Another Nursing Dx Priority Question

[ekrieg]

I've read through about a million posts on nursing diagnoses and how to prioritize. Even my instructor says: "ABCs, what's going to kill my patient first?" I'm currently taking a med surge class and one of the assignments is to write NCLEX style questions for our quiz. Of course we have to include the rationale for the right answer as well. So I decided, as I usually do when I feel I'm not strong in an area, to write a question on prioritizing nursing diagnoses. The question is something like this:

8. A nurse on the oncology unit has just written a care plan for a patient receiving chemotherapy. Her nursing diagnoses are listed below. The most appropriate prioritization order is:

i. Risk for deficient fluid volume r/t vomiting and diarrhea

ii. Risk for infection r/t immunosupression

iii. Imbalanced nutrition: less than body requirements r/t side effects of chemotherapy

iv. Disturbed body image r/t loss of weight and loss of hair

So I understand by using the ABCs, and what's going to kill my patient first, and also taking into account Maslow's hierarchy, etc. I'm thinking that the correct order is something like:

i, ii, iii, iv

But in all of my reading, I haven't been able to find out where Risk for Infection falls into things. I understand that "Risk for Deficient fluid volume" runs into a drop in BP, and that's a cardiac issue... definitely a priority. But is deficient fluid volume a higher priority than infection? Why or why not?

Thanks,

Erin

[Aneroo, LPN]

I'd change one of the risk for's to an actual problem. The "risk for" comes second to an actual problem.

[JanineD23]

I actually agree with your order. I saw an older post where the comment was made that a "risk for" can be a priority if the patient's life could be at danger because of it or if it affected the patient's ABCs.

I will admit that my first instinct was to put Risk for infection first simply because it can have serious complications. :)