Nanda priorities

My most helpful (care plan -wise) instructor told me to look at causes and results when prioritizing dxs. If one of your dxs is causing the other (diarrhea causing deficient fluid volume) it would be a higher priority, because resolving that problem would resolve the sequelae.

Diarrhea and Bowel Incontinence seem a bit redundant, no?

If the pt's perianal area is red and excoriated, maybe consider a dx about Skin Integrity?

And since some of the pt's problems are caused by CDiff, what about Infection? (I know NANDA technically says "Risk for infection"... but I've had every single instructor tell me that Infection was an acceptable nursing dx).

Hope that helps!

First thing to do to get a nursing dx is to look at your pt. Do an assessment and go through the chart. You build a nursing dx on the problems the pt has or is at risk for---then you go to the nursing dx book and start pullilng out any/all potential dx's. Finally, you start reading the parameters of the dx. Does the pt's s/s fit the dx? If it does, then use it if it does not, get rid of it.

Question: how do you know your pt's accute confusion is related to fluid loss? I/O: how much has been lost, how much has been replaced. Is there a deficit? What does the labs reveal--lytes, H/H. How is the turgor? Are the pt's eyes sunken, mouth dry, and is there intense thurst. Is the patient's confusion so much that the pt is unable to drink or recognize thirst? Is the pt receiving fluid replacement if so what.

Skin impaired: What is the info to prove impaired skin. Is the skin red, or what? Or are you talking about a risk of skin integrity ?

Read the nursing DX book and find out exactly what nanda diagnosis will match your pt's s/s, labs, fluid in/out, etc. Then prioritize your dx's by the ABC--airway, breathing, circulation--this includes heart rhythm as well as the quantity/quality of liquid within or not in the system.