RN Diagnosis Chronological order

Nursing Students Student Assist

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Nursing Diagnosis One:

Tissue Integrity, Impaired, related to (Braden scale of 9, Obesity, Immobility in bed) as evidenced by friction ulcer 1cmX.5cmX1mm.

Nursing Diagnosis Two: Urge Incontinence related to decreased ability to control urination associated with decreased level of consciousness as evidenced by patient ANOX2 (Person, Place) and voiding in diaper/disposable underwear 2X in 2 hours.

Nursing Diagnosis Three: Human Dignity Compromised related to perceived humiliation during Emergency Room Transfer process as evidenced by soiled disposable patient underwear.

I am asked to place these in order of chronological importance.

I believe this is correct, but I am also debating number three should move to the number one.

What are your thoughts + thank you for your time

Specializes in Pedi.

Chronological means ordering things based on when they occurred (in time). So if that were really your assignment, you'd be ordering them based on which happened first.

Specializes in Nephrology, Cardiology, ER, ICU.

Moved to Nursing Student Assistance Forum

I was asked to have chronological in order of importance, according to the school

Chronological means time-referenced, and prioritizing means in order of importance. I have never heard of listing nursing diagnoses chronologically, only in priority order. That doesn't mean what occurred prior to something, though. Do you think you might have misunderstood?

She said priority, I re-referenced the syllabus. I assumed that was chronological. I do step A and then step B and then Step B, chronologically, with reference to time and priority. That aside, I will be submitting tomorrow. I placed Human Dignity diagnosis as number 1, since I feel that is pinnacle to our profession (or in my case future profession).

Specializes in Complex pedi to LTC/SA & now a manager.

Use Maslow's Hierarchy of Needs to determine priority 95% effective.

She said priority, I re-referenced the syllabus. I assumed that was chronological. I do step A and then step B and then Step B, chronologically, with reference to time and priority. That aside, I will be submitting tomorrow. I placed Human Dignity diagnosis as number 1, since I feel that is pinnacle to our profession (or in my case future profession).

You may need to re-prioritize, rethink this. Out of the 3 you have, which one puts your patient in the most harm.

Like the PP said, use Maslows to start with. But I can't say I agree with you #1

She said priority, I re-referenced the syllabus. I assumed that was chronological. I do step A and then step B and then Step B, chronologically, with reference to time and priority. That aside, I will be submitting tomorrow. I placed Human Dignity diagnosis as number 1, since I feel that is pinnacle to our profession (or in my case future profession).

That's what I thought. In planning care, "priority" means, "What's the most important?" It could be the thing you'll do first, like "Get this patient to safety," or,"Clear the airway," or, "Prevent further complications of immobility." It has nothing to do with chronological, so your assumption was mistaken. Glad we cleared that up.

Now as to setting your care priorities, I would recommend the safety/injury prevention as more pressing. But part of planning nursing care to deliver or delegate to others is what you're learning here, so be prepared to justify your priorities to your faculty. If you can convince your CI that perceived humiliation in the ER at admission is higher in Maslow's Hierarchy of Needs than an existing skin injury that will certainly worsen without attention, come back and we'll chat about that.

Well, according to Nanda it is ranked number one (numerous literature). And, in my humble opinion, changing the soiled would be highest priority before assessing a friction ulcer that developed over time. You don't just let someone sit in their own "soil" you fix the problem that is most pressing. Adding friction lotion, or wiping a little moisture, is not more pressing than changing someone being discharged in their own soil. No theology would persuade me and I would happily take a mark off.

Submitted Wednesday. Thanks for everyone's time.

Specializes in Emergency, Telemetry, Transplant.
Chronological means time-referenced, and prioritizing means in order of importance. I have never heard of listing nursing diagnoses chronologically, only in priority order. That doesn't mean what occurred prior to something, though. Do you think you might have misunderstood?

It's sorta like lining up alphabetically by height.

Well, according to Nanda it is ranked number one (numerous literature). And, in my humble opinion, changing the soiled would be highest priority before assessing a friction ulcer that developed over time. You don't just let someone sit in their own "soil" you fix the problem that is most pressing. Adding friction lotion, or wiping a little moisture, is not more pressing than changing someone being discharged in their own soil. No theology would persuade me and I would happily take a mark off.

Submitted Wednesday. Thanks for everyone's time.

But wouldn't you want to stage the wound and make sure there is no tunneling or undermining? I feel like the human dignity DX would be last priority because your patients physical safety comes first.

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