Nursing Diagnosis

he has difficulty in sleeping and he was wake up more frequently during the night in order to urinate. So, he just able to sleep for 3 to 4 hours and not in continuous manner. In addition, he has physical disability as a result of right hip fracture secondary to recurrence fall. However, he was able to stand but with supportso he is moving now by assistance of wheelchair. However, he was able to

perform the ADLs independently.

Mr. M.A.M was weak person, consuming 3 meals per day in addition to eating food between the meals. He doesn't has any swallowing difficulties but he stated that I felt that I lost some kg from my weight”.

Finally, the pt. usual bowel habits was irregular as he usually complain of

constipation.

Part of this assignment is realizing that there is no assigned hierarchy for an individual patient; you, the assessing nurse, get to decide which of the nursing diagnoses you made is the most important to your patient, and defend your choice to your faculty. That's an exercise you will perform many, many times per day as you juggle what has to happen next.

In addition to Maslow's Hierarchy of Needs, there are other prioritization frameworks: ABCs, safety and risk reduction, urgent versus chronic, etc. Here is a link to ATI with some explanations. These are meant for NCLEX style questions, but they can also work for care plan prioritization.

Bad Request

But, based on your assessment, which problem seems to be causing or have risk for causing altered health for your patient?

Most patients are at risk for fall, but if a person is a 2 person transfer, impulsive, STML, has multiple lines, and on anti-coagulants, then a fall could kill them. Risk for fall may be the priority. Or, if they always use the call light, no lines, and can follow directions, may be low priority.

Constipation can range from discomfort to bowel perforation. So depending on last BM, any constipating meds, hx of bowel issues, physical assessment, this may or may not be a priority.

Same goes for imbalanced nutrition, sleep disturbance, elimination. How big of an issue is it for the client? Is it life-threatening? Is it an acute or chronic issue? One more thing to consider is that the problem with the most data to support it, is often the priority.

Rose_Queen said:

There is no magical formula that tells you which of your nursing diagnoses is most important. What matters is what is the priority for your patient based on your nursing assessment. What does your nursing assessment tell you is the priority for the patient and what is your rationale?

This is true but as in the ED, life limb and sight issues will get you a ticket to the front row.