Ask Dr Nerenberg | Health and Fitness

which of the following nursing diagnosis should be given highest priority?

Bella Flores has just undergone surgery on her right lower leg. During the night, she
required an analgesic to help her sleep. She doesn’t have appetite to eat but is able
to take in liquids without nausea. Which of the following nursing diagnosis should be
given highest priority?
a. Impaired tissue perfusion: peripheral
b. Imbalanced nutrition: Less than body requirement
c. Pain
d. Impaired physical mobility

It’s A. Impaired tissue perfusion. Remember the ABCs of life? Airway, Breathing, CIRCULATION. Tissue Perfusion is under Circulation. The case says that she just had a surgery on her lower leg.. impaired perfusion to that injured leg can lead to ischemia of the tissues, then to necrosis.. too bad if gangrene sets in (it might require another surgery– could be amputation). You don’t want complications post-op. We prioritize the safety of the patient or the patient’s body part. It should be the top priority.

B — Nutrition isn’t the highest priority here.. she can take liquids… it means she can still ingest liquid food. Osterized feedings, NGT, Parenteral Nutrition.. lots of ways to meet her nutritional needs.

C. Pain — No.. she’s already on analgesia. It says there, she’s given an analgesic. SAfety first, before pain management.

D. Impaired Physical Mobility — Not the top priority… it’s expected she’s a post-op patient.. her mobility would be limited. That’s why there are Physical Therapists… Even if she’s not actively walking (don’t expect her, she just had a surgery), if mobility is required… the PTs and Nurses will facilitate recommended exercises (as ordered by the doctor).

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