Final answer:
Nurses document specific nursing diagnoses in patient care plans to guide care, which includes a health issue, cause or related factors, and evidence. Diagnoses for patients like patient B might focus on hyperthyroidism, and for an obese patient, conditions like heart failure or venous insufficiency. Understanding the skeletal muscle pump's role in venous return helps explain the patient's swollen feet and ankles.
Step-by-step explanation:
Nurses often document nursing diagnoses in patient care plans to describe a patient’s health condition and guide subsequent care and interventions. The information documented typically includes a specific diagnosis with an associated cause or related factors and the evidence supporting the diagnosis. For example, a diagnosis could be “Decreased cardiac output related to altered myocardial contractility.” This is a precise statement that identifies a health issue (decreased cardiac output), the cause or related factor (altered myocardial contractility), and implies a direction for care based on the identified problem.
In the case of patient B, with symptoms including weight loss, sweating, increased heart rate, and trouble sleeping, a nurse might identify a nursing diagnosis relevant to these symptoms, such as “Hyperthyroidism related to an overactive thyroid gland as evidenced by weight loss and tachycardia.” For an obese patient with signs like swollen feet, fatigue, and shortness of breath, conditions like heart failure, venous insufficiency, or pulmonary conditions may be considered.
When a patient presents with hypoxemia and signs suggestive of pneumonia, as in the vignette with Barbara, the diagnosis might be “Impaired gas exchange related to inflammatory process in the lungs as evidenced by hypoxemia and abnormal lung sounds.”
Understanding the role of skeletal muscle pumps in venous return can help explain why an obese patient who stands all day has swollen feet and ankles. The muscle activity helps propel blood back to the heart against gravity, and lack of physical activity may hinder this process, contributing to the patient's symptoms.