Nursing diagnosis help...please!

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I have a patient who has a long history of illness.. but he is in the hospital for a UTI, he has MR, parkinson's disease, renal failure, cannot talk, can barely move and is on bedrest. he is also developing a pressure ulcer stage one on his sacrum. this may seem stupid, but i wondered if someone could tell me what the most important diagnosis would be. i have a ton, but i'm really paranoid about my teacher and i wanna try and get it right. so far i have:

Impaired skin integrity r/t rigidity, decreased range of motion, bradykenesia, inability to turn self in bed,increased shearing forces and increased pressure on sacrum secondary to necessity of keeping client in semi fowler position to avoid aspiration aeb possible stage one pressure ulcer on sacrum.

impaired physical mobility r/t effects of muscle rigidity, tremors and slowness of movements on activity of daily living in parkinsons disease aeb inability to ambulate and perform adl

impaired verbal communication r/t dysarthria seconday to ataxia of muscles in speech in parkinsons disease aeb no verbal communication.

can someone help me? Thanks

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Specializes in Adult Oncology.

You have those in the right order in my opinion.

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Specializes in VA-BC, CRNI.

Can he make his needs known? ie can he make his pain needs known? Big item with Medicare!

The second thing I would focus upon is skin integrity.

BTW I would make sure to keep any medical Dx out of the Nursing Dx.

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