prioritzing nursing diagnoses

[jam0518]

My patient was a 3 1/2 year old pt with asthma. He has been hospitalized 4 times for this. He has no history of other diseases. I am working on a careplan and have these top 6 diagnoses picked out, but I do not know which 2 to pick!!

Ineffective breathing pattern

Ineffective airway clearance

Impaired spontaneous ventilation

Impaired gas exchange

Decreased cardiac output

Fear (due to him being so young and when his parents leave he becomes afraid of the nurses and being alone in the hospital) - I know this one is a stretch

[Silverdragon102, BSN]

Moved to the Nursing Student Assistance forum

[nurseprnRN, BSN, RN]

remember that nursing diagnoses do not come from medical diagnoses. nurses make them on the basis of their own nursing assessments. you don't give us the evidence you have for each of these except for the fear one, and it is definitely not a stretch-- if he is demonstrating fear (by...?) when his parents leave him, that certainly counts.

so it's impossible to tell which ones would apply. remember, you assess first, diagnose second. you wouldn't think much of a doc who announced the first time he walked in to see you in the exam room, "glad to meet you. you have leukemia. now, let's examine you, and maybe we should check your labs."

so: what did you observe or learn from the chart that makes you think he has:

ineffective breathing pattern

ineffective airway clearance

impaired spontaneous ventilation

impaired gas exchange

decreased cardiac output

anyway?

[classicdame, MSN, EdD]

I'll let you wrestle with the DX related to his medical diagnosis. I just want to say that fear and anxiety and lack of knowledge are ALWAYS present. Choosing a psycho-social nursing diagnosis is a good thing, IMHO

[mindlor]

Airway, breathing, circulation, Maslow.

It is that simple grasshoppa

[nursingilove]

impaired spontaneous ventilation is def priorty b/c of airway.

[nurseprnRN, BSN, RN]

is there evidence of this occurring? it is a more important thing than a lot of the others, but...if there is no evidence that it is occurring and is an active clinical issue, it's no issue at all.