Priority Order of nursing Nursing Diagnosis..

AuntieRN · Oct 8, 2006

The way we were taught to prioritize them were ABC's first then safety..etc...Now I just graduated so perhaps some of the more seasoned nurses have a better suggestion but...I would probably have picked something like:

risk for fluid volume defecit r/t low RBC (can't use anemia as it is a diagnosis so you have to use something that refers to it.)

acute pain r/t incision

risk for infection r/t incision

impaired skin integrity r/t incision, bedrest

Hope this helps. Writing careplans was not my strong point. I know what to do and how to take care of my pts, but for the life of me can not seem to put it under NANDA and write it on paper in a plan form. Good luck to you!!

nervefreak · Oct 8, 2006

Thanks for reply.... Sorry, but what is ABC? Airway breathe Cardiac???

Also the pt is on 1.2 L fluid set and 1800 Cal Diet.

We were told to pick out 2 physiologic, (one should related to skin)1. psychosocial..

Use skin one for Concept Mapping..Care plan has taken me soo many days and I'm still working on it.. :mad:

augigi, CNS · Oct 8, 2006

I was always taught to do physical needs first, then psychosocial needs. Actual needs first, then risks.

There are lots he could have:

- Risk unstable blood sugars

- Risk impaired skin integrity r/t immobility, chronic disease, diabetes, nutritional deficits

- Infection r/t surgical incision, diabetes, nutritional deficits, immobility (don't think anticoagulant leads to infection)

- Risk bleeding (anticoagulant therapy, surgical incision)

etc etc

nervefreak · Oct 8, 2006

Daytonite,

Much appreciated. Thanks for those links and they really did great help on my confusion about care plan and RNSG dx.

My final RNSG Dx..

1, acute pain r/t incision, surgery

2. impaired skin integrity

3. infeective role performance

Does it make moare sense now??

Daytonite, BSN, RN · Oct 8, 2006

I would change the order to:

Impaired Skin Integrity
Acute Pain R/T surgical intervention
Ineffective Role Performance

Under both Maslow and Gordon, this is the sequence these nursing diagnoses would be listed in priority.

You don't list your "related to" items or "defining characteristics" for the Impaired Skin Integrity or the Ineffective Role Performance. You have determined these elements already, haven't you?

nervefreak · Oct 8, 2006

Yes, I have listed r/t and AED on my paper. Thanks again, Daytonite. Once I'm done with my lst paper (clock is kicking... :madface: ), I'm gonna go through all the links you gave me AGAIN. If anything confuses me again, I will ask you for sure. !!!!

augigi, CNS · Oct 8, 2006

That order is because pain is considered a "psychosocial" need and not a physical need.

Daytonite, BSN, RN · Oct 8, 2006

Pain is listed second below Impaired Skin Integrity because under Maslow's Hierarchy of Needs the physiological need for nourishment of the skin and tissues (in order to heal) comes above satisfying pain which is an issue of comfort. Under Gordon's 11 Functional Patterns Impaired Skin Integrity comes under the Nutritional-Metabilic Functional Health Pattern (#2 out of the 11), whereas Acute Pain comes under Cognitive-Perceptual (#6 out of the 11). Ineffective Role Performance is a self-esteem need under Maslow which is on the second tier of the pyramid on his hierarchy. That is the rationale behind the way I sequenced them.

Megsd, BSN, RN · Oct 8, 2006

In Gordon's 11 paterns, are they really ranked in priority order? I never thought about it. I always have difficulty prioritizing my nursing diagnoses... that would really help to have that to follow (it's a little more detailed than Maslow).