Prioritizing Nursing Diagnosis

Published

Help is appreciated guys. I going back an forth trying to decide which is first: Innefective tissue perfusion or Impaired physical mobility. I have subjective and objective data for both. I know I have to consider the ABCs. If circulation is the problem, then is Innefective tissue perfusion, but there's no edema, just the skin color is not normal, and the diminished peripheral pulses are present. On the other hand, If I cannot move is Impaired physical mobility, because I need to be assisted for the ADLs, then is Impaired physical mobility. Thanks a lot.:) PS :writing: I know the top one has to be the one in which I can have some intervention to make a difference in the status. If it is Impaired physical mobility, this could be the one, but I do not have any respiratory conditions to address, it would be only as preventive measures.

Up Vote Up Vote ×
just the skin color is not normal, and the diminished peripheral pulses are present.

We need more assessment data.

Why was your patient admitted?

What is their diagnosis?

Age? Social Hx? PMH?

Breath sounds? Heart sounds?

Recent labs? Continent?

Diaphoretic? What are the pulses on a scale? Bowel sounds? Capillary refill? Their skin is red and they have diminished pulses? What is this related to? How did they end up like this? Why are they immobile? How do they void? BS commode? Foley? Bed pan? How do they transfer? What's their immobility due to? CVA? Fracture?

There's sooo much more to know.

I'm inclined to say if you aren't getting PERFUSED that's a lot more sucky than not being able to move... but I don't know your patient well enough to assert that's THEIR priority.

Up Vote Up Vote ×

Thanks StudentOfHealing, you're right, more data is needed. Heart condition ok. Respiratory ok. Hx. PVD, DM II, Ulceration in feet, plus recent BKA LL. (2 days post-op). Even though everything leads to Ineffective tissue perfusion with CRT

Up Vote Up Vote ×

Thanks StudentOfHealing, more data is needed. Hx. PVD, DM II, Ulcerated toes, RA. CRT

Up Vote Up Vote ×

Use Maslow's hierarchy to help you prioritize.

In the ER you get the highest priority if you have a life or limb threat.

EDIT: I think you're missing some important risk diagnoses. I don't have a NANDA book handy but what are the defining characteristics for impaired mobility? Are you concerned about impaired mobility because of the effect it's having on ADLs or is there something deeper going on?

Up Vote Up Vote ×

Thanks outrunningzombies, my concern is total dependency to perform ADLs, risk for impaired mobility, risk for impaired skin integrity, risk for falls, and with impaired mobility the possibility to develop PE. Thanks a lot

Up Vote Up Vote ×

Good! Now grab your NANDA book and make sure your diagnoses are in it. I know risk for PE isn't one. I imagine there's a nursing way to say it. Make sure to look at the defining characteristics for the diagnoses so you can determine if they are the most appropriate ones.

Why did you get rid of the impaired perfusion?

Up Vote Up Vote ×

Yes, you're right. Looking at the defining characteristics points to Ineffective Tissue Perfusion. Circulation is priority over mobility. It helps to think and go through the assessment data, but thank you guys for clear out my head! :up::up::up: Thank you allnurses!!!

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Remember ABC's Airway breathing circulation then Maslows.

Up Vote Up Vote ×
Specializes in NICU.

I love these questions!

Up Vote Up Vote ×
+ Join the Discussion