Help with prioritizing nursing diagnosises

  1. 0
    Hello all,

    I am having trouble prioritizing my five nursing diagnoses. Patient is one day post-op c-section with 500ml fluid loss. This is my order:

    1. Acute pain r/t abdominal incision

    2. Risk of fluid volume deficit r/t blood loss secondary to cesarean delivery and postpartum complication.

    3. Risk of infection potential r/t abdominal incision secondary to cesarean birth.

    4. Risk of GI function alteration r/t motility & decreased activity level a/e/b lack of bowel movement

    5. Potential knowledge deficit of self-care needs r/t Post cesarean section delivery.

    I felt that acute pain took priority over fluid volume deficit due to the "risk of" part.

    Thanks,
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  4. 5 Comments so far...

  5. 2
    What is going to send the patient into the morgue more quickly. Start with your basic life support, what do you check first. If any of those are compromised, then that is the priority diagnosis. Then go down your systems. Pain is important but it won't kill you either.
    pmabraham and Esme12 like this.
  6. 0
    I would go with risk for fluid volume deficit
  7. 2
    I agree with going by what would kill them the quickest first.

    1. Risk of fluid volume deficit r/t blood loss secondary to cesarean delivery and postpartum complication.
    2. Risk of infection potential r/t abdominal incision secondary to cesarean birth.
    3. Acute pain r/t abdominal incision
    4. Risk of GI function alteration r/t motility & decreased activity level a/e/b lack of bowel movement
    5. Potential knowledge deficit of self-care needs r/t Post cesarean section delivery.
    Esme12 and pmabraham like this.
  8. 0
    The only comment I have, because I think you should think this through yourself, is that it does not appear the g.i. function alteration is a "risk" if the pt has not had a bowel movement and you would have expected one based on your history taking. The fvd also may or may not be a "risk" depending whether or not the patient is hemodynamically stable with a 500 cc fluid loss?
    Last edit by Roseyposey on Feb 10, '13 : Reason: always have more to say; happy fingers
  9. 0
    500cc is only a little more than two cups. What was in those two cups? Was it all blood, or is this an I&O imbalance with urine > intake? How's her crit? Does that put anything into perspective?


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