How to Determine Priority Nursing Diagnosis - Nursing Care Plan

Maslow's hierarchy of needs can be the basis for the nurse to make a priority nursing diagnosis. Maslow's hierarchy of five levels are:

1. Biological and Physiological needs.
2. Safety needs.
3. Love and belongingness needs.
4. Esteem needs.
5. Self-Actualization needs.

Physiological needs is a top priority and must be met before the needs of the higher level.

Example of Maslow's hierarchy of needs :

1. Biological and Physiological needs :

• Respiration (circulation, temperature), 
• Hydration (avoiding pain, break or mobilization), 
• Nutrition (elimination, skin care), 
• Sey.

2. Safety needs.

• Environment free from danger.
• Stable living conditions.
• Regulations and laws in society.
• Free from threats.
• Clothes.
• Protection of the.
• Free from infection.
• Free from fear.

3. Love and belongingness needs.

• Affection.
• Seyyuality.
• Affiliates in the group.
• Relationship friends, family, community.

4. Esteem needs.

• Get respect from colleagues.
• The development of a sense of competence.
• Feelings of self-respect and self recognition.

5. Self-Actualization needs.

• All levels of the previous requirements have been met.
• Against self-satisfaction.

Examples of Priority for Nursing Diagnosis sequence with Maslow's hierarchy

1. Ineffective airway clearance (Physiological: High).
2. Fluid volume deficit (Physiological: High).
3. Pain (Safety: Medium)
4. Knowledge deficit (Love and belongingness: Medium).
5. Altered family processes (Love and belongingness: Medium).
6. Disturbed body image (Physiological: Medium)
7. Disturbed sleep pattern (Physiological: Medium).
8. Constipation (Physiological: Medium)

In addition, determines the priority of the problem can be defined in three categories, namely:

1. Urgent problem is a problem that can not be delayed. This problem requires action quickly and accurately. If not, then the client's condition will deteriorate, and even can cause death or disability. Example: a client who is not aware, and airway obstructed by secretions. Nursing intervention should be carried out immediately, if within five minutes left untreated will cause the death of the client because the pineapple obstructed.
2. The problem that must be made planning (care plan) is an actual problem or risk must be made planning nursing, according to the client's condition. Example: Clients with immobilization, it must be planned to tilt left or right to prevent pressure sores.
3. Important problem with handling can be delayed, regardless of the client's health condition (refer), example: fat woman in the recovery phase of the operation. This does not need to concern for the client is in the hospital. But after the client return the nurse can advise the client in consultation with other health services.

Actually, there are other things that can become a benchmark in priority, for example:

1. The nature of the problem or nursing diagnoses is the actual problem has a higher priority.
2. Problems or independent or collaborative nursing diagnosis is a matter of self-occupied top priority issue than collaborative problem.
3. Easy or not solved.

After that, there are some other guidelines which may be used as a guide in determining priorities (Rubenfeld and Scheffer 1999) is

1. Issues immediately life threatening.
2. Issues of security.
3. Priorities identified by the client.
4. Priorities identified by the nurses.