Logically prioritizing Nurs. Dx.

  1. How do you logically prioritize Nursing Diagnoses? Logically, you're told to follow Maslow's hierarchy of needs (physical needs first), but that isn't enough of an explanation.

    For example, you can write a dx. for "diarrhea" but is that necessarily the main problem? What about things that happen because of diarrhea like "risk for electrolyte/fluid imbalance" or "pain related to diarrhea"?

    You can't just put all three into one dx., and since they are all techinally "physical needs" how do you pick which one is more important?

    TIA
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  2. 6 Comments

  3. by   memphispanda
    I think this sort of depends on the outlook of your instructor...every semester I had to adapt to that particular instructors idea of what's the priority.

    For one of them, it was "What's going to kill the patient first"...So you could look at your list and determine that the electrolyte problem would be the priority because pain won't kill you.

    For another, it was "What is the priority to the patient" What is HE most concerned about?" So most likely she would have preferred the pain diagnosis.

    And then there was the one who wanted us to choose the diagnosis we were most likely to be able to do something about to make the situation better. "But can you FIX that?" In this case it would be a matter of looking at what was causing the problems, what my options were for dealing with the problems, and determining which I could the most good by focusing on.
  4. by   CPB
    We were always told that actual problems (pain, fluid volume deficit,etc...) take priority over potential problems (risk for injury, risk for fluid/electrolyte imbalance, etc...) Do you guys have to include collaborative problems in your care plans? I'm graduating in 4 weeks and they just started telling us to add these to our care plans probably a month ago.
  5. by   nocturne716
    Not outrightly said so, but I'm assuming collaborative problems should be included.
  6. by   icesk8ie
    I think the best way to deal with prioritizing is first remembering your ABC's. Impaired Gas Exchange, if it is on my care plan, always is my first priority. If none of these apply, I then go for Fluid and Electrolytes, such as Fluid Volume Deficeit/Excess. Those are just my guidelines. Hope that helps.

    --icesk8ie
  7. by   iiwdn
    I was taught to list and not worry about priority. Each entry has a priority in your care tactics. Each entry also has its own time line, care plan, and hopefully-- completion date.
    On another note, Nursing Diagnoses and care plans are the bane of this nurse's existence. Most facilities now have standardized forms which you can check and date and sign a few things and then be done with it and move on to important things!! Granted, paperwork is important but noone will fault you in the real world if it's not in the right order.
  8. by   TinyNurse
    I guess I would go ABC's then head to toe as I still do in ER nursing.
    but as far as my instructors went, and as far as i can see now, some may have 20 nursing diagnoses, and my instructors wanted them all. I have been an RN 7 months now, so it's all fresh in my brain. xoxo and best of luck in schoo lJen

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