Concept map for Multiple Myeloma

[mkcline1]

I am doing a concept map for a patient with Multiple Myeloma. I have chosen problems that I need to prioritize. I have always been told pain is the first priority and I have always done this but I have something where I think it might be second. This patient has Thrombocytopenia and platelets are a 7. I have bacteremia, chronic pain, depression, and nutrition status of less than body requirement. I first had pain as 1, then infection, low platelets, depression than nutrition. I talked to another person and she said to have infection, pain, low platelets, depression and then nutrition. Can anyone help me?

Thank You,

Lisa

[Compassion_x]

Are you making more of a problem list or nursing diagnosis? I find concept maps more helpful when using nursing diagnoses.

Write out all your assessment data first, and follow ADPIE. Acute pain comes before chronic pain. Therefore, if this patient has chronic pain, I would say in general that infection would come first, especially if it's something like bacteremia or sepsis. Anything that can be life threatening goes before pain, especially chronic. Think of what will kill your patient first. Is it chronic pain? Probably not. And platelets a 7? As in 70,000?

Basically, more information is needed to truly help you. But I would say infection, low platelets, and nutrition would be bigger concerns than depression or chronic pain as they are things that can and need to be helped now.

[Esme12, ASN, BSN, RN]

Low platelets is not a nursing diagnosis. Nursing diagnosis is based all about the patient assessment and the patient needs.

If this is just a list of problems think about Maslows hierarchy of needs.

Five Levels of the Hierarchy of Needs

There are five different levels in Maslow’s hierarchy of needs:

1. Physiological Needs
   These include the most basic needs that are vital to survival, such as the need for water, air, food, and sleep. Maslow believed that these needs are the most basic and instinctive needs in the hierarchy because all needs become secondary until these physiological needs are met.
   
2. Security Needs
   These include needs for safety and security. Security needs are important for survival, but they are not as demanding as the physiological needs. Examples of security needs include a desire for steady employment, health care, safe neighborhoods, and shelter from the environment.
   
3. Social Needs
   These include needs for belonging, love, and affection. Maslow described these needs as less basic than physiological and security needs. Relationships such as friendships, romantic attachments, and families help fulfill this need for companionship and acceptance, as does involvement in social, community, or religious groups.
   
4. Esteem Needs
   After the first three needs have been satisfied, esteem needs becomes increasingly important. These include the need for things that reflect on self-esteem, personal worth, social recognition, and accomplishment.
   
5. Self-actualizing Needs
   Self-actualizing people are self-aware, concerned with personal growth, less concerned with the opinions of others, and interested fulfilling their potential.
   

You have

pain then infection, low platelets, depression than nutrition. I talked to another person and she said to have infection, pain, low platelets, depression and then nutrition

Is the pain chronic or acute? DO they have an infection? How do you know this? what is a normal platelet count? How low is this patients count? Is this critical? What are the complication from a low platelet count?

All care plans are about the patient assessment....I see a list of patient diagnosis. What is your assessment? Then we can tell you what is important.