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:
- temperature control
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:
- desperately need help with careplans (in nursing student assistance forum)
- careplans help please! (with the r\t and aeb) (in general nursing student discussion forum)