how to prioritize problems for psychiatric patients?

[jac989011]

how do i prioritize these nursing problems?

i'm not sure if i'm doing it correctly.

can anybody help?

i thought of prioritizing them according to severity, ABC's and Maslow's needs and this is how it came out:

(patient's case is manic bipolar 1 disorder with psychotic features)

1. risk for suicide

2. imbalanced nutrition: less than body requirements

3. sleep deprivation

4. altered thought processes

5. ineffective coping

6. [chronic] low self-esteem

7. partial self-care deficit: hygiene

8. knowledge deficit

9. readiness for enhanced self-concept

how would you prioritize these?

please help...

and thank you, too.

[UM Review RN, ASN, RN]

Any diagnosis is prioritized by the A,B,C's --airway, breathing, circulation and Maslow.

So ask yourself which of these problems will affect the airway, the breathing, and so on. Then you move on Maslow and to the problems that can physically affect the patient, the most serious first, because those can also affect the mental, emotional, and spiritual function. "Risk for" dx's have not happened, so they go at the bottom of the list. But in this case, since the patient is a psych patient, I would go for the suicide risk first.

Personally, I like your list the way it is. But I'm not the expert. Hopefully, she'll be along shortly. Yes, Daytonite, I'm talking about you.

[Daytonite, BSN, RN]

maslow guides us how to prioritize within each of the tier's (http://en.wikipedia.org/wiki/maslow's_hierarchy_of_needs):

1. physiological needs (in the following order)
   
   • the need for oxygen and to breathe [the brain gets top priority for oxygen, then the oxgenation of the heart followed by oxygenation of the lung tissue itself, breathing problems come next, then heart and circulation problems--this is based upon how fast these organs die or fail based upon the lack of oxygen and their function.]
     
   • the need for food and water
     
   • the need to eliminate and dispose of bodily wastes
     
   • the need to control body temperature
     
   • the need to move
     
   • the need for rest
     
   • the need for comfort
     

[*]safety and security needs (in the following order)

• safety from physiological threat
  
• safety from psychological threat
  
• protection
  
• continuity
  
• stability
  
• lack of danger
  

[*]love and belonging needs

• affiliation
  
• affection
  
• intimacy
  
• support
  
• reassurance
  

[*]self-esteem needs

• sense of self-worth
  
• self-respect
  
• independence
  
• dignity
  
• privacy
  
• self-reliance
  

[*]self-actualization

• recognition and realization of potential
  
• growth
  
• health
  
• autonomy
  

this is how i would prioritize them based on diagnostic label alone:

1. risk for suicide (this must be sequenced first because the patient's life is in jeopardy)
   
2. altered thought processes (a physiologic need that involves the working of the brain)
   
3. imbalanced nutrition: less than body requirements (a physiologic need: nutrition)
   
4. sleep deprivation (a physiologic need: rest)
   
5. partial self-care deficit: hygiene (a physiologic need: comfort)
   
6. knowledge deficit (safety need)
   
7. [chronic] low self-esteem (a self-esteem need - one's self- worth is more important than their self-reliance)
   
8. ineffective coping (a self-esteem need: self reliance)
   
9. readiness for enhanced self-concept (self-actualization need)