Need Help with Priority


I had a pt who is admitted to hospital due to COPD and pneumonia. She is almost treated and she has clear lung sounds. she coughs and has green to white sputum. O2 98% weight loss about 200 pound to 160 pound. now she is gaining weight and has apetite. she has pain on her right knee and hip. she gets physical therapy such as walking, bicycling, and lifting her knee.

I thought about nrg Dx

1. Ineffective airway clearance r/t presence of secretions

2. Chronic pain r/t hip and knee weakness

3. Impaired physical mobility r/t knee and hip pain

4. Inbalanced nutrition r/t pneumonia and COPD

I am not sure about these Dx and the priority.

Please help me.

Daytonite, BSN, RN

4 Articles; 14,603 Posts

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

i think your diagnoses are chosen ok, but some of your related factors are not appropriate for the diagnoses that are matched with and need changing. the priority of the list needs rearrangement:

  1. ineffective airway clearance r/t presence of secretions
    • change to excessive secretions

[*]imbalanced nutrition: less than body requirements r/t pneumonia and copd

  • the r/t factor is the reason the person has been losing weight and it is not because of a disease, it is because they are not eating enough or their body is just not absorbing enough from the food they are eating

[*]impaired physical mobility r/t knee and hip pain

[*]chronic pain r/t hip and knee weakness

  • weakness does not cause pain. pain is almost always due to some kind of injury to the tissues which has brought about an inflammatory response which has resulted in enough swelling which is what has caused the pain. does this patient have some type of arthritis?

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