Which nursing diagnosis is most important?

[RN_Pink]

I have to do a care plan on my client for this week. I am not sure which diagnosis would be considered #1. He had decreased cardiac output due to cardiomyopathy. He was in fluid overload. He was fatigued, short of breath, etc. Also he has chronic renal disease. I am not sure which would be #1, the decreased cardiac output or the Ineffective Tissue Perfusion (Renal) - renal disease. Any suggestions!

[ImThatGuy, BSN, RN]

Even in sustained VT you've got to have an airway or your VT will eventually become VF. I realize you've got to look past that to a point as do all skilled providers, but in the OP's scenario I still say that ABC rule works. Heart over kidneys. The OP will learn that too just as we have.