HELP! Care plan question Due tomorrow!

[miss_pitty_pat]

I need help! I am doing my care plan for Med/Surg II. Last semester my instructor told us that Actual diagnoses are always prioritized above RIsk for diagnoses. My list is as follows: 1. Acute Pain 2. Anxiety 3. Diarrhea 4. Deficient knowledge 5. Risk for deficient fluid volume 6. Risk for impaired skin integrity 7. Risk for injury. I am getting help from a 2nd year student (as part of her service learning project) and she is telling me to put the risk for dx first because they relate more to the patient's admission dx. I don't know what to do and it is due tomorrow! :banghead:Also, she told me to delete the Diarrhea dx because it is a medical dx and not a nursing dx. I got it straight from my All in One Careplanning book saying it is a nursing dx. I have been unable to reach the 2nd year student who was helping me and I need some suggestions PLEASE! Thanks in advance for any help!

[sleepy1010]

Hi, Your friend is right diarrea is not a nursing dx. the careplan books can be confusing. they may have medical diagnosis like diarrea listed with nursing diagnosis 4 that medical problem. Ex - risk 4 fluid volume deficit is the primary nursing dx 4 diarrea. Also I would start with the acute pain and the go to risk 4 fluid vol and then risk 4 infection. Hope that helps a little!

[Daytonite, BSN, RN]

i answered this on the general nursing student discussion forum. go by what your instructor is telling you. i say the same thing. actual problems (diagnoses) get sequenced first over anticipated problems.

1. diarrhea - yes, this is an official nanda nursing diagnosis!
   
2. acute pain
   
3. deficient knowledge
   
4. anxiety
   
5. risk for deficient fluid volume
   
6. risk for impaired skin integrity
   
7. risk for injury
   

[Daytonite, BSN, RN]

hi, your friend is right diarrea is not a nursing dx.

this is quite wrong. diarrhea is a nursing diagnosis and can be found in the nanda international nursing diagnoses: definitions and classifications 2009-2011 taxonomy on page 107. definition: passage of loose, unformed stools. it also has webpages on the gulanick-myers care plan constructor (http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=16) and the ackley/ladwig constructor (diarrhea).

[BabyLady, BSN, RN]

Some nursing instructors do not like the 'risk for....' dx to be used as the primary diagnosis. The reasoning behind it is that you can be "at risk" for just about anything...in other words, there is usually something you can find that is more pressing.

[Dianacabana]

Daytonite mentioned the Care Plan Constructor which is a resource with the text Nursing Care Plans (Gulanick/Myers). The text is outstanding. My clinical instructor recommended it and my group really likes using it (we all share a copy). So easy to use, excellent information and rationales.