I just started nursing school and we are learning how to write a nursing care plan. I am having a hard time choosing which diangosis to pick from the NANDA list. I know you look at the most critical first but some are so close and I am choosing the wrong ones. Is there any books that might help? I have looked at the web sites and I have the Nursing Diagnosis handbook even on my PDA but I need any advise.

Thanks

I just started nursing school and we are learning how to write a nursing care plan. I am having a hard time choosing which diangosis to pick from the NANDA list. I know you look at the most critical first but some are so close and I am choosing the wrong ones. Is there any books that might help? I have looked at the web sites and I have the Nursing Diagnosis handbook even on my PDA but I need any advise.

Thanks

What are the specifics? What is the pts situation? What two...or more nursing diagnosis are you having questions about?

adamsmom. . .usually, the first diagnoses to go up on the top of the list are those that affect the airway, breathing or circulation (as in the heart). this is just like the abc's of cpr. there are certain nanda diagnoses that fit into these three categories. i'll leave it to you to look them up.

the next in the hierarchy kind of depends on what your nursing program has directed you to place in importance. these are three of the most popular systems:

• gordon's 11 functional patterns
  
• maslow's hierarchy of needs
  
• roper, logan & tierney activities of living

do any look familiar to you? if you have ackley and ladwig's nursing diagnosis handbook you will find a grouping of all the nursing diagnoses under each of the patterns/needs of maslow and gordon at the back of the book in appendix a & b. in the care plan books by doenges, moorhouse and murr they list, on one page, all the nursing diagnoses by the diagnostic divisions as suggested by nanda (it is loosely based on maslow's hierarchy of needs). you always need to consider what is an immediate danger to the patient's life or limb. maslow is very specific in listing the following in order of importance in the category of physiological needs which must be met first:

1. oxygen
   
2. food
   
3. elimination
   
4. temperature control
   
5. sex
   
6. movement
   
7. rest
   
8. comfort

hope this gives you some help and guidance.

i am, however, a little concerned as to how you are coming to the choosing of nursing diagnoses in the first place. each nursing diagnosis, like each medical diagnosis has specific signs and symptoms. most of the careplan books published today have permission from nanda to list them. (if you do not have a careplan book, i strongly recommend that you invest the $40 it costs to get one.) in the care planning processing you look at all the data you have collected. that is step one. step two is to note the abnormal symptoms you gleaned during your assessment process and start looking to see where you can group them together into the symptoms that identify them as a specific nursing diagnosis (this is where a good careplan book with the nursing diagnoses defined can help you). the nursing interventions then easily fall into place, as do the goals and outcomes.

i strongly recommend that you read through these threads:

https://allnurses.com/forums/f205/desperately-need-help-careplans-170689.html - desperately need help with careplans (in nursing student assistance forum)

https://allnurses.com/forums/f50/careplans-help-please-r-t-aeb-121128-7.html - careplans help please! (with the r\t and aeb) (in general nursing student discussion forum)

I just graduated from school - but haven't yet taken boards. The care plan book that I used the most was Mosby's Nursing Care Plans - Nursing Diagnosis and Intrerventions. The second book that I used was Prentice Hall's Nursing Diagnosis Handbook. Both books helped me alot. I did very well on my care plans using these books. I also purchased a med / surg careplan book that I used a little. You can never have too many books!!!