diagnosis prioritization

[AirForceTraumaRN]

I have three diagnosis I have to put in priority order.

Hypertension, anxiety and arthritis

I know hypertension is first but I am confused about the last two. I feel like anxiety should be second and arthritis third but I'm just not sure. Any help would be appreciated.

[erin1205]

Anxiety is a nursing diagnosis, but hypertension and arthritis are medical diagnoses. So, I don't think you can exactly prioritize one over another...

[Daytonite, BSN, RN]

1. Anxiety

Hypertension and arthritis are medical diagnoses and we are nurses. I can tell you how to prioritize nursing diagnoses because I am a nurse. But I'm not a doctor and haven't a clue as to how doctors prioritize medical diagnoses.

[AirForceTraumaRN]

They will be nursing diagnosis I was unsure of the order

Ineffective tissue perfusion

Anxiety

Activity intolerance

Is this the correct order?

[Daytonite, BSN, RN]

No. The correct order is:

1. Ineffective Tissue Perfusion (you need to specify the part of the body involved) - [Physiological need for oxygen]
   
2. Activity Intolerance - [Physiological need for energy]
   
3. Anxiety - [safety and security need]

[CT Pixie, BSN, RN]

Arthritis could also have a NANDA of Pain-Chronic (which would still put it above Anxiety according to Maslow.)

[AirForceTraumaRN]

Thanks for the help:nurse:

[nightmare, RN]

How differently you approach your care plans to the way we do it in UK! Now I would have said,treat the anxiety and that in turn helps lower BP and,as arthritis can be exacerbated by stress ,also helps alleviate symptoms there.I expect we all have the patients best care at heart it's just a different point of view.

[AirForceTraumaRN]

Nightmare...That's kinda how I was thinking!! That's why I asked the question. I was very confused and I am not sure how my prefessor will view this.

[nightmare, RN]

Good girl29 you will need to do this according to what YOU are taught!!!Don't forget I am in a different country and we do not use NANDA here.I would not like you to get into trouble quoting my way of doing things!!

[Daytonite, BSN, RN]

goodgirl29. . .i prioritized by maslow's hierarchy of needs commonly used by many nursing programs here in the u.s.:

1. physiological needs (in the following order)
   • the need for oxygen and to breathe [the brain gets top priority for oxygen, then the oxgenation of the heart followed by oxygenation of the lung tissue itself, breathing problems come next, then heart and circulation problems--this is based upon how fast these organs die or fail based upon the lack of oxygen and their function.]
     
   • the need for food and water
     
   • the need to eliminate and dispose of bodily wastes
     
   • the need to control body temperature
     
   • the need to move
     
   • the need for rest
     
   • the need for comfort

[*]safety and security needs (in the following order)

• safety from physiological threat
  
• safety from psychological threat
  
• protection
  
• continuity
  
• stability
  
• lack of danger

[*]love and belonging needs

• affiliation
  
• affection
  
• intimacy
  
• support
  
• reassurance

[*]self-esteem needs

• sense of self-worth
  
• self-respect
  
• independence
  
• dignity
  
• privacy
  
• self-reliance

[*]self-actualization

• recognition and realization of potential
  
• growth
  
• health
  
• autonomy

[PsychNurseWannaBe, BSN, RN]

How differently you approach your care plans to the way we do it in UK! Now I would have said,treat the anxiety and that in turn helps lower BP and,as arthritis can be exacerbated by stress ,also helps alleviate symptoms there.I expect we all have the patients best care at heart it's just a different point of view.

I couldn't help but snicker when I read this. I was thinking the same way. I know they way it is supposed to be done in the U.S. but sometimes I can't help but think there are many different ways to approach a patient. For me I believe there are times when alleviating psychosocial events leads to better physiological outcomes. Again...that is my person view.