A construction worker admitted to the unit with a chest injury and broken ribs from a fall from a ladder has nursing diagnoses of "Disturbed Sleep Pattern," "Ineffective Breathing Pattern," and "Risk for Infection."

Question

The client states, "I've never been sick a day in my life and am really worried about how I can support my family while I'm out of work." When evaluating the client's plan of care during the shift the nurse adds the nursing diagnosis "Anxiety" to the plan of care. Which diagnosis would receive priority for nursing intervention?
A) Risk for Infection
B) Ineffective Breathing Pattern
C) Disturbed Sleep Pattern
D) Anxiety

Answer 1

Answer: B

Nursing diagnoses of "Ineffective Breathing Pattern," "Disturbed Sleep Pattern," and "Risk for Infection" are diagnoses that need to be considered because of the client's inability to fully expand his lungs because of his rib injury. Of these, "Ineffective Breathing Pattern" would receive the highest priority in the nurse's care planning. Addressing the client's disruption in sleep patterns in order to promote quicker healing and taking measures to minimize his risk for infection are also important, but are lower in priority than addressing his current ineffective breathing. In addition, addressing the client's psychosocial needs-his worry about being unable to support his family while he recuperates-is also an important aspect of holistic nursing care, but again of lesser priority than his ability to breathe effectively.