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plbernal
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Life threatening problems
First Priority
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Safety & requires nursing intervention
Second Priority
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Non urgent activities that relieve symptoms, promote healing and prevent complications
Third Priority
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Activities addressing a patient's discharge
Fourth Priority
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What are the First Priorities?
(10)
- Airway compromised
- Choking
- Impaired gas exchange
- Cardiac arrest
- Shock
- Hemorrhage
- Unconciousness
- Unresponsive
- Mental status change
- Seizures
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What are the Second Priorities?
(11)
- Acute pain
- Acute urinary elimination
- Diabetic needing insulin
- Increased BP need PRN meds
- Abnormal labs
- Protection from injury & infection
- Life saving monitoring/equipment
- Monitoring for prevention of sensitive nursing outcomes
- Ask for assistance
- 2 people transfers & turns
- Moving a heavy patient
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What are the Third Priorities?
(6)
- Routine meds
- Nutrition
- Ambulation/positioning
- Monitoring for medication side effects
- Teaching
- Plan of care
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What are the Fourth Priorities?
(3)
- Discharge teachings
- Arrange for equipment/supplies at home
- Follow up appointments
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The CCU notifies you a patient on telemetry went form NSR to A-Fib.
Second Priority - An untreated med problem needing immediate attention
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The morning labs indicate a patient with a heparin infusion has a PTT of 80.
Second priority - monitoring for prevention of nursing sensitive outcomes
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The patient with a small bowel obstruciton continuies to have N/V unrelieved by medication given one hour ago
Second Priority
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A newly-diagnosed diabetic patient, discharhed this AM, is having difficulty drawing up insulin.
Fourth Priority - Discharge teaching
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A patient who recently suffered a stroke needs assistance eating lunch.
Third Priority - Nurtrition
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An obese patient with right hemiparesis needs to get up in a wheelchair
Second Priority - 2 person transfer/move heavy patient
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Elderly famale patient with chronic brain syndrome is crying out for help and attempting to get up.
Second Priority - protection from injury
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A patient reports pain and swelling at an IV site. The IV site is to be discontinued after this infusion.
Second Priority - Protection from injury/infection
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A 72yo post-MI patient is going home after lunch. He lives alone in an upstairs apartment.
Fourth Priority - arrangement for equipment/supplies for use at home
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The postop cholecystectomy patient is having chest pain with dyspnea and diaphoresis.
First Priority - Respiratory, impaired gas exchange
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The patient with an O2 sat of 91% on 3L/NC needs I.S. teaching.
Third Priority - Teaching
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Which of Mr. X's needs should the nurse address first?
A. Nausea
B. Anxiety
C. Shortness of breath
D. Ampicillin
E. IV out
C. Shortness of breath (this multiple choice question has been scrambled)
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Which of Mr. X's needs should the nurse address second?
A. IV out
B. Nausea
C. AmpicillinE. Anxiety
D. Shortness of breath
A. IV out (this multiple choice question has been scrambled)
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Which of Mrs. Y's needs is a first-priority need?
A. Blood sugar >400mg/dl
B. Nausea
C. RR of 24
D. HR of 110
A. Blood sugar >400mg/dl (this multiple choice question has been scrambled)
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Enjoys getting up early and going to bed mid-evening; experiences greatest energy levels in the early part of the day
Early bird time style
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Likes to sleep until mid-morning and feels most energetic in the mid-afternoon or evening
Owl time style
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Likes to do one thing at a time; deadlines and adherence to well-thought out plans are important; finds interruptions to be irritating; personal space is significant.
Monochronic Orientation
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Can do many things at once and is easily distracted; tolerates interruptions easily and can change plans readily; deadlines are goals but not absolute
Polychronic Orientation
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Approaches time with logic and orderliness; structures time in minutes and hours; schedules activities in time segments and carries them out in an ordered sequence; likes to know the rules and play by them; usually meet their own goals; may elect to work at the expense of fun, play, and other creative and relaxing activities
Left brain dominant
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Resists rules and schedules; prefers looking at a project as a whole and completing it in their own way and time frame; are creative and flexible thinkers; may not meet needed completion times
Right brain dominant
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Which new patient should the nurse see first?
1. Diagnosis of alchohol abuse with impending DTs
2. Newly casted fractured fibula reporting pain
3. Scheduled for AM nephrectomy.
4. Appendicitis with temp. 101.2
1. Diagnosis of alcholol abuse with impending DTs
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After receiving report, which activity has top priority?
1. Assessing a newly admitted pneumonia patient
2. Giving morphine to a fresh post-op patient
3. Preparing to give A.M. medications
4. Reviewing patients’ Plans of Care
1. Assessing a newly admitted pneumonia patient
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Which action by the nurse will best decrease workplace interruptions?
1. Closing the patient’s door when entering room
2. Documenting in a secluded area
3. Waiting until after the physician rounds to complete assessments
4. Telling patients the unit is short staffed
1. Closing the patient’s door when entering room
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Maslow's Hierarchy of Needs
- Physiologic
- Safety
- Love and Belonging
- Self-esteem
- Self-actualization
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The need to succeed, need to belong and need to control are what theory?
McClelland’s Trichotomy of Needs
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Which theory uses the factors of intrinsic & extrinsic?
Herzberg’s Motivation-Hygiene Theory
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