The nurse is caring for a Native American in a rural rehabilitation facility. The nurse notices that the patient has eaten very little since his admission 10 days ago
When she asks the patient about his eating, he states, "I can't eat any of this food. It just isn't what I eat at home and we don't prepare our foods this way." The nurse explains that the patient is on a very specific cardiac diet as a result of his heart attack and that he has lost 7 pounds since admission. Based on this scenario, what is/are the most appropriate nursing diagnosis(es) for this patient? Select all that apply.
a. Noncompliance related to difficulty adhering to the medical regimen
b. Possible Knowledge deficit related to disease process
c. Imbalanced nutrition: less than body requirement related to cultural dietary practices
d. Decreased appetite related to anxiety secondary having a heart attack
B, C
The most appropriate nursing diagnoses for this patient are Possible Knowledge deficit related to disease process and Imbalanced nutrition related to dietary preferences. Both these diagnoses relate to the patent's verbalization of different food choices and preparations. Given the scenario, it seems likely the patient does not understand the relationship of diet and cardiac health, but there are no specific data to support lack of knowledge. Therefore, the knowledge is (at this stage) possible rather than actual. At this time, the nurse can assess how much the patient knows, and as necessary teach the patient about the disease process and how the cardiac diet relates to his diagnosis. The patient can then participate in planning food choices and food preparations congruent with his diagnosis and culture. One must be careful with using "noncompliance" as a nursing diagnosis as (1) it has a negative connotation, and (2) it is used when the plan of care is mutually agreed upon and then the patient does not follow the plan. In this item, there is no indication that the plan (diet) was mutually agreed upon. Additionally, there is no information in this item indicating the patient is anxious.
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