Nursing DX priority questions

[blueyes34107]

I am a nursing student who's program bases our care plans on Maslow. At my last clinical I had a patient with Major Depressive Disorder (severe) who was in general good health. I am required to complete 2 care plans, one physiologic and one psychosocial. In trying to prioritize different nursing diagnosis for my physiologic careplan, I keep focusing on the fact that he was on fall risk precautions, had an unsteady gait with shuffle steps, a history of falls, and a medication list that had at least 2 medications that had dizzyness as a side effect. This all points to a safety/ security need according to Maslow (in my oppinion). Since the patient is generally healthy, and we were not allowed to touch the patients for a hands on assesment, could that be considered physical? I tried to relate it back to a more physiological care plan, but the best I could come up with was "impaired mobility". Could anyone offer some hints as to which route they would go?

[dudette10, MSN, RN]

Risk for falls instead of impaired mobility seems like the diagnosis that is more appropriate because his/her mobility is not impaired, balance is.

This is a physical need, not a psychosocial one. Maslow's addresses both physical and psychosocial needs.

ETA: Here's your assessment data that points to risk for falls.

had an unsteady gait with shuffle steps, a history of falls, and a medication list that had at least 2 medications that had dizzyness as a side effect.

[blueyes34107]

Isn't impaired mobility a safety/ security diagnosis, though? (I know it's not psychosocial,) but I was trying to pull a diagnosis that pertained more to a physiological need (rather than safety/ security) which is where I arrived at impaired mobility (although, to be honest I could see that as a safety/ security also). How do you distinguish between a physiological need and a safety/ security need. I know that physiologic means food/ air/ water, but if all of that is healthy, you just go to the next level, right?

[dudette10, MSN, RN]

Yes, you're right. I misunderstood a couple things in your post (not an issue with your post...an issue with my interpretation of it). :)

The only thing I can think of for this particular patient that may be a physiologic (lowest level) need would be hygiene. Does your assessment data reveal any issues with hygiene, which is sometimes a problem with severely depressed patients?

If not, yes, I would think you would have to move up a level.

[blueyes34107]

Thanks for the help!