Which type of needs would be placed as a low priority in the prioritization of client care?

Phase 3: Planning

The planning stage of the nursing process will require the nurse to use decision-making and problem-solving skills in designing a plan of care for each patient. During planning, priorities are set due to multiple nursing diagnoses assigned including a variety of proposed interventions. Planning is a category of nursing behaviors in which client-centered goals and expected outcomes are specifically chosen to resolve the client's problem and achieve the goals and outcomes (Potter & Perry, 2005). Priority setting involves ranking nursing diagnoses in order of importance. With prioritizing, the nurse can attend to the client's most important needs and organize ongoing care activities. 

Priorities are classified as high, intermediate, or low.

• High-priority nursing diagnoses are those that if untreated, could result in harm to the client. In many cases, these diagnoses protect basic needs of safety, adequate oxygenation, and comfort. Example: Risk for other-directed violence, impaired gas exchange, acute pain, risk for ineffective airway clearance.
• Intermediate priority nursing diagnoses involve non-emergent, non-life threatening needs of the client. Example: Ineffective peripheral tissue perfusion in a post-operative patient can place the client at risk for post-operative venous stasis and DVT, therefore maintaining normal circulation to the lower extremities becomes an immediate priority.
• Low priority diagnoses are client needs that may not be directly related to a specific illness or prognosis but may affect the client's future well-being. Many focus on the long-term health care needs of the client. Example, the post-operative client will be discharged after surgery and will be required to manage the wound and nutritional needs at home (Potter & Perry, 2005). Example: Deficit knowledge is an important diagnosis but must be considered a low priority when issues such as pain management and patent airway are a major concern with the client.

Establishing Goals and Expected Outcomes

After identifying nursing diagnoses for the client, the nurse must determine what the best approach to address and resolve the problem. Goals and expected outcomes are established to guide the plan of care. These are specific statements of client behavior or physiological responses that a nurses uses to resolve a problem (Potter & Perry, 2005). A client-centered goal is a specific and measurable behavior or response that reflects a client's highest possible level of wellness and independence in function (Potter & Perry, 2005). An example of a client-centered goal is: "Client will perform self-care hygiene independently", "Client will remain free of infection", "Client will accept body image alteration".


There are two types of goals: short-term goals and long-term goals



Short-term goals are objectives that are expected to be achieved within a short time frame, usually less than a week. Short-term goals are applicable for the immediate care plan due to shorter hospital stays (Potter & Perry, 2005). For instance if the nursing diagnosis acute pain related to the tissue trauma of a surgical incision is utilized, a short-term goal would be "Client will achieve comfort within 24 hours postoperatively"(Potter & Perry, 2005).


Long-term goals are objectives expected to be achieved over a longer time frame, usually over weeks or months. Long-term goals are more appropriate for after discharge, especially from acute care settings. These goals are more appropriate for those clients in home care settings and "adapting to chronic illnesses who reside in long-term care facilities and for those clients in rehabilitation, mental health, ambulatory care, and community nursing settings (Carpenito, 1997 as cited in Potter & Perry, 2005).
For instance if the nursing diagnosis deficient knowledge regarding postoperative home care related to inexperience is utilized, a long-term goal may be "Client will adhere to postoperative activity restrictions for one month (Potter & Perry, 2005).
The nurse must realize that long-term goals are essential to continuity of care. Failure to do so may hinder the client's success to recovery. 



Read Chapter 17, pages 318-338 for more on the planning phase.

(Potter  & Perry, 2005; Swearingen, 2004 )

Assignment 3B: Goals and expected outcomes