Priority Nursing Diagnoses and Interventions for Patients

This assignment addresses two patient scenarios: Mr. Song, diagnosed with heart failure, and Vivian, diagnosed with ovarian metastatic cancer. For Mr. Song, the student identifies decreased cardiac output and activity intolerance as priority nursing diagnoses. The solution outlines interventions such as fluid management, output monitoring, and chest pain assessment for decreased cardiac output, and encourages slow activity with rest periods for activity intolerance. For Vivian, the student identifies back pain, fatigue, and abdominal bloating as priority diagnoses. The solution proposes interventions including medication for pain, sleep therapy and physical activity for fatigue, and dietary adjustments for bloating. The assignment emphasizes the importance of timely diagnosis and appropriate interventions in nursing care and references relevant literature and best practice guidelines.

NURSING
Name of Student
Institution Affiliation

QUESTION ONE
Heart failure is a serious medical condition requiring appropriate and timely diagnosis.
Diagnosis of heart failure entails review of symptoms, taking of medical history and physical
medical careful examination. Nurses play an important role in the determination of heart failure
in patients. For Mr. Song, one of the priority nursing diagnosis would be decreased cardiac
output which is largely associated with Heart failure Araújo, Nóbrega & Garcia, 2013).
Decreased cardiac output refers to a situation whereby the heart fails to pump adequate
blood to meet body’s metabolic demands. This would be a priority diagnosis for the patient. In
this regard, the failure by the right ventricle to pump an adequate volume of blood into the lungs
may lead to fluid accumulation in the abdomen, Jugular veins and the liver l. Another priority
nursing diagnosis would be activity intolerance. Activity intolerance arises whereby the body
lacks sufficient psychological; and physiological energy to undertake necessary day-to-day
activities (Araújo, Nóbrega & Garcia, 2013).
Treatment of these diagnosis requires multipole interventions by a nurse. For decreased
cardiac output a nurse would need to closely monitor the intake of fluids and restrict fluids when
necessary. Secondly, a nurse would also need to record output and intake rates including hourly
urine output while noting the decrease in output. Thirdly an assessment of chest pain including
its duration, quality, severity, radiation and location would also be an effective strategy (Martins
& Rabelo, 2010).
Some of the interventions for activity intolerance include having the patient carry out the
required activities slowly in an extended duration with time for resting. Secondly, the patient
may also be refrained from performing activities that are not essential. The final strategy would

be encouraging the patient to perform activities consistent with his energy levels (Pereira et al.,
2016).
Question Two
Priority diagnosis for Vivian range from back pain, Fatigue and abdominal bloating. Back
pain in ovarian metastatic cancer patients such as Vivian can be managed through interventions
such as using over the counter medications such as ibuprofen and aspirin. It can also be managed
through administration of weak opioid medications such as codeine. Thirdly, it can also be
treated through administering strong opioid medications including methadone, Roxicodone and
Oxycodone (Jelovac & Armstrong, 2011).
Secondly fatigue can be managed through sleep therapy to minimize sleep disturbances
and help the patient to sleep better. Besides, encouraging and facilitating patients to engage in
physical activity can help to minimize fatigue. Counselling is also one of the strategies that may
be used to manage fatigue in the patient (Bower et al.,2014).
On the other hand, abdominal bloating may be treated through strategies such as
encouraging the patient to consume more soluble fibers, facilitating the intake of more prebiotic
fibers to enhance the growth of good bacteria and limiting intake of gassy foods (Foley, Burgell,
Barrett & Gibson,2014).

References
Araújo, A. A. D., Nóbrega, M. M. L. D., & Garcia, T. R. (2013). Nursing diagnoses and
interventions for patients with congestive heart failure using the ICNP®. Revista da
Escola de Enfermagem da USP, 47(2), 385-392.
Bower, J. E., Bak, K., Berger, A., Breitbart, W., Escalante, C. P., Ganz, P. A., ... & Ogaily, M. S.
(2014). Screening, assessment, and management of fatigue in adult survivors of cancer:
an American Society of Clinical oncology clinical practice guideline adaptation. Journal
of clinical oncology, 32(17), 1840.
Foley, A., Burgell, R., Barrett, J. S., & Gibson, P. R. (2014). Management strategies for
abdominal bloating and distension. Gastroenterology & hepatology, 10(9), 561.
Jelovac, D., & Armstrong, D. K. (2011). Recent progress in the diagnosis and treatment of
ovarian cancer. CA: a cancer journal for clinicians, 61(3), 183-203.
Martins, Q. C. S., Aliti, G., & Rabelo, E. R. (2010). Decreased cardiac output: clinical validation
in patients with decompensated heart failure. International Journal of Nursing
Terminologies and Classifications, 21(4), 156-165.
Pereira, J. D. M. V., Flores, P. V. P., Figueiredo, L. D. S., Arruda, C. S., Cassiano, K. M., Vieira,
G. C. A., ... & Cavalcanti, A. C. D. (2016). Nursing Diagnoses of hospitalized patients
with heart failure: a longitudinal study. Revista da Escola de Enfermagem da USP, 50(6),
929-936.