Help! Care plan question

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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!:D

Don't forget to check your meds list and labs for the patient. These will help you to prioritize as well. If your patient is on 5 different forms of pain medication (yes, it happens...) then Acute Pain trumps all! As for the rest of the dx, well....what do YOU see as the pts primary problems? What are the most important things that need to happen before discharge? As for the diarrhea, are you sure that your pt isn't already in fluid volume deficit? Check your Intake/Output. It's all the little things that you can find in charting that will help you along the way. Care plans stink simply because of the "Official Mighty Nursing Diagnosis Format" that they must follow, but break it down. Use your assessment data, your conversations with your patient, and your intuition. I tend to see care plans as 'math'.....You have 'X' because of 'Y'.....you can see these from 'Z'..........now for the ABCDs of how I'm going to fix this! I hope that wasn't more confusing......:twocents:

Shan

Specializes in med/surg, telemetry, IV therapy, mgmt.

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 a 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

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