Need Help with Diagnosis

[redsknnurse]

I am trying to do my care plan for my patient, but I cannot decide which diagnosis is the priority. I have a 76 y/o female who was admitted with a CVA. She has difficulty swallowing and is on a thickened liquid diet, and she has not had a BM in 5 days. So is my priority diagnosis, Risk for Aspiration or Constipation? Please Help!

[kimmedans]

you need to look at her bm habits, to see if this is normal for her or if she has had anything that may contribute to the constipation. but risk for aspiration would be more of a priority.

[dec192008]

A general rule of thumb I use is that something that the pt already has (like constipation) is more of a priority than any "risks for" UNLESS the "risks for" deal with airway, breathing, and/or circulation. Has anyone else heard this? Correct me if I'm wrong!

[dec192008]

P.S. I also forgot to mention that if your patient is on a "thickened liquid diet", less bowel is likely to be produced and bowel movements are likely to be less common than their usual bm pattern when consuming solids.

[Daytonite, BSN, RN]

The need for food and water in order to survive takes priority over the need to eliminate wastes. You need to sequence Impaired Swollowing first and Constipation after it.