Welcome to our very last week of blogging! Last week we
discussed things that nurses can do to help their patients with pediatric Long
QT Syndrome. We called these areas to focus on “nursing interventions.” A
nursing intervention is a response to a nursing diagnosis. There is a large difference between a nursing diagnosis and a medical diagnosis. A medical diagnosis
is where a provider is trying to identify or treat the condition, whereas a
nursing diagnosis focuses on how the body physically and psychologically
responds to the disease and treatment.
Five key nursing diagnoses that I will discuss during this
blog are:
1) alteration in cardiac output
2) risk for death anxiety
3) risk for ineffective health maintenance
4) risk for ineffective individual coping
5) risk for ineffective community coping
1) alteration
in cardiac output
This nursing diagnosis focuses on
how LQTS creates a functional challenge for the heart. Any dysrhythmia (mistimed
or uncoordinated heart beats) that occur due to LQTS will often cause a change
in how much blood is squeezed effectively from the heart. This is just like a
pump that isn’t working appropriately. Adhering to a medication routine and/or
following provider recommendations for an implanted defibrillator will help
prevent the irregular heart beats from occurring, thus keeping cardiac output
consistent (Seattle Children’s Hospital 2015).
2) risk for death anxiety
As I have
discussed throughout this blog, LQTS can have very serious and fatal
consequences if not properly diagnosed and managed. When a provider explains
the seriousness of this condition a risk for death anxiety could occur in both
the patient and their family. Counseling may be helpful in teaching coping
skills to help manage anxiety.
3) risk for ineffective health maintenance
There are a
lot of changes that occur when a patient is diagnosed with a chronic disease.
Especially because I’m primarily focusing on pediatric patients in this
blog—health maintenance will require both the patient and family to get on
board with these sudden new changes. Examples could include creating a colorful
visual medication schedule to help the patient and caregivers know when
medications are to be taken. Other factors in this nursing diagnosis include:
consistent attendance for medical appointments, access to healthcare providers
that understand LQTS, etc.
4) risk for ineffective individual coping
With all of the big changes that
come with diagnosis of a chronic disease, we must check in to see how the
pediatric patient is coping. Many feelings such as fear and stress can come up
as a child begins to understand and take ownership of their condition. Age
appropriate interventions such as counseling and support groups can be helpful
in assisting a pediatric patient in managing their disease.
5) risk for ineffective community coping
This nursing diagnosis focuses on all of the other members
of the patient’s life. For example, symptoms of LQTS exacerbations will often
be seen when the child is undergoing physical stress such as during PE in
school or at an after school sport. Informing teachers and coaches of
signs/symptoms/how to best care for this child will be vital in keeping the
patient safe. Similarly, it is helpful for all caregivers and family members to
learn how to adjust to changes such as a rigorous medication schedule or
exercise limitations that occur when a child is diagnosed with LQTS.
Here’s a table that my professor asked us to create
demonstrating a break down of one of the examples that I just listed above in a
table format.
Nursing Diagnosis
|
Related to
|
As Evidenced By
|
Nursing Intervention
|
Goal
|
Risk for ineffective health maintenance
|
Pt and family do not fully understand scheduling of
medications
|
Unable to describe care coordination of medication
administration
|
Create visual schedule that parents and child can use to
track medication administration
|
Consistent compliance with taking medication
|
Source:
Seattle
Children's Hospital. (2015, January 1). Long QT Syndrome. Retrieved March 1,
2015, from http://www.seattlechildrens.org/medical-conditions/heart-blood-conditions/long-qt-syndrome/
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