Ranking Nursing Diagnoses?

CT Pixie, BSN, RN · Jan 27, 2011

You go with actual problems in A,B,C order (airway,breathing, circ..then usually follow Maslow's) then you put the risk for problems..again in ABC order and maslows

your first would be either Acute Pain or Ineffective clearance (I'd go with pain as when you're in pain you can't think of anything else..it impedes proper breathing and resp rate etc) and the last would be the only risk for that you mentioned Risk for infection

MunoRN, RN · Jan 28, 2011

You can't really rank Nursing Diagnoses just based on the Nursing Diagnosis itself. A productive cough related to a cold and status asthmaticus would both have the Nursing Diagnosis of ineffective airway clearance, yet they would very different priorities applied to them. Risk for infection in a neutropenic chemo patient with a stage IV ulcer would be different than in a patient with a small scratch and a competent immune system. Acute pain could be a stubbed toe or stabbing chest pain radiating to the arm, neck, and jaw; two very different problems with very different nursing priorities and actions, yet the same nursing diagnosis.

This is one of many problems with Nursing Diagnoses. We take medical diagnoses/symptoms and translate them into a broad, generic nursing diagnosis, which to be at all useful has to be translated back into the original medical diagnoses and/or symptoms, making the step of converting patient specific data better described in medical terms into a nursing diagnosis useless.

Connie1109 · Jan 29, 2011

It all depends on the actual diagnosis but if you are to order those just as how you wrote them then you can follow the ABC's + P

Always rank them by the ABC's + P

A: Airway

B: Breathing

C: Circulatoin

P: Pain

MunoRN, RN · Jan 29, 2011

It all depends on the actual diagnosis but if you are to order those just as how you wrote them then you can follow the ABC's + P
Always rank them by the ABC's + P
A: Airway
B: Breathing
C: Circulatoin
P: Pain

Although it's common in Nursing schools, I'm not sure how the ABC's got applied to prioritizing nursing diagnoses. ABC's as a group come before pretty much anything else, but A does not always come before B or C. For instance, a chest cold would fall under Airway, and a currently active MI would fall under circulation. Between the two, the active MI is a much bigger priority problem compared to the chest cold, even though C comes after A. Acuity of the problem and threat to life needs to be considered more than the order of ABC.

Music in My Heart · Jan 30, 2011

Although it's common in Nursing schools, I'm not sure how the ABC's got applied to prioritizing nursing diagnoses. ABC's as a group come before pretty much anything else, but A does not always come before B or C. For instance, a chest cold would fall under Airway, and a currently active MI would fall under circulation. Between the two, the active MI is a much bigger priority problem compared to the chest cold, even though C comes after A. Acuity of the problem and threat to life needs to be considered more than the order of ABC.

While I'm sure that the ABC mnemonic will persist in perpetuity, if for no other reason than simplicity, the order is clearly no longer correct in terms of prioritization given that MI survival data indicate that effective chest compressions are what really count. The new BLS protocols are eliminating rescue breathing altogether (as I understand it).

KristeyK · Jan 30, 2011

I just took mine in August. It's not eliminating the altogether, just for some cases with adults. (Peds and things that would affect the airway, you still do the rescue breathing.)

Generally, if your instructor is like mine, they want ABC first, then pain, then take it from there. (Unless we have specific information to indicate otherwise...)

guest112 · Mar 12, 2011

Currently struggling with nursing dx. This is all helpful. Thanks