The nurse is using the PED model to write a nursing diagnosis. Which nursing diagnoses demonstrate that the nurse used this model appropriately? Select all that apply.
Ineffective Breathing Pattern as evidenced by cyanotic lips.
Risk for infection related to recent surgery.
Nutrition less than adequate related to anxiety as evidenced by weight loss of ten pounds.
Ineffective coping related to depression as evidenced by a suicide attempt.
Noncompliance (DASH diet) related to denial of having the disease.
Correct Answer : A,C,D
The PED model is a framework for writing nursing diagnoses that stands for Problem, Etiology, and Defining Characteristics. A nursing diagnosis written using the PED model includes a statement of the client's problem (P), the cause or contributing factors of the problem (E), and the observable signs and symptoms that indicate the presence of the problem (D). In this case, options a), c), and d) are examples of nursing diagnoses that demonstrate appropriate use of the PED model. Each of these diagnoses includes a statement of the client's problem, the cause or contributing factors, and the defining characteristics that indicate the presence of the problem.
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Correct Answer is B
Explanation
According to Kubler-Ross's stages of grieving, denial is the first stage. It is a defense mechanism that helps individuals cope with the overwhelming emotions associated with loss. In this case, the client is refusing to believe that the loss of her husband is happening and is likely experiencing denial as a way to cope with her grief
Correct Answer is C
Explanation
During the introductory (orientation) phase of the nurse-client relationship, the nurse should focus on establishing trust and rapport with the client. One way to do this is by eliciting information from the client through active listening and open-ended questioning. This allows the nurse to gather important information about the client's health status, needs, and concerns and helps to establish a foundation for the therapeutic relationship. Reviewing progress toward personal objectives and encouraging self-exploration is more appropriate for later phases of the relationship.
Talking with others who have information about the client may also be helpful, but it is important to prioritize direct communication with the client during this phase.
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