Question

Discussion: Leadership & Prioritization 22 unread replies.22 replies. You are the RN working on a surgical unit, and you are assigned the following four clients: A 62-year old male with a history of COPD and CHF, who had a cholecystectomy A 28-year old female with a head injury from a motorcycle accident who had burr hole surgery A 43-year old female with controlled AFib who has a broken right leg from falling off a horse A 62-year old college professor who had a stroke while playing tennis Their surgeries were all unremarkable, and they are all 1-day postoperative. You heard the following updates in change-of-shift report this morning: 02 sat 92% on 2L, lung sounds diminished bilaterally, non-productive cough Persistent confusion and slight restlessness, moves all extremities Pain level is 8/10, up from 5/10 last night. Right pedal pulses weak, right foot swollen. Complaining of headache at 10/10, unrelieved by pain medication. Questions:

1.Which of these clients should the nurse see first? Explain your answer.

2 What other information is needed (if any) to make your decision.

3 Use the Nightingale library and the CINAHL search system to find an article from a peer-reviewed journal published in the last 5 that supports the priorities of nursing care you identified.

Answer 1

Patients are:

A 62-year old male with a history of COPD and CHF, who had a cholecystectomy

A 28-year old female with a head injury from a motorcycle accident who had burr hole surgery

A 43-year old female with controlled AFib who has a broken right leg from falling off a horse

A 62-year old college professor who had a stroke while playing tennis

Information from previous staff are the following.

02 sat 92% on 2L, lung sounds diminished bilaterally, non-productive cough Persistent confusion and slight restlessness, moves all extremities Pain level is 8/10, up from 5/10 last night. Right pedal pulses weak, right foot swollen. Complaining of headache at 10/10, unrelieved by pain medication.

1.Which of these clients should the nurse see first? Explain your answer.

A 62-year old male with a history of COPD and CHF, who had a cholecystectomy will be see first, because he has the respiratory emergency as well as cardiac emergency. This patient may at risk for post operative complications. Check his Oxygen saturation, he may be restless, chances of pedel edema.

2 What other information is needed (if any) to make your decision.

Need all patient status separately , In the statement (02 sat 92% on 2L, lung sounds diminished bilaterally, non-productive cough Persistent confusion and slight restlessness, moves all extremities Pain level is 8/10, up from 5/10 last night. Right pedal pulses weak, right foot swollen. Complaining of headache at 10/10, unrelieved by pain medication. ) they did not mention which patient is in this status. Explanation needed regarding , past h/O medications, surgery , underlying conditions, feeding , nutritional status, any further investigations or procedures for today ? Laboratory findings any ? Skin Integrity, pasychological status, Any patient is under sedation ? needs of ventilator any . ? Any special consideration to any patient .?

3 Use the Nightingale library and the CINAHL search system to find an article from a peer-reviewed journal published in the last 5 that supports the priorities of nursing care you identified.

Priorities Of nursing care

The five priorities focus on

Example.

Recognising that someone is dying

Communicating sensitivity with them and others important to them

Involving them and others important to them in decisions

providing support

Providing an individualised plan of care and delivering it with compassion.