more important nsg dx?

  1. After surgery which is a more important nursing diagnosis:

    Risk for infection r/t surgical incision

    constipation (pt. can't be discharged until she has a BM)

    I think constipation because it is an actual problem, the pt. wants to leave & can after a BM...But my instructer is big on "What will kill the pt. first".
    BUT if the pt. can be discharged isn't the risk for infection negligible?

    Help, please.
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  2. 10 Comments

  3. by   daisywill
    Quote from Boe
    After surgery which is a more important nursing diagnosis:

    Risk for infection r/t surgical incision

    constipation (pt. can't be discharged until she has a BM)

    I think constipation because it is an actual problem, the pt. wants to leave & can after a BM...But my instructer is big on "What will kill the pt. first".
    BUT if the pt. can be discharged isn't the risk for infection negligible?

    Help, please.
    I would say risk for infection r/t surgical incision. If the patient can be discharged the risk for infection is NOT negligible. Remember nursing diagnosis distend out of the hospital care. That person can still get an infection when he/she leaves the hospital. Constipation can be a problem but if the patient hasnt had a BM the Doctor will usually give a laxative. Infection is the #1 priority here.
  4. by   Altra
    Quote from daisywill
    I would say risk for infection r/t surgical incision. If the patient can be discharged the risk for infection is NOT negligible. Remember nursing diagnosis distend out of the hospital care. That person can still get an infection when he/she leaves the hospital. Constipation can be a problem but if the patient hasnt had a BM the Doctor will usually give a laxative. Infection is the #1 priority here.
    Agree. Think about what would happen if the pt. did contract an infection - tissue damage, fever, sepsis and all the problems related to these.

    Your other option was constipation. A problem, yes, but not to the same immediate degree as, say, bowel obstruction.

    HTH
  5. by   Boe
    Thank you, I was leaning towards the infection risk, but I don't like not having subjective data
  6. by   lzygrl42
    I think risk for infection also,

    you can't do constipation because the patient really isn't constipated. you can't be constipated if your bowels are cleaned out.

    Risk for constipation would be good but risk for infection is a higher priority.




    Quote from Boe
    After surgery which is a more important nursing diagnosis:

    Risk for infection r/t surgical incision

    constipation (pt. can't be discharged until she has a BM)

    I think constipation because it is an actual problem, the pt. wants to leave & can after a BM...But my instructer is big on "What will kill the pt. first".
    BUT if the pt. can be discharged isn't the risk for infection negligible?

    Help, please.
  7. by   llg
    If the patient became infected, it could be difficult to treat and life-threatening.

    If the patient became constipated, it would be easily treated and cause only a minor delay in discharge.

    It's not even close -- infection wins by a mile. A person's life outranks a little inconvenience and mild discomfort.

    llg
  8. by   studentnurse74
    Quote from llg
    If the patient became infected, it could be difficult to treat and life-threatening.

    If the patient became constipated, it would be easily treated and cause only a minor delay in discharge.

    It's not even close -- infection wins by a mile. A person's life outranks a little inconvenience and mild discomfort.

    llg
    I agree......
  9. by   Nrs_angie
    Quote from llg
    If the patient became infected, it could be difficult to treat and life-threatening.

    If the patient became constipated, it would be easily treated and cause only a minor delay in discharge.

    It's not even close -- infection wins by a mile. A person's life outranks a little inconvenience and mild discomfort.

    llg
    Apparently you have never been constipated. :chuckle
    A little inconvenience and mild discomfort??? blahhhhhh
    Constipation feels more like ----> :angryfire
    Okay maybe not that severe; well unless you have a hemorroid
    But it can be alot fore than mild discomfort.
  10. by   lisamc1RN
    I understand your confusion. We've always been told to stick to real problems first and then worry about the "at risk for" dx but they always add that BUT on the end of it that says that if there is an at risk for airway, breathing, circulation, or infection problems then they take priority.
  11. by   NurseFirst
    Quote from lisamc1
    I understand your confusion. We've always been told to stick to real problems first and then worry about the "at risk for" dx but they always add that BUT on the end of it that says that if there is an at risk for airway, breathing, circulation, or infection problems then they take priority.
    We have a nursing instructor, who, when we ask her a question about priorities and such will often say "It depends," frequently prefixed by "I think the answer to any nursing question is..."

    I imagine it comes from answering questions from students before the student has given them sufficient information!!!

    NurseFirst
  12. by   Jennerizer
    Risk for infection is most important when it comes to surgery. I would even say that pain is higher on the scale than constipation. If the pain isn't treated, then the pt isn't gonna want to move/ambulate & that also could increase the risk of infection as well as the risk for constipation. And anyone that has had surgery will be feeling some sort of pain unless it's being treated.

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