Help! Prioritizing nursing diagnoses

[KatieMcKay]

Please help! I need to come up with three nursing Dx for a concept map.

My top 2 are: impaired gas exchange r/t decreased functional lung tissue secondary to pneumonia and altered tissue perfusion r/t inadequate hemoglobin and hematocrit secondary to anemia.

My patient had anemia, stage 4 pressure ulcer, UTI, pneumonia

for my third Dx I am conflicted. I tried to use maslow's and ABC to prioritize but I'm not sure which of the following are more important:

altered tissue integrity

imbalanced nutrition less than body req. (my or was elderly and malnourished but they also had him NPO for a possible procedure)

Impaired bed mobility

chronic pain

like I said, I tried to use maslow's and ABCs to prioritize and I got the first two down, but the third I just can't decide which one is more important. Hopefully y'all can help me out!!

Thanks!

[indygirl526, ASN, RN]

You could use:

Acute pain rt impaired tissue aeb stage 4 pressure ulcer

Impaired tissue integrity rt stage 4 pressure ulcer

[alohalife]

I would agree with the Dx of impaired skin integrity AEB stage 4 pressure ulcer

[NurseGirl525, ASN, RN]

I guess I'm not seeing what your assessment says. You can't base your nursing dx off of medial dx. What is your assessment telling you? What does your patient need at this moment? That is how you prioritize. I can't help you yet because nor can anyone else until we know what your assessment is. That is what this assignment is about. It's about seeing the big picture, looking at your patient and what they need you to take care of right now. Just picking out any nursing dx does not help the patient. What are this patient's labs? What are their vital signs? What is the patient telling you through your assessment? That needs to be your focus.

[Tex.]

Your nursing Dx should tie into the main problems: PNA, uti, wound.

There's your three. Don't complicate the PNA and divide it into two Dx.

[Samm06, BSN, RN]

Imbalanced nutrition less than body requirements is a very important nursing diagnosis because without adequate nutrition the patient's wounds will not heal the way they should in a healthy manner (as you mentioned they have a pressure ulcer).