss of mobility.” You have many questions concerning Todd’s immediate and long-term needs.
After you obtain necessary data, you need to organize and analyze them to form some initial impressions about what they mean.
Full Spectrum Nursing Model
Theoretical Knowledge: What theoretical knowledge will you need to identify the collaborative problems and nursing diagnoses for Todd?
Critical Thinking (Inquiry-Based on Credible Sources):
What resources would you use to find out more about the pathophysiology of renal failure?
How do you know the source is credible? When you are making your assessments of Todd, who is your best source of data? Why?
Nursing Process (Diagnosis):Explain one collaborative problem for Todd. If you do not know the potential complications of chronic renal failure, look them up in a medical-surgical or pathophysiology textbook. Explain why you would not use a nursing diagnosis to describe the problem.
After further assessment, you observe that Todd’s skin is intact and without redness or lesions. Use nursing diagnosis (problem and etiology) to describe your concerns about his skin. Based on Maslow’s hierarchy of needs, which problem has the highest priority?
Ethical Knowledge: The scenario doesn’t provide enough information for you to identify the ethical dimensions of Todd’s care. However, based on what you already know about him, speculate about some things that might create ethical questions for you.
Patient Preferences: Think critically about the patient’s preferences and concerns. Suppose that Todd’s main concern is not the same as the high-priority problem you identified. Speculate about some other concerns he might have. What else might he want to have resolved that could—for him—be more important than his chronic renal failure? Aside from his physical condition, what life concerns do you think Todd might have right now?