pls help prioritize nursing diagnosis

[rosearias1]

hi, i suppose to make a nursing care plan about a patient suffering from anemia secondary to upper gastrointestinal bleeding secondary to benign peptic ulcer? pls help me which nursing diagnosis should i prioritize? i am considering inefffective tissue perfusion and acute pain? which one should be my first p/riority.. /thanks///

[Jen2002]

Always prioritize nursing diagnosis as you would triage. What will kill the person always comes first.

[Daytonite, BSN, RN]

i just addressed prioritizing this morning in this thread and you should read my last post on the thread: https://allnurses.com/nursing-student-assistance/has-priority-pain-428404.html - which has priority? pain or nutrition?

ineffective tissue perfusion, specify should be listed before acute pain. however, ineffective tissue perfusion as you have written it is not a complete diagnosis and i am not understanding why you would use this. you must specify what organ is being affected by the poor tissue perfusion. which organ has poor tissue perfusion here? ineffective tissue perfusion, gastrointestinal occurs when there is a blocked artery or an infarct of an artery has occurred--it is like having a stroke in one of the gi arteries. it is a life threatening situation. these patients will have no bowel sounds, their abdomens become distended, they are nauseated and have severe, and i mean severe, abdominal pain. these patients often die. that is not what is going on with this patient. if they had ineffective tissue perfusion in the gi area they would not be losing blood from the ulceration.

the pathophysiology of an ulcer is that it is caused by acid eating away at the mucosal lining of the gi track to the point that an ulcer is formed. with anemia due to blood loss or hemorrhage deficient fluid volume is the problem because of the loss of fluid (blood) and this is manifested by low h&h counts.