Domain 4. Activity-rest
Class 4. Cardiovascular-pulmonary responses
Diagnostic Code: 00278
Nanda label: Ineffective lymphedema self-management
Diagnostic focus: Lymphedema selfmanagement
Introduction to Nursing Diagnosis: Ineffective Lymphedema Self-Management
Nursing diagnosis defines the conditions that can be used as the basis for nursing intervention and as a link between patient’s health condition and the recognition of the problems. Nursing diagnoses are categorized as actual, risk and related factors to reflect the nature of the problem. The diagnosis of Ineffective Lymphedema Self-Management is an example of diagnosis with risk factors, which nurses use to understand potential issues in the care and treatment of their patients.
NANDA Nursing Diagnosis Definition
The Nanda definition for Ineffective Lymphedema Self-Management is “Ineffective Lymphedema Self-Management related to inadequate information, education, or motivation regarding lymphedema care.” This diagnosis is included in the taxonomy of NANDA nursing diagnoses because it is a specific condition that often presents as an area of concern in the care of people with lymphedema.
Defining Characteristics
The defining characteristics for this diagnosis include both subjective and objective components. Subjectively, the patient may experience a decreased ability to self-manage their lymphedema, difficulty recognizing early signs of lymphedema, lack of knowledge about lymphedema symptoms, and a lack of motivation to follow through with healthcare recommendations. Objectively, physical findings may include edema, increased limb size, deficient control of limb positioning, decreased skin integrity, and/or impaired mobility.
Related factors for Ineffective Lymphedema Self-Management include a range of possible contributors to this diagnosis including deficits in knowledge, understanding of individualized factors, or access to information or equipment. Circumstances leading to the condition may also include physical impairments, psychosocial responses, or cultural influences that limit the individual’s ability to learn or access resources.
At Risk Population
The population at risk for this diagnosis includes individuals with a history of or current diagnosis of cancer, cardiovascular disease, diabetes, obstructed lymph vessels, or a truncal injury. Those who have been operated on or received radiation therapy are also at an increased risk for this diagnosis.
Associated Conditions
Additional associated conditions may be seen with this diagnosis and include compromised skin integrity, arthritis, fibromyalgia, hypothyroidism, lymphadenectomy, lymphedema, lymphedema syndrome, sacroiliac joint dysfunction, and venous insufficiency.
Suggestions for Use
To accurately diagnose and manage the condition, it is important to consider the patient’s medical history, current physical status, accessibility to lymphedema care, learning style, and life priorities. The nurse should assess any physical limitations, psychological response to a perceived disability, lifestyle changes, and provide appropriate guidance on self-management of the condition. Additionally, access to appropriate resources including massage, water exercise, range of motion, and other modalities should be explored in order to assist the patient with the long-term overall management of their lymphedema.
Suggested Alternative NANDA Nursing Diagnosis
Alternative NANDA nursing diagnoses to consider when assessing Ineffective Lymphedema Self-Management include Impaired Physical Mobility, Activity Intolerance, high risk of impaired skin integrity, Social Isolation, Anxiety, and/or Fear.
Usage Tips
When caring for patients who may suffer from Ineffective Lymphedema Self-Management, it is important to take into account their individual needs and those of their care team in order to create a successful plan of care. By focusing on evidence-based practice and educating the patient on the importance of self-care, the threat of complications can be minimized. Communication between the patient and the team members should be established in order to review the importance of adhering to the plan of care, review any warning signs of too little or too much activity, discuss support systems and other options, and to avoid feelings of isolation or depression.
NOC Outcomes
The following NOC outcomes can be used when determining the impact of Ineffective Lymphedema Self-Management:
- Knowledge: Disease Progression & Management
- Self-Care: Lymphedema Management
- Skin Integrity: Skin Condition
- Mobility: Physical Functioning
- Affective Responses: Mood Disturbance
- Social Interaction: Social Support
When assessing the effects of Ineffective Lymphedema Self-Management, it is necessary to consider the effects of these outcomes and provide resources to improve them.
Evaluation Objectives and Criteria
The evaluation objectives for the diagnosis of Ineffective Lymphedema Self-Management should include the following criteria: changes in the patient’s knowledge related to the progression and management of their lymphedema; improved effectiveness in the self-care of lymphedema management; improved skin integrity; improvement in physical functioning; alleviation of mood disturbance; and increases in social support.
NIC Interventions
The following NIC Interventions should be used to address the diagnosis of Ineffective Lymphedema Self-Management:
- Patient Education:Lymphedema Self-Management
- Risk Identification: Lymphedema Complications
- Therapeutic Exercise: Range of Motion and Limb Positioning
- Lymphedema Treatment: Massage
- Energy Conservation: Physical Activity
- Behavior Control: Cognitive Restructuring
Nursing Activities
Nursing activities when addressing Ineffective Lymphedema Self-Management should focus on providing education and instruction on the self-management of the condition and coordinating access to the necessary resources for an effective plan of care. The nurse should be knowledgeable of and actively promote the use of safe and appropriate preventive strategies for lymphedema. The nurse should evaluate the patient’s ability to follow through with the recommended plan of care and provide guidance and support to sustain a successful regimen of self-management.
Conclusion
In conclusion, a comprehensive nursing assessment is essential when caring for patients who may suffer from Ineffective Lymphedema Self-Management. By taking into account the patients’ individual needs and the available resources, the patient can develop a successful plan of care that will allow them to effectively manage their condition throughout their lifetime. With the right knowledge and insight, the patient should be able to obtain self-efficacy in the pursuit of optimal health.
5 FAQs
- What is Ineffective Lymphedema Self-Management?
Ineffective Lymphedema Self-Management is a recognized nursing diagnosis with risk factors that can arise from inadequate information, education, or motivation regarding lymphedema care. It is important for the nurse to assess and recognize this diagnosis in order to provide appropriate guidance and education to the patient. - Who is at risk for this diagnosis?
Individuals with a history of or current diagnosis of cancer, cardiovascular disease, diabetes, obstructed lymph vessels, or a truncal injury are at an increased risk for this diagnosis. Additionally, those who have been operated on or received radiation therapy may also be at risk. - What are the defining characteristics?
The defining characteristics for this diagnosis include both subjective and objective components. Subjectively speaking, the patient may experience decreased ability to self-manage their lymphedema, difficulty recognizing early signs of lymphedema, lack of knowledge about lymphedema symptoms, and a lack of motivation to follow through with healthcare recommendations. Objectively, physical findings may include edema, increased limb size, deficient control of limb positioning, decreased skin integrity, and/or impaired mobility. - What are the associated conditions?
The associated conditions that may be seen with this diagnosis include compromised skin integrity, arthritis, fibromyalgia, hypothyroidism, lymphadenectomy, lymphedema, lymphedema syndrome, sacroiliac joint dysfunction, and venous insufficiency. - What are the nursing activities?
Nursing activities when addressing Ineffective Lymphedema Self-Management should focus on providing education and instruction on the self-management of the condition and coordinating access to the necessary resources for an effective plan of care. The nurse should be knowledgeable of and actively promote the use of safe and appropriate preventive strategies for lymphedema. The nurse should evaluate the patient’s ability to follow through with the recommended plan of care and provide guidance and support to sustain a successful regimen of self-management.
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