Quote from jkcmom
swallowing takes priority over shortness of breath - airway, airway, airway...
that is true when the symptoms pertain to the airway
. however, the nursing diagnosis, impaired swallowing, does not have anything directly to do with the airway. its definition is: "abnormal functioning of the swallowing mechanism associated with deficits in oral, pharyngeal, or esophageal structure or function." nursing diagnoses: definitions & classification 2005-2006
published by nanda international, page 195. nanda lists the causes (related factors) for it as being due to either congenital defects or neurological problems. a cva might create the neurological problem for the patient. while aspiration prevention is an outcome of this diagnosis, that does not establish it a topmost priority. in reality this nursing diagnosis would only be used if positive attempts were being made to feed the patient orally.
the nursing diagnoses dealing with airway obstruction, airway clearance and oxygenation that take often take priority over others are:
- impaired gas exchange
- ineffective breathing pattern
- ineffective airway clearance
- impaired spontaneous ventilation
- dysfunctional ventilatory weaning response
in maslow's hierachy of needs, the physiological needs are also arranged in priority. that priority is:
- oxygenation (no oxygen getting to the brain or tissues leading to cell death)
- temperature control
when using nursing diagnoses you must always be familiar with the definition of the nursing diagnosis and the defining characteristics and related factors that nanda has approved as part of the descriptors for them. choosing nursing diagnoses is not something you can always do by looking at a list and picking out the ones that "seem" to fit your needs. that is not the intent of nanda or critical thinking at all! for this reason a nursing diagnosis book
is much better for a beginner of care plan writing than someone who has been doing it for awhile and knows the signs, symptoms and causes of the various diagnoses. applying nursing diagnoses should be taken as seriously by nurses as physicians diagnosing medical conditions. physicians also have to learn the signs, symptoms and causes of many more diseases than the 172 current nursing diagnoses that nurses have to work with.