Prioritizing nursing Dx

  1. 0 Could someone help me put these in priority according to Maslows. I'm having trouble deciding.

    Risk for falls
    Constipation
    Anxiety
    Activity intolerance

    Thank you.
  2. Visit  losilva95 profile page

    About losilva95

    Joined Aug '13; Posts: 22; Likes: 6.

    30 Comments so far...

  3. Visit  losilva95 profile page
    1
    Ok it's me again. I decided on:

    Constipation
    Activity intolerance
    Risk for falls
    Anxiety

    Anyone agree?
    blodeuwedd likes this.
  4. Visit  StudentOfHealing profile page
    0
    I think more assessment data is necessary. IMO ... it depends on the circumstances surrounding the diagnoses.

    Why are they constipated?
    Why do they have activity intolerance?

    why why why.

    b/c for example ... constipation would not be the priority diagnosis for a post partum woman ... bc it is expected for the first 2-3 days.

    get it?
  5. Visit  Stephalump profile page
    0
    I'd say

    I'd say

    risk for falls
    Constipation
    Activity intolerance
    Anxiety

    But really...that's just a shot in the dark based on no information.
  6. Visit  Esme12 profile page
    0
    Quote from losilva95
    Ok it's me again. I decided on:

    Constipation
    Activity intolerance
    Risk for falls
    Anxiety

    Anyone agree?
    why do you believe they belong in this order?
    Last edit by Esme12 on Oct 30, '13
  7. Visit  MendedHeart profile page
    0
    Risk fors are usually always last with the exception of maybe aspiration or bleeding

    Where would these fall on maslows?

    1st-physiology inludes excretions(constipation would probably kill you before activity intolerance, and just because getting constipated is an expected outcome for many patients, its still not a good thing or considered a low priority. That is why we are so big on bowel regimine) and I would put mobility and activity in this category as well, I think Anxiety could be either here or in Esteem, but leaning more towards physiology.
    2nd safety-could make a point that falls could be second IF this based purely on Maslows and not the big picture
  8. Visit  GrnTea profile page
    1
    Quote from 2013SNGrad
    Risk fors are usually always last with the exception of maybe aspiration or bleeding

    Where would these fall on maslows?

    1st-physiology inludes excretions(constipation would probably kill you before activity intolerance, and just because getting constipated is an expected outcome for many patients, its still not a good thing or considered a low priority. That is why we are so big on bowel regimine) and I would put mobility and activity in this category as well, I think Anxiety could be either here or in Esteem, but leaning more towards physiology.
    2nd safety-could make a point that falls could be second IF this based purely on Maslows and not the big picture
    First: "Risk for" nursing diagnoses are very often properly placed first, as safety ranks above all of the physiological needs in Maslow's hierarchy. This poster is asking specifically for a ranking in Maslow's hierarchy.

    Second: It is a fallacy that "risk for..." nursing diagnosis is somehow lesser or not "real." If you look in your NANDA-I 2012-2014, there is a whole section on Safety, and almost all of the nursing diagnoses in that section are "risk for..." diagnoses. However, because NANDA-I has learned that nursing faculty is often responsible for this fallacy, the language on these has recently been revisited and will be changed to "Vulnerable to ..." in the next edition due out in late 2014.

    Third: This sort of assignment is often made not only to see if somebody can recite rote information but to elicit your thought processes and see how well you can defend your reasoning.

    So, OP, what is the reasoning you have applied to your ranking, as applied to a specific patient or to people in general?

    Last: Activity intolerance will probably kill you faster than constipation, and this is why we are so concerned with assessing the risk for and treating the complications of immobility. Depending on your patient assessment, some sort of bowel regimen (regimen = a routine or plan; regime = a system of government; regimine = an interesting neologism, though) is often an expected part of a nursing plan of care because so many things that happen to people in medical care experience changes in their bowel pattern.
    Esme12 likes this.
  9. Visit  psu_213 profile page
    3
    Not to mention that their activity intolerance could be playing a role in their constipation.

    And none of that really matters if the fall on the way to the bathroom and suffer a fatal injury.
    4boysmama, Esme12, and GrnTea like this.
  10. Visit  MendedHeart profile page
    0
    Quote from GrnTea

    First: "Risk for" nursing diagnoses are very often properly placed first, as safety ranks above all of the physiological needs in Maslow's hierarchy. This poster is asking specifically for a ranking in Maslow's hierarchy.

    -This is not true, physiology is first according to Maslows

    Second: It is a fallacy that "risk for..." nursing diagnosis is somehow lesser or not "real." If you look in your NANDA-I 2012-2014, there is a whole section on Safety, and almost all of the nursing diagnoses in that section are "risk for..." diagnoses. However, because NANDA-I has learned that nursing faculty is often responsible for this fallacy, the language on these has recently been revisited and will be changed to "Vulnerable to ..." in the next edition due out in late 2014.

    -Again, not true. I never said they are not real diagnosis, however majority of the time actual problems come before risks, like I said above, which was drilled into us in nursing school.


    Third: This sort of assignment is often made not only to see if somebody can recite rote information but to elicit your thought processes and see how well you can defend your reasoning.

    So, OP, what is the reasoning you have applied to your ranking, as applied to a specific patient or to people in general?

    Last: Activity intolerance will probably kill you faster than constipation, and this is why we are so concerned with assessing the risk for and treating the complications of immobility. Depending on your patient assessment, some sort of bowel regimen (regimen = a routine or plan; regime = a system of government; regimine = an interesting neologism, though) is often an expected part of a nursing plan of care because so many things that happen to people in medical care experience changes in their bowel pattern.

    -I dont underdtamd how you can see activity intolerance as killing someone faster than constipation. Thats ridiculous. What if the patient is just a little bit intolerant but still walks and moves. Constipation leads to SBO and Ileus which is lethal

    I really dont understand why you always have to undermine my advice and be in adverse to me. I think its very rude and condescending.
    ^^^^^
  11. Visit  MendedHeart profile page
    0
    Quote from psu_213
    Not to mention that their activity intolerance could be playing a role in their constipation.

    And none of that really matters if the fall on the way to the bathroom and suffer a fatal injury.
    Just because its not number one or two on priority list doesnt mean you dont intervene on it. We take care of several problems with patients, could be 10 diagnosis, I think the point of this assignment may be to learn Maslows and put it into context with nursing diagnosis, there may not even be an actual pt here. Who knows.
  12. Visit  LadyFree28 profile page
    0
    2013SNGrad, Grn is enlightening the proper use of NANDA diagnoses to everyone's benefit; her knowledge of diagnoses is pretty stellar; I don't see nor hear the condescending "tone" that you describe...

    But I digress...risk for, especially in terms of safety, is a priority diagnosis...GrnTea is spot on, and that is the criteria per NANDA, and how I was educated in nursing school; although it safe to say NANDA supersedes the discretion of a nursing instructor.

    I would also like to hear MORE about the OP's rationale, and go from there.
    Last edit by LadyFree28 on Oct 31, '13
  13. Visit  MendedHeart profile page
    0
    But this assignment is based on Maslows. I get what you are trying to say, but prioritizing problems is taught actual above risks. It is ABCs, then Maslows, etc.....I really do not understand where your info is coming from. I understand the use of NANDA for NDs, but prioritizing has other factors involved. Its nice you are defending your friend, but its constant and truely directed at her, thanks.
  14. Visit  LadyFree28 profile page
    0
    Quote from 2013SNGrad
    But this assignment is based on Maslows. I get what you are trying to say, but prioritizing problems is taught actual above risks.
    Again, risks can be ACTUAL problems... http://www.nanda.org has the criteria; also the NANDA-I book has more information on formulating a nursing diagnosis; again, GrnTea was pretty in. The mark and you can find what she stated from NANDA itself.

    It is ABCs, then Maslows, etc.....I really do not understand where your info is coming from. I understand the use of NANDA for NDs, but prioritizing has other factors involved. Its nice you are defending your friend, but its constant and truely directed at her, thanks.
    I'm not sure if GrnTea would consider me a friend; it's a nice thought though, but the fact of the matter is, when eliciting a response that may be off the mark; enlightenment is the best response, and an appreciation for the enlightenment is in place, especially from for more experienced colleagues in the field

    You continue to state a "risk for" diagnoses prioritized below; it is not, especially if there is an assessment in play; no, we don't have an assessment; however; whether we have one or not doesn't eliminate the fact that your line of thinking the a "risk" diagnoses cannot be first priority; that is my point, and from being a member for a good amount of time, that is where GrnTea is driving, I may be off the mark, regardless of our "friend status", but just using my nursing knowledge that I have been cultivating for a while in the business of nursing.

    Also, looking at the Maslow's model; Safety is above the physiological; there is a reason why the safety is above the physiological; although the theory itself was taught about fulfilling those needs from the bottom up; in theory in nurse of the nursing model; Safety is a biggie; safety first from Maslow's; that's why as you stated ABC's the Maslow's...Think about it, of the ABC's are intact, what ELSE should we be assessing for? That's where the "risk for" especially if it will be detrimental to the patient comes into play, especially in terms of safety.


    Granted, I could receive a report, let's' say is pretty vague, but those diagnoses come up. I don't go into a pts room, see that their ABCs are intact, and forget to make sure there is O2 at the bedside, side rails up; if the ares is cluttered, it remains clear, that, my friend, is called a safety check-a part of Maslow's.

    I then can proceed to my assessment of the diagnoses and go from there to activity intolerance and constipation to see if they are related and whatever diagnoses a patient may have.
    Last edit by LadyFree28 on Oct 31, '13

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