A nurse is preparing a plan of care for a child with a primary immunodeficiency. Which nursing diagnosis is the priority?

A) Imbalanced nutrition, less than body requirements related to poor appetite
B) Ineffective protection related to impaired humoral defenses
C) Acute pain related to inflammatory processes
D) Risk for delayed growth and development related to chronic illness


Ans: B
The child with a primary immunodeficiency lacks the necessary immune responses that provide protection from infection. Therefore, the priority nursing diagnosis would be ineffective protection. Imbalanced nutrition and risk for delayed growth and development may be appropriate, but these would not be the priority. Acute pain would be more appropriate for a child with juvenile idiopathic arthritis.

Nursing

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