Let’s talk about a problem that sometimes comes up in clinical practice. Students will sometimes tell us that they are not “allowed” to identify risk diagnoses for their patients, and that they are told that they must focus on “real problems,” especially in the hospital setting.
Is this a valid consideration? Let’s use this case as an example:
A malnourished adolescente gave birth to a 27-week-old infant. The patient experienced pre-eclampsia and a placental abruption, and the infant is in critical condition in the NICU. Diagnoses that are identified in the postpartum individual, upon assessment, were: imbalanced nutrition, less than body requirements (00002); risk for bleeding (00206); and parental role conflict (00064).
In this case, there are two problem-focused diagnoses and one risk diagnosis. Given the placental abruption and pre-eclampsia, and the possibility that her state of imbalanced nutrition could include anemia, the priority diagnosis in the initial postpartum period is most certainly risk for bleeding, as this could be life-threatening. The two problem-focused diagnoses are important, but not life-threatening, and therefore have a lower priority for care.
So, don’t assume a risk diagnosis is somehow “less important” than a problem-focused diagnosis. All diagnoses are “real”, and all must be considered and properly prioritized.
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