Help! Prioritizing care. Care Plan.

[ciao_amore616]

Sorry if this is the wrong spot.

I was wondering if anyone can help me with a care plan. I'm really stuck as to what the priority of care should be for a patient. Say the patient has ESKD, diabetes, and an acute infection. That and a handful other comorbidities.

I at first wanted to go ahead and write a care plan having to do with the acute infection since it is the current problem being treated (vs managed). I don't see how the infection could compromise homeostasis since pt is on antibiotics and not septic. If pt were septic I'd go with that. So then I thought it must be something to do with the ESKD. But I honestly couldn't figure out what about it. Electrolyte levels were not all abnormal except sodium (high) and calcium (high). Pt is not hypervolemic. Pt is hypotensive but it is their baseline. I thought may something to do with circulatory function but nothing seems compromised except for hypotension.

I honestly can't figure out the immediate threat to the patient. They have so much going on that I'm confused. I have a feeling I'm approaching this the wrong way but I've dug myself a grave (a bad grade grave) with my own confusion. I've spun circles around this for a while.

I know the information's not much to go off of but any help/suggestions would be great.

Thanks for your time.

[203bravo, MSN, APRN]

When doing a nursing care plan you don't pick a medical diagnosis and then make the plan work.. you do your head to toe nursing assessment and then write your plan based on what's going on at the time of the assessment. It is possible that it has nothing to do with their long term diagnosis or even their admitting diagnosis.. It's all about what's going on with them right now.

That being said, it would be impossible for anyone to offer you any real assistance based on the information that you have provided... But if you don't have any other then think about the disease processes and what it does to body systems and what your patient would likely be experiencing and don't forget about their knowledge level about the disease processes and any mobility issues.

Best of luck.

[ciao_amore616]

You're totally right. You made me realize I was going about the whole thing the wrong way.