lacerated spleen

[rayray35]

I need some help! I am a new nursing student and have to write a care plan for my patient that has a lacerated spleen. She is not having surgery and is getting ready to be released. She is a heavy drinker who drinks 12-18 drinks a day. I have come up with acute pain, risk for bleeding, risk for impaired liver function, constipation, risk for infection, deficient knowledge, and nausea for my nursing diagnosis, I know physiological needs to come first but 5 of these are physiological so how do I prioritize them? Any help would be greatly appreciated!!

[phoenixrn]

Start with your ABCs (Airway, Breathing, Circulation)

One of those nursing dx can be prioritized based on that. Good work so far!

[traumaRUs, MSN, APRN]

Moving to nursing assistance forum

[psu_213, BSN, RN]

As someone already mentioned, think ABCs first. This is not the official nusing education answer, but think about problem will be the first to cause their death (this would probably eliminate constipation...although I hope that was not your priority dx. to begin with).

Also, is "risk for bleeing" and "risk for impaired liver fxn" NANDA dxs? The last time I had to do a formal care plan was 2008 when I grad. from ADN school...have they added these since then?

[rayray35]

Start with your ABCs (Airway, Breathing, Circulation)

One of those nursing dx can be prioritized based on that. Good work so far!

Ok I am still confused, do the actuals always come first? This is how I "think" they

should be prioritized but am always second guessing myself! Acute Pain, risk for bleeding,

risk for infection, constipation, risk for impaired liver function, nausea, and deficient

knowledge or should deficient knowledge be towards the top since if she does continue

to drink alcohol she will die!! This is hard!! I appreciate all your help and expertise!!

[rayray35]

As someone already mentioned, think ABCs first. This is not the official nusing education answer, but think about problem will be the first to cause their death (this would probably eliminate constipation...although I hope that was not your priority dx. to begin with).

Also, is "risk for bleeing" and "risk for impaired liver fxn" NANDA dxs? The last time I had to do a formal care plan was 2008 when I grad. from ADN school...have they added these since then?

Yes risk for bleeding and constipation is a NANDA, no I didn't think constipation was my first nurse dx but am still confused what should be! I know bleeding could kill her ecspecially internal bleeding but should actuals come before risks for?