Determining Priority Diagnosis for Home Health

[stdntograd06, BSN, RN]

I did a home health visit on an elderly lady with CHF and have to do a care plan with my priority nursing diagnosis.

First, she exhibited no symptoms of CHF, no complaints of cardiac, respiratory, or otherwise.

My issue is that from the time we arrived at the front door, you could see a bunch of issues:

extremely cluttered home with a pathway the width of the walker

foul odor throughout

rabbits in cages in the living room

client sits in a rocking chair most of the time

incontinent

no real assistance with care, medication, hygeine, etc..

unsafe mobility and living conditions

noncompliance with meds (they were in a pill box and a bag on the floor

My first priority would be SAFETY, but can you have a "Risk for Injury, Skin Breakdown, Impaired Skin

Integrity, etc..." as a priority? I say yes if it is indeed a safety issue.

I could use some help with this one please.

Thank You-

Kelly