NDX: Impaired Parenting for pediatric patient.

[FollowThru11]

Ok this is a case study question. I had a patient who was admitted to the hospital with pyelonephritis. As she was being treated for this kidney infection other problems arose such as the patient was found to have lice and possible sexual abuse was stated. The mother stated that she thinks that the father is sexually abusing the child and that she had previously had the child examined and there was not enough evidence to prove sexual abuse aside from a small tear. I'm alittle stuck here because in the case study we must have 3 NDX in order of priority. My thinking was 1st to address the problem she was originally admitted for the pyelonephritis. Now after meeting with my instructor she says to include the sexual abuse and lice. So now I'm thinking the sexual abuse should be the primary nsg dx but since it was not diagnosed I don't think I can use Rape-Trauma Syndrome. So now I'm on:

Impaired parenting r/t failure to thrive, possible abuse, inadequate child arrangements, low socioeconomic class, and inability to put childs needs before own AMB a flat affect, withdrawal, loss of appetite, presence of infestation with reoccurence, mother stating, "I think she is being sexually abused by her father," and grandmother stating, "after today they are without a home,"the child is not enrolled in day care or preschool at the age of 4.

Is this too much for 1 nursing diagnosis? Is this a primary nursing diagnosis because if this isn't resolved than the patient is at risk for multiple infections, mental disturbances, and physical harm.

[FollowThru11]

I think I need to break this up and add self care defecit-hygeine.