Which nursing diagn. would be more priority?

  1. Which Nursing Diagnosis would be more priority: Bowel Incontinence or Self Care deficit? Anyone know? Im having a hard time choosing. These both are related to cognitive impairment on a geriatric pt.
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  2. 9 Comments

  3. by   cardiacRN2006
    I think you'll get some varied answers on this one.

    For me, when I think of incontinence, I think of macerated skin, and impaired skin integrity, which can lead to infection or wounds.

    So I'd pick that one.
  4. by   APBT mom
    Quote from cardiacRN2006
    I think you'll get some varied answers on this one.

    For me, when I think of incontinence, I think of macerated skin, and impaired skin integrity, which can lead to infection or wounds.

    So I'd pick that one.
    That's my thought too.
  5. by   EricJRN
    I think it's going to depend on your assessment findings. Can you give us more details?
  6. by   smk1
    [QUOTE=lizzyberry;2473372]Which Nursing Diagnosis would be more priority: Bowel Incontinence or Self Care deficit? Anyone know? Im having a hard time choosing. These both are related to cognitive impairment on a geriatric pt.[/QUOTE

    What is the bowel incontinence related to? Is this a temporary thing? Has the self care deficit been a long term issue?

    Without having my book right in front of me, I am thinking that self care deficit could encompass bowel incontinence in some ways. If you can correct the deficit the physical ill effects of bowel incontinence wouldn't be much of a problem though psychosocial issues would still exist. I guess we would need a lot more info to decide.
  7. by   lizzyberry
    Pt. with dementia pt. who is in her upper ninety's. Pt. with hypertension. Is there a nursing diagnosis relating to HTN?
  8. by   SuesquatchRN
    It's her bowels.

    HTN can lead to orthostatic hypotension which can lead to falls - risk for injury.
  9. by   Hellllllo Nurse
    Without knowing more about the pt- I'm going to assume incont of B&B, W/C bound, wanderer.
    1.Injury- high risk r/t cognitive impairment, secondary to? AEB?
    2.Tissue integrity, high risk, immobility, incontinance
    3. Self care
  10. by   Daytonite
    Quote from lizzyberry
    Which Nursing Diagnosis would be more priority: Bowel Incontinence or Self Care deficit? Anyone know? Im having a hard time choosing. These both are related to cognitive impairment on a geriatric pt.
    Which self-care deficit? There are a number of them. An elimination need comes before a self-care deficit of bathing/hygiene/dressing/grooming but is on the same level with a toileting self-care deficit and ranks below a feeding self-care deficit.
    Is there a nursing diagnosis relating to HTN?
    NO. Is there a medical diagnosis relating to Decreased Cardiac Output? You are asking for the difference between apples and oranges.

    Any nursing diagnosis is based upon the signs and symptoms your patient has. You determine those signs and symptoms from the thorough assessment that you have done of the patient. This involves going through the patient's medical record and reading what the doctor has documented, reviewing the tests results and doing your own interview and physical examination of the patient. You pull out the abnormal items that you found. This is Step #1 of the nursing process. To help you learn what was abnormal you use textbooks and other materials that tell you what is normal to help you out. This is how you learn about the various conditions. In Step #2 of the care planning process you take the list of abnormal assessment items that you found which you can now call signs and symptoms (NANDA calls them defining characteristics) and start looking for nursing diagnoses. Every nursing diagnosis has a list of signs and symptoms (NANDA calls them defining characteristics) and that's what you need to look at. If some of your patient's signs and symptoms aren't on the list of defining characteristics for a nursing diagnosis, then you can't legitimately use it because you would be diagnosing the patient incorrectly.

    So, my next question for you would be, what are your patient's signs and symptoms that you got from your nursing assessment? The proper question you should be asking is: my patient has the following signs and symptoms. . .what nursing diagnosis(es) fit these signs and symptoms?
  11. by   CT Pixie
    I'm going with Bowel Incontinence. Reason..

    bowel incontinence can lead to a breakdown in skin intergrity very quickly which can leave the body open for infection which can lead to all sorts of life threatening illness/disease.

    self care deficit can lead to a lot of things but for me I'm thinking, you need to keep that skin intact its your first line of defense to prevent infection.

    With self care deficit w/pt with dementia the best you may be able to do is get her/him to wash face, hands and brush teeth. But that won't stop the skin from breaking down.

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