prioritizing

[stellatina1988]

For the following 3 nursing diagnosis,

1---fluid volume deficit

2---impaired nutrition

3---risk for falls

if I am going to prioritize these 3 nursing diagnosis, do you think they are in the right order????? someone help plz!!!

[sarahsmile44]

I would say fluids, falls then nutrition if it were my careplan.

[gumby1411]

Definitely nutrition last. I'm tied between fluids and falls, however, I'm leaning toward fluid volume deficit as the 1st priority because that is a current problem while risk for falls is a "risk" and not yet a problem.

[sarahsmile44]

Right, and fluid volume deficit can lead to electrolytes imbalance which could lead to death...especially with potassium levels being so sensitive :)

[stellatina1988]

why put nutrition at last?

I think poor nutrition would lead to weakness, then lead to fall risks

[sabrina_RPN]

I'm going to say fluid, nutrition, falls. Reason being fluid deficit causes poor nutrition which can cause weakness and falls. Most patients who come in for dehydration are first fluid resuscitated, the nutrition is addressed. Which relates in a stronger patient and therefore preventing weakness which could attribute to falls.

Just my 2 cents,

Sabrina

[gumby1411]

Well, I guess it depends on why the pt is at a risk for falls - is it due to generalized/musculoskeletal weakness? Dementia? Hx of seizures?

I still think nutrition is last because you want to make sure the pt is safe before their nutrition is taken care of. Of course nutrition is important and can affect electrolyte imbalances, but I think the pt's safety takes priority over that. Again - my .

[itsmejuli]

Using ABCs and Maslow all three are equal priority...right?

[Suethestudent]

Fluid and nutrition are Maslow priority 1 because they are physiological needs. Risk for falls is 'safety' which is Maslow level 2 so technically it should be fluid, nutrition and risk for falls. However if your patient has for example syncope, vertigo, vision disturbance or dizziness and they are not operating with awareness of their limitations then use your nursing judgement and change priorities with a rationale ready if your instructor asks why you did it. Create scenarios in your mind and do a 'what if?' and see what the consequences turn out to be.

HTH

[gumby1411]

I stand corrected. You guys are right, pt safety comes after food/fluids. Still doesn't seem right that the nutrition can't wait until after the pt's environment is safe, but according to Maslow's hierarchy, it's not the priority compared to the other two.

But I wonder, you have a pt that is at risk for falls, wouldn't you take precautions against them falling out of bed before you get their IV's running or food delivered? I suppose it also depends on the urgency of the deficit and how dehydrated the pt is.