CNA253: Scenario-Based Nursing Diagnosis and Care Planning for Ms. L

This assignment presents a scenario involving a patient, Ms. L, experiencing continuous vomiting and abdominal pain. The student, CNA253, is tasked with identifying and prioritizing two nursing diagnoses: risk for deficient fluid volume and pain in the upper abdomen. The assignment includes a detailed care plan for each diagnosis, outlining goals, related actions, rationales, and evaluation outcomes. For the first diagnosis, the student emphasizes the importance of an ultrasound to assess the cause of the pain and the insertion of a nasogastric tube. For the second diagnosis, the student focuses on fluid replacement and pain management. The care plan also includes a reflection on the simulated episode of care, highlighting the importance of diagnosis and care planning. The student also provides a list of relevant references supporting the care plan.

Your student number:
CNA253 AT3
Scenario: Identify your patient
Ms. L
Articulate and Prioritise Nursing Diagnoses
1. Risk for deficit fluid volume as the vomiting is continuous for 72 hours
2. Pain in the upper abdomen and the pain rating is 8 out of 10 scales.
Provide a valid reason for the prioritisation
The priority would be treating and finding the proper site of the pain in the abdomen. However, the fluid risk also needed to
be assessed by means of medical tests.
Goals, Actions and Evaluation: (400 words)
Diagnosis 1 Goal/s Related actions Rationale Evaluate outcomes
Risk assessment of the
pain
Ultra sound of the
abdomen for site
detection of
The pain.
Proper medication.
Nasogastric tube
insertion inside the
body for the
decompression.
Molassiotis et al.
(2016), highlighted
that the risk
assessment of the pain
is needed in case of
the nauseate condition
of a patient as it would
be leading to stomach
cancer if the proper
diagnosis could not be
assessed. According to
Ultra sound of the
stomach would be
helpful in the
determination of any
kind of foreign content
causing the problem or
other tumour like
protrusions are the
cause of the disease.
Thus on the basis of
the evaluation the

Allan et al. (2018), the
pain and vomiting are
the common
symptoms of nausea
however the
assessment of the
problem needed to be
done with utmost
priority as the
conditions could lead
to other severe
problems.
treatment can be
proceeded. On the
other hand the
medication for the pain
relieves and the
Nasogastric tube
insertion would also be
helpful for the site
detection of the
problem.
Diagnosis 2 Goal/s Related actions Rationale Evaluate outcomes
Deficit Fluid volume
prevention
Proper medication.
Providing basin in very
close range in order to
provide proper care in
this situation.
Providing with liquid
hydrating agents such
as saline and others.
Rocca and Vetrugno
(2016), highlighted
that the need of the
fluid treatment is one
of the primary health
Liquid hydrating
agents would be
helpful in decreasing
the deficiency of the
patient’s body and

Preventing
dehydration process of
the body.
care process as in the
nauseate condition
extreme vomiting of
the patient puts him or
her in a fluid deficit
condition and the body
fluid providence is
needed to support the
patient’s condition.
According to Oh and
Sutherland (2016),
isotonic fluids are
needed to be provided
to these patients and
normal saline that is
the sodium chloride is
the common fluid that
is used in this kind of
thus help in the
stabilising the vomiting
conditions of the body.

situation.
Reflection on this simulated episode of care: (100 words)
As a nurse I have gained experience about this case and the primary care planning of the patients with nausea. On the basis
of the situation and the evaluation of the outcome I can also say that the need of the diagnosis of the condition is very
important and based on the assessment plan the primary care would be provided to the patient. The fluid deficiency
prevention and the pain control are the factors that would be needed for the primary care and these care planning would
needed to be assessed with the help of the other physiological aspects of the patient’s health.
Reference list:
Molassiotis, A., Lee, P.H., Burke, T.A., Dicato, M., Gascon, P., Roila, F. and Aapro, M., 2016. Anticipatory nausea, risk factors,
and its impact on chemotherapy-induced nausea and vomiting: results from the Pan European Emesis Registry study. Journal
of pain and symptom management, 51(6), pp.987-993. Accessed from https://www.jpsmjournal.com/article/S0885-
3924(16)00057-9/pdf
Allan, G.M., Finley, C.R., Ton, J., Perry, D., Ramji, J., Crawford, K., Lindblad, A.J., Korownyk, C. and Kolber, M.R., 2018.
Systematic review of systematic reviews for medical cannabinoids: Pain, nausea and vomiting, spasticity, and harms.
Canadian Family Physician, 64(2), pp.e78-e94. Accessed from http://www.cfp.ca/content/cfp/64/2/e78.full.pdf
Della Rocca, G. and Vetrugno, L., 2016. Fluid Therapy Today: Where are We?. Turkish journal of anaesthesiology and
reanimation, 44(5), p.233. Accessed from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5118006/pdf/tard-44-5-233.pdf
Oh, G.J. and Sutherland, S.M., 2016. Perioperative fluid management and postoperative hyponatremia in children. Pediatric

Nephrology, 31(1), pp.53-60. Accessed from https://link.springer.com/content/pdf/10.1007%2Fs00467-015-3081-y.pdf