Which nursing diagnosis is priority

The nurses performed nursing processes involving these patients. In of the evaluated processes the Nursing Diagnosis was included as part of it. At the beginning of the research the nurses chose to work with 8 diagnoses that they understood to be the most frequent in the reality to be studied. At the beginning of the research process, however, they realized the need to include three other diagnoses, therefore, 11 NANDA-I Classification Nursing Diagnoses were developed.

The eight diagnoses listed initially for the study were: chronic pain, ineffective respiratory pattern, impaired skin integrity, impaired skin integrity risk, impaired tissue integrity, anxiety, risk of infection, and unstable glycemic risk. These 8 diagnoses were analyzed in relation to total medical records. Subsequently, the diagnoses of unbalanced nutrition were incorporated: less than the body needs, constipation and risk of constipation.

This second group of diagnoses was analyzed in relation to 69 records of the total of that were part of the study. The Nursing Diagnoses were organized in an excel spreadsheet, systematically updated during data collection, for further analysis.

In the analysis of the data, the simple frequencies of identification of each diagnosis were observed, these being tabulated through absolute frequency and percentage. The medical records of all patients hospitalized during the study period were analyzed, i. Daily records were considered in each of the medical records, and the same medical record was evaluated more than once, depending on the length of hospital stay.

The study complied with the formal requirements contained in the national and international regulatory standards for research involving human beings. The results indicate an important nursing adhesion to the Nursing Care Systematization, which is performed daily for each of the patients hospitalized in the unit studied. It was verified that the nursing history, prescription and nursing evolution stages were routinely performed, and that the nursing diagnosis was no longer recorded in 5 of the charts analyzed.

In the analysis of the percentage of occurrence of nursing diagnoses in the patients hospitalized at the Clinical Medical Units studied, it was observed that of medical records: The diagnoses of unbalanced nutrition: less than the bodily needs; risk of constipation and constipation evaluated in 69 charts, obtained the following percentages of frequency: 31 Evaluating the nursing diagnoses together with the related factors, it was obtained that the risk of infection with occurrences was related to invasive procedures in Risk of impaired skin integrity, present in occurrences, was related to physical immobility 41 Impaired skin integrity with occurrences was related to mechanical factors 36 Of the 39 occurrences of impaired tissue integrity, 16 The diagnosis of unstable glycemia risk with occurrences was related to 45 Risk of constipation present in 34 situations was related to the change in usual eating patterns 9 Constipation with 26 occurrences was related to the change in dietary patterns 4 The diagnosis of anxiety with occurrences was related to threat to health status 44 Chronic pain with 35 occurrences was related, chronic physical disability 33 Regarding the diagnosis of ineffective respiratory pattern with 57 occurrences, it was related to respiratory muscle fatigue 14 Unbalanced Nutrition, less than the bodily needs, was identified in 36 Twenty-one Regarding skin integrity diagnoses, Table 1 shows the occurrences of defining characteristics:.

Table 1 Occurrence of the defining characteristics of the nursing diagnoses of impaired skin integrity and impaired tissue integrity in medical clinic Source: Adapted 8. In addition to these, unbalanced nutrition, less than bodily needs, was characterized by lack of interest in food 13 Constipation was characterized by inability to eliminate feces 9 Table 2 below shows the defining characteristics of the diagnoses of anxiety, chronic pain and ineffective respiratory pattern.

Table 2 Occurrence of defining characteristics according to nursing diagnoses anxiety, chronic pain and ineffective respiratory pattern in patients admitted to the medical clinic service Source: Adapted 8. Finally, the study identified the predominant diagnostic statement.

Anxiety assessed in situations was related in 35 9. Regarding the diagnosis of risk of infection of occurrences, Risk of impaired skin integrity, with evaluations, was related to physical immobility in 41 From evaluations of impaired skin integrity, 23 Ineffective respiratory pattern, present in 86 evaluations was related to respiratory muscle fatigue and characterized by dyspnea in 13 The nursing diagnosis chronic pain with 74 occurrences was related to chronic physical incapacity characterized by verbal report of pain in 29 Unbalanced Nutrition: less than the body needs related to biological factors appeared in 21 situations, that is, 9 The same diagnosis is associated with other related factors and other defining characteristics in 41 Coping-Stress Tolerance: Coping and effectiveness in terms of stress tolerance.

Value-Belief: Values, beliefs including spiritual beliefs , and goals that guide choices and decisions. The nurse should refer to a care planning resource and review the definitions and defining characteristics of the hypothesized nursing diagnoses to determine if additional in-depth assessment is needed before selecting the most accurate nursing diagnosis. Nursing diagnoses are developed by nurses, for use by nurses. For example, NANDA International NANDA-I is a global professional nursing organization that develops nursing terminology that names actual or potential human responses to health problems and life processes based on research findings.

This list is continuously updated, with new nursing diagnoses added and old nursing diagnoses retired that no longer have supporting evidence. NANDA-I nursing diagnoses are grouped into 13 domains that assist the nurse in selecting diagnoses based on the patterns of clustered data.

Nursing diagnoses focus on the human response to health conditions and life processes and are made independently by RNs. Patients with the same medical diagnosis will often respond differently to that diagnosis and thus have different nursing diagnoses. For example, two patients have the same medical diagnosis of heart failure. However, one patient may be interested in learning more information about the condition and the medications used to treat it, whereas another patient may be experiencing anxiety when thinking about the effects this medical diagnosis will have on their family.

The nurse must consider these different responses when creating the nursing care plan. A medical diagnosis identified for Ms. Associated conditions are medical diagnoses, injuries, procedures, medical devices, or pharmacological agents that are not independently modifiable by the nurse, but support accuracy in nursing diagnosis. The age of the person who is the subject of the diagnosis is defined by the following terms: [9]. The duration of the diagnosis is defined by the following terms: [10].

The edition of Nursing Diagnoses includes two new terms to assist in creating nursing diagnoses: at-risk populations and associated conditions. Associated Conditions are medical diagnoses, injuries, procedures, medical devices, or pharmacological agents. These conditions are not independently modifiable by the nurse, but support accuracy in nursing diagnosis [12].

Related factors also called etiology are causes that contribute to the diagnosis. Defining characteristics are cues, signs, and symptoms that cluster into patterns.

A risk nursing diagnosis is different from the problem-focused diagnosis in that the problem has not yet actually occurred. Problem diagnoses should not be automatically viewed as more important than risk diagnoses because sometimes a risk diagnosis can have the highest priority for a patient. To create a nursing diagnosis statement, the registered nurse completes the following steps.

Defining characteristics is the terminology used for observable signs and symptoms related to a nursing diagnosis. For example, objective and subjective data such as weight, height, and dietary intake can be clustered together as defining characteristics for the nursing diagnosis of nutritional status.

When creating a nursing diagnosis statement, the nurse also identifies the cause of the problem for that specific patient. Related factors should not be a medical diagnosis, but instead should be attributed to the underlying pathophysiology that the nurse can treat.

When possible, the nursing interventions planned for each nursing diagnosis should attempt to modify or remove these related factors that are the underlying cause of the nursing diagnosis.

A nursing diagnosis statement should contain the problem, related factors, and defining characteristics. These terms fit under the former PES format in this manner:.

In addition to providing guidance and direction in terms of nursing care delivery, plans of care, including nursing care plans and other systems like a critical pathway, provide the mechanism with which the outcomes of the care can be measured and evaluated.

Appropriate and effective client care is dependent on the accuracy and appropriateness of the client's plan of care. For this reason, reasessments and updating and revising a plan of care as based on the client's current status is necessary. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of establishing priorities in order to: Apply knowledge of pathophysiology when establishing priorities for interventions with multiple clients Prioritize the delivery of client care Evaluate the plan of care for multiple clients and revise plan of care as needed Actual needs and problems take priority over wellness, possible risk and health promotion problems and short term acute patient care needs and problems typically take priority over longer term chronic needs.

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