Help! Priority nsg diagnosis for paranoid schizophrenic???

[xurn09]

Hi all,

I've just started my mental health clinical. My patient has the medical diagnoses of paranoid schizophrenia and anti-social personality disorder, as well as a history of substance abuse. Though the patient has been in a mental health facility for over a year by the order of the court, to me, the largest issue would be the patient's denial of any mental illness, as well as denying any drug and/or alcohol abuse. So would the priority ND be "Ineffective Coping/Ineffective Denial"?

I'll take any advice anyone has!! Thank you!!

[SuesquatchRN, BSN, RN]

My gut would be more of a risk for injury r/t impaired thought processes a/e/b....

Denial isn't really a part of psychosis. You can't deny what you are incapable of recognizing.

[Daytonite, BSN, RN]

a care plan is merely seeking the solution to patient's problems. in doing that, the patient assessment is the foundation of determining what their problem(s) is(are). if, after your assessment and analysis of the data you have collected, you find that ineffective coping and/or ineffective denial are the only problem(s) for this patient based on the data you have to support it, then the facts speak for themselves. they are of equal priority. you have listed no other facts of this case that would indicate a classification of rank that is higher in precedence than ineffective coping and/or ineffective denial. i always used maslow's hierarchy of needs to prioritize problems (http://en.wikipedia.org/wiki/maslow's_hierarchy_of_needs).

medical diagnoses have only some bearing on nursing diagnoses. like medical diagnosing, nursing diagnosing depending on doing a thorough workup first (history taking, examining of the patient) and then making a judgment about what their nursing problem(s) are using the nanda nursing diagnosis taxonomy to help you with classifying.

there is help with how to write and construct care plans on this thread in the general nursing student discussion forum

• https://allnurses.com/forums/f50/help-care-plans-286986.html - assistance - help with care plans