Question

The assessment of a client admitted with increased ascites related to cirrhosis reveals the following: pulse 86 beats per minute and weak, respirations 28 breaths per minute, blood pressure 130/88 mm Hg, and pulse oximetry 90%. Which nursing diagnosis should receive top priority

Answer 1

The nursing diagnosis which should receive top priority is ineffective

breathing pattern.

Ascites is a medical condition in which fluids build up in the stomach. The

weight of the accumulated fluid can exert a force on the diaphragm which

may result in difficult and ineffective breathing pattern.

In this scenario, the results given indicates high respiratory rate due to

difficulty in taking in air . The  low oxygen saturation also indicates the

diagnosis. The high respiration rate could cause or other severe

issues such as cell death which is why it must receive top priority.

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