nursing diagnosis by priority... can u help me put these in order?

Question

Hi, i'm a nursing student and I'm writing a paper. Part of it is nursing diagnosis by priority. I need a little help deciding which would come first... the pt has bipolar disorder..

-a. risk for suicide related to depression associated with bipolar disorder as evidenced by feelings that his family can’t deal with him anymore and he feels like “everyone is shitting on me”,
b. risk for violence directed at others related to manic excitement as evidenced by agitated behaviors,
c. defensive coping related to an inadequate level of perception of control as evidenced by grandiosity and argumentative behavior,
d. chronic low self-esteem related to shame and impaired self-appraisal as evidenced by hypersensitivity to slights of criticism, and
e. impaired memory related to neurologic disturbance as evidenced by incidences of forgetting information caused by Electroconvulsive Therapy.


The " risk for" ones confuse me, because if it's not happening now... shoudl it be priority?

Answer 1

Follow your ABC's, airway, breathing, circulation with all nursing priority questions. Since none of these apply move on to safety, which would be risk for suicide.

a
b
e
d
c


That is how I would prioritize the goals.

Also, dig a little deeper. Are there any underlying causes that you can see. Possibly medical history. Most people with defensive coping have a underlying problem. (could be abuse or recent life changes)

Hope I've helped.

Answer 2

I would say B, risk for violence is # 1 priority, followed by A, risk for suicide, then C, D, and E in that order.
Harm to others would be the most risky, necessitating immediate intervention, possibly with some form of restraint and/or medication, followed by harm to self, necessitating immediate help, the others can be dealt with through ongoing therapy.

Answer 3

Well choose between A or B, because those are acts of violence and harm to yourself or others. That's a priority to stop that from happening. Then I would go with e,c and d.

Answer 4

As a nurse myself, B would be the one that would receive first attention because of the chance of harm to himself and/or others. The rest could be in any order.