Question

The nurse is completing a patient's shift assessment and notes that the patient is lethargic, but restless and agitated. Which nursing diagnosis should the nurse include to the plan of care based on this data?

Answer 1

The nurse should include nursing diagnoses related to Imbalanced Nutrition: Less Than Body Requirements, Disturbed Sleep Pattern, and Anxiety in the patient's care plan, considering symptoms of weight loss, difficulty sleeping, and agitation.

Step-by-step explanation:

Based on the presentation of lethargy, restlessness, and agitation, the patient in this scenario may have a complex clinical picture that could be represented by several potential nursing diagnoses. However, given the additional symptoms provided, which include weight loss, profuse sweating, increased heart rate, and difficulty sleeping, along with agitation, anxiety, sleep problems, nausea and vomiting, abnormal heart rhythms, low blood pressure, and muscular problems, the nurse might consider the diagnosis of Imbalanced Nutrition: Less Than Body Requirements due to weight loss and potential metabolic demands, Disturbed Sleep Pattern due to difficulty sleeping and sleep problems, and Anxiety due to the restlessness and agitation.

The care plan should address these diagnoses by implementing interventions that aim to stabilize the patient's nutritional status, improve sleep quality, and manage anxiety. Nutritional support, sleep hygiene measures, and anxiety-reducing techniques such as guided relaxation should be considered.