Care plan - teaching plan help

cbc1147 · Jul 19, 2011

Im a senior in nursing school and I know every school of nursing and its faculty are different. The only word of advice I can give you is always always always follow Maslows Hierarchy of Needs. To me her first priority nursing diagnosis should be related to her nutrition and maybe lack there of from her fatigue. This would be in regards to Maslows number 1 foundation of needs, physiological. Second would be a diagnosis related to her depression, which would fall under safety, which is number 2 on the pyramid, and so on.

I hope this makes sense. I just feel in my case at school if I follow the hierarchy of needs, I can argue my point if they challenge me on grading, which has only happened once and then after discussing my thinking with the instructor and the hierarchy she agreed and all was well.

Hope this helps. Good luck, let me know if you have any other questions.

collins anyiam · Jul 20, 2011

I quite disagree wit applying Maslow's hierachy of need in priotizing nursing care. When ur caring 4 a pt, the most important issues that if not tackled immediately can result to complications should take priority. A good example is a pt who returned from surgery. Now, ur priority should be on maintaining a patent airway bcos d pt might have *ineffective airway clearance or ineffective breathing pattern as d case may be, r/t copious tracheobronchial secretions., or the effect of anaesthesia and not focusing on the post-op anxiety or pain. Now in ur case, i think Risk for injury r/t to peripheral neuropathy as evidenced by numbness should be ur 1st diagnosis,bcos this pt has to know how to care for herself to avoid injury, bearing in mind the consequences/complication of injury in a pt with numbness. The nxt diagnosis shld b *activity intolerance r/t altered metabolic process as evidenced by pts verbalization of weakness. Etc.

Hope this gives u a clue on hw to prioritize ur care.

nurseprnRN, BSN, RN · Jul 22, 2011

the nclex always wants to know that you know how to keep your patient safe first. could be airway, could be moving away from the fire before you pick up the phone, could be being sure an elder isn't being ripped off by an unscrupulous family member or sexually abused.

this lady's got multiple safety needs-- she has already fallen once, she can't feed herself enough, she has social isolation, she can't adequately seek health care....

one of the truly great things about the nanda taxonomy is that you can apply it in the ways that best fit your individual patient.

you got under safety: risk for falls/injury, risk for impaired skin integrity;

under coping and stress you've got anxiety, ineffective coping, fear, anticipatory grieving, impaired resilience

under health promotion, you've got ineffective health maintenance, maybe readiness for enhanced self-health maintenance...

under nutrition, you've got imbalanced nutrition /less than body requirements, impaired swallowing, risk for ...

under elimination and exchange, you've got risk for urinary/bowel incontinence....

you see where i'm going with this. you do not have to pull this out of the air-- the book is right there waiting to help you. you can find nsg dx to help you in every domain of this woman's life. and that's the point.

if you don't have the nanda 2009-2011 handbook, you want it right now. you put tabs on the pages for each domain, and then you look at each one in turn and pull out the diagnoses that pertain to your patient. then you look at them, and figure out which defining characteristic(s) and related factor(s) apply to your patient and you are soooo off and running.

hint: i am decades out of school, and this is not the nsg dx i had when i was there. i use this book every day as i work as an independent nurse consultant, because the nursing process is my legal basis for practice, and this is the scientifically-validated body of knowledge for me to document that. this isn't something you will never need again once you get out of fundamentals or even when you graduate. get the book and fall in love with the power of nursing. and besides, you'll knock your faculty's socks off.