most nursing programs
direct their students on how to prioritize their nursing diagnoses. maslow's hierachy of needs or gordon's 11 functional health patterns are two common systems of organizing nursing diagnoses by priority. nanda actually started out using gordon's functional health patterns years ago when it was grouping the diagnoses. they've tweaked it a bit, but in their publication, nursing diagnoses: definitions & classification 2005-2006
published by nanda international, you can definitely see the similarity to gordon's work. when i am responding to student questions on prioritizing nursing diagnoses, i go by maslow. maslow really lists the priorities for you so there isn't much thinking on your part. it also takes abcs into account. here is a website where you can read about the hierarchy. http://en.wikipedia.org/wiki/maslow's_hierarchy_of_needs
if you happen to have a copy of nursing diagnosis handbook: a guide to planning care
, 7th edition, by betty j. ackley and gail b. ladwig, the maslow pyramid is printed out on page 1325. the bottom of the tier of the pyramid is physiological needs and that is what takes precedence. within physiological needs the prioritization from most important to least important is as follows:
- oxygen (this takes into account your abcs, tissue perfusion, etc. - remember the brain must get it's oxygen first and foremost, then the heart, then the remaining tissues of the body)
- food (ultimately an organism can't live without food, water, and electrolytes)
- elimination (or, a way to get rid of waste products)
- temperature control
- movement (gross movement takes priority over finite movement)
- comfort (this is where things like pain and some of the adls rank)
the ackley/ladwig book goes on in the next few pages to list the nursing diagnoses that fit under each tier of maslow's pyramid.
any diagnoses that are anticipatory, such as those that begin with the words "risk for" always are listed at the very end of your diagnostic lists because they are not actual problems, but problems you are trying to prevent. within them, you also prioritize by the same logic you used for the actual problems that are listed before them.
there are three "sticky" threads on the student nursing forums where a lot of care planning and nursing process information from past postings has been accumulated. some of it is well-worth looking at. i recently posted websites where you can view sample case studies that have been done by students.
just yesterday we had a thread going on the difference between a goal and an outcome. you can read it here: http://allnurses.com/forums/f50/help...me-187170.html
i invite you to at least peruse the threads on these two student forums on a regular basis for information and help with care plans
. while i understand that you posted in this forum because you are thinking of the experience factor of licensed nurses, i fashion my answers for students to conform with what they are being required to provide on care plans by their instructors, not for what goes on in actual practice. care plans being done for school have the much broader purpose of helping you to learn to think critically as well as to learn about diseases, their treatment and the nursing interventions that are possible.
i check these two forums almost daily for student questions about care planning and nursing diagnosis.
the link that was given to you above by adria37 is from the ackley/ladwig care plan constructor. i often link students into some of the nursing diagnosis pages from the site. let me advise you, however, that the site does not help you with prioritizing your diagnoses. the nursing diagnoses do not have the complete listings of nursing interventions that are printed in the book. the website also does not contain a complete listing of the 172 nanda nursing diagnoses. there have been numerous times that i have gone to their index to search for a specific nursing diagnosis only to find that it has not been included in the website. to have a complete list you really should invest the money in their book (i've listed it above).
if you are having problems getting your care plan going, either post a thread to one of the above forums or pm me. and, by the way, in the nursing process, your nursing diagnoses should always be chosen based on the assessment data that you have collected about the patient. that is what drives any care plan. ask and i will help you.