Diagnoses
Based on the presented evaluation of the patient, the two most suitable nursing diagnosis for Mary are the following:
- Hyperthermia associated with a possible infection that has been caused by skin lesions.
- Lack of a balanced diet and nutrition due to the patient’s inability to ingest food because of mouth tenderness. Fatigue, weight loss, and mouth soreness all point to the likelihood of unbalanced nutrition.
Patient Education and Interventions
When it comes to the first nursing diagnosis of hyperthermia associated with possible infection, the care plan should consist of several stages for a nurse to implement. First, it is essential to adjust and control the patient’s environmental factors such as room temperature to regulate the patient’s temperature. Second, the patient should be given antipyretic medications to lower her body temperature by acting in the hypothalamus and blocking prostaglandins’ synthesis. Third, the patient should be instructed to increase her fluid intake to prevent dehydration from furthering the symptoms of hyperthermia. The last step is associated with providing the patient with additional cooling mechanisms that may help in relieving hyperthermia. Such mechanisms can include cold packs, cooling mattresses, tepid baths, and so on (Schneiderbanger, Johannsen, Roewer, & Schuster, 2014). The patient’s teaching plan should start with educating the patient on the importance of testing for possible infections because they could have caused hyperthermia. Also, the patient should be educated on how to identify the symptoms of hyperthermia and use preventative measures such as rest and increased fluid intake to aid in coping with the condition. It is important to inform the patient about the negative implications of experiencing hyperthermia for a long period of time so that she understands that her body cannot withstand the immense physical pressure.
In order to ensure that the patient does not experience the adverse outcomes of an unbalanced diet, it is essential to first ascertain Mary’s healthy body weight for her age and height and then refer her to a dietician who will be able to develop a nutritional plan that will take into consideration her skin condition. The patient should be asked about times when her appetite is at the highest points and account for these times when suggesting the highest-calorie meal to sustain healthy body weight. Because Mary also reported extreme fatigue associated with her condition, she can also be advised to take liquid energy supplements that are easier to take and have shown evidence of boosting energy and producing weight gain. Lastly, it is essential to take into consideration that malnutrition could be caused by an infection, for which the patient should be tested (Jones & Berkley, 2014). When it comes to patient education, the primary focus should be placed on informing the patient that healthy diet choices will contribute to her recovery. Mary should be educated on the importance of avoiding drinking wine and encouraged to do mild physical exercises to balance her metabolism and boost her energy. Her family and boyfriend should be advised to support the patient in the maintenance of a healthy nutritional pattern developed by a nutritionist because social influences usually prevent patients from adhering to new dietary plans. Lastly, the patient should be advised to check her weight and make sure that she is not losing any during her recovery because it can contribute to further imbalances; when experiencing any discomfort (e.g., with mouth soreness) during food intake, Mary should be encouraged to contact her healthcare provider and seek advice on food replacements or adjustments.
References
Jones, K., & Berkley, J. (2014). Severe acute malnutrition and infection. Paediatrics and International Child Health, 34(1), 1-29.
Schneiderbanger, D., Johannsen, S., Roewer, N., & Schuster, F. (2014). Management of malignant hyperthermia: Diagnosis and treatment. Therapeutics and Clinical Risk Management, 10, 355-362.