Prioritazation question. Need help asap

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Any help would be greatly appreciated. I have all of my nursing diagnosis written and i am having trouble prioritizing them. Do actuals come before potentials? The actual diagnosis are Pain, anxiety, and deficient knowledge while the potentials are more of the ABCs such as risk for ineffective airway clearence, risk for imparied skin integrity, acute pain, etc. Do I put the actuals before the potentials even though the potentials precede the actuals in maslows heirarchy?

THanks in advance!

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Specializes in Oncology, Palliative Care.
Do actuals come before potentials? The actual diagnosis are Pain, anxiety, and deficient knowledge while the potentials are more of the ABCs such as risk for ineffective airway clearence, risk for imparied skin integrity, acute pain, etc. Do I put the actuals before the potentials even though the potentials precede the actuals in maslows hierarchy?

I am right there with you being frustrated with this stuff!! I have a lot of trouble with it too... my instructors say that *usually* actuals will come before risk-for diagnoses, unless your risk-for could be more life threatening if it were to happen than your actual could ever be. for example, last week i had a postpartum patient who's #1 diagnosis was risk for fluid volume deficit because if she did actually hemorrhage it would kill her faster than anything else... even though she actually had pain, anxiety, impaired skin integrity, disturbed sleep pattern, and deficient knowledge. It seems like almost anything ABC related would come before pain (comfort), anxiety (safety and security), and deficient knowledge (safety and security).

They've also made it clear that pain will hardly ever be your #1 unless you have a patient where palliative treatment will be most important (maybe cancer, sickle cell, AIDS).

Any time i'm stuck on something i ALWAYS search for DAYTONITE's postings... she has passed away since i joined the discussion board, but her info has been invaluable!!!! Here's a link to my favorite Maslow post by her https://allnurses.com/nursing-student-assistance/priority-diagnosis-278240.html

also, my care plan book has a list that groups the diagnoses by physiological, safety security, love and belonging, self-esteem, and self actualization needs.... they aren't prioritized- which is where Daytonite's help came in, but grouping them helps. does your care plan book have that?

Does any of that help?? Stick with it, and good luck :)

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I am right there with you being frustrated with this stuff!! I have a lot of trouble with it too... my instructors say that *usually* actuals will come before risk-for diagnoses, unless your risk-for could be more life threatening if it were to happen than your actual could ever be. for example, last week i had a postpartum patient who's #1 diagnosis was risk for fluid volume deficit because if she did actually hemorrhage it would kill her faster than anything else... even though she actually had pain, anxiety, impaired skin integrity, disturbed sleep pattern, and deficient knowledge. It seems like almost anything ABC related would come before pain (comfort), anxiety (safety and security), and deficient knowledge (safety and security).

They've also made it clear that pain will hardly ever be your #1 unless you have a patient where palliative treatment will be most important (maybe cancer, sickle cell, AIDS).

Any time i'm stuck on something i ALWAYS search for DAYTONITE's postings... she has passed away since i joined the discussion board, but her info has been invaluable!!!! Here's a link to my favorite Maslow post by her https://allnurses.com/nursing-student-assistance/priority-diagnosis-278240.html

also, my care plan book has a list that groups the diagnoses by physiological, safety security, love and belonging, self-esteem, and self actualization needs.... they aren't prioritized- which is where Daytonite's help came in, but grouping them helps. does your care plan book have that?

Does any of that help?? Stick with it, and good luck :)[/quote

Thank you!! This helps soo much. Now I have to go change my careplan prioritization. : )

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Specializes in ER, progressive care.

use Maslow's Hierarchy of Needs and also your ABC's to prioritize diagnoses.

always think of what's going to kill them the quickest! for example, you have an immunocompromised patient, who are always at risk for infection. infection will KILL these patients so it is imperative to decrease the spread of infection to these patients.

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I have found that the answer depends to a large degree upon my instructor and how they view priorities. Sometimes the answer is more obvious (ABC's, emergent conditions), but sometimes it seems to be a coin flip (risk for this vs. that).

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Specializes in Psych.

i do the what will kill you first method :)

So if it was Risk for ineffective breathing vs pain, I would take Risk for ineffective breathing.

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Specializes in ER, progressive care.
i do the what will kill you first method :)

So if it was Risk for ineffective breathing vs pain, I would take Risk for ineffective breathing.

This, because people do not die from pain ;)

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