Which nursing diagnosis takes the highest priority for this client?
A client is admitted to the health care facility after 3 days of nausea, vomiting, and fever.
The patient needs to stay hydrated with cool, clear fluids such as water or diluted juice. Drinking slowly is best because drinking quickly can trigger vomiting. Deficient fluid volume is a state in which the fluid output exceeds the fluid intake. It happens when water and electrolytes are eliminated from normal body fluids.
The risk factors with this condition include vomiting, diarrhea, nausea, and liver dysfunction. The goal is to balance the patient's fluid intake and output. Fevers seem to play a vital role in keeping germs at bay.
Deficient fluid volume related to nausea and vomiting-rationale: deficient fluid volume related to nausea and vomiting takes highest priority because vomiting causes loss of fluids and electrolytes. no evidence suggests that the client has a fluid volume excess or ineffective cardiopulmonary tissue perfusion. although the client does have imbalanced nutrition, this nursing diagnosis isnt a high priority at this time. client needs category: physiological integrity client needs subcategory: reduction of risk potential cognitive level: application reference: craven, r.f., and hirnle, c.j. fundamentals of nursing: human health and function, 5th ed. philadelphia: lippincott williams & wilkins, 2007, p. 942.