My care plan patient has multiple dx, and I am not sure which one would be considered a primary and then secondary. Admission MD dx:hypoxemia,potential sepsis, diffuse edema, left leg swelling, obtundation, anemia. Also included are: End stage kidney disease secondary to diabetes and hypertension. He is on dialysis 3x week, He has a rt partial foot amputation. He came to the hospital due to a left foot unhealing wound that went sepsis, they amputated his left lower leg at calf, and will be going back to surgery in a few days to half more cut off, so its a below the knee amputation. He has hx of MRSA, so on contact isolation. I know my care plan has to focus on the primary medical dx, but not positive what that may be. Would it be DM, and then secondary would be end stage kidney disease or CRF? I am really lost. My focus on nrsg dx is more about his inability to move & cope with this, but I don't think an amputation is a primary med dx. I have to make a concept map of the primary dx as well. SO I am stuck until I figure out the primary dx. Any advice would be soooooooo helpful. It figures I end up with the most difficult care plan pt(at least he is sweet).