The nurse is caring for a postpartum patient. The patient's labor has lasted over 28 hours within the hospital; the patient has not slept and is disoriented to date and time. What is the most appropriate nursing diagnosis?
a. Impaired parenting
b. Insomnia
c. Ineffective coping
d. Sleep deprivation
D
This patient has been deprived of sleep by staying awake during a 28-hour labor. Disorientation is one potential sign of sleep deprivation. In this scenario, we have a clear cause for the patient's lack of sleep, and it is a one-time episode. Insomnia, on the other hand, is a chronic disorder whereby patients have difficulty falling asleep, awaken frequently, or sleep only for a short time. This scenario does not indicate that this has been a chronic problem for this patient. Although ineffective coping can manifest as a sleep disturbance, we have clear evidence that it was labor that deprived this patient of sleep, not an inability to cope. It could be difficult to care for an infant when sleep deprived; however, this scenario gives no evidence that this mother displays impaired parenting and is not caring adequately for her child or lacks the skills to do so.
You might also like to view...
A nurse reviewing arterial blood gas results identifies the oxygen saturation level as low. The nurse interprets this information to reflect changes in which process?
1. Ratio of oxygenated hemoglobin to total hemoglobin 2. Percentage of cardiac output 3. Content of oxygen in arterial blood 4. Autoregulation
The public health workforce should demonstrate competency in which of the following competency categories?
a. Financial planning and management b. Workforce needs assessment c. Acute care services d. Curriculum development
The patient in the ambulatory clinic asks the nurse in the billing office, "Why do I have to pay $10.00 for this visit when I have insurance?" What is the nurse's most appropriate response?
a. "I don't know how your insurance works. You need to pay this and follow up with your insurance company." b. "This a co-payment you are required to pay per clinic visit as described in your insurance plan." c. "Healthcare is expensive and insurance companies can't pay all of the costs." d. "This is part of your insurance premium that you pay monthly."
A 79-year-old client, recently widowed, says to the nurse, "My wife kept up our condominium single-handedly, and now my kids expect me to cook and clean for myself. I'm not lazy, but I don't know how to cook and I've burnt myself twice just frying up what was supposed to be bacon and eggs. I'm so frustrated and I've already lost 10 lb this month." Which initial nursing statement should the nurse make to the client?
A. "I'm calling the doctor immediately to obtain a homemaker for you!" B. "Seems as if you feel lost without your wife and maybe a bit ignored by your children." C. "First things first. What are you doing eating bacon and eggs? That's not a good meal for you." D. "Meals-on-Wheels can help you minimize the frustration you are having cooking. Are you a member of the local senior center?"