Originally Posted by janfrn
My inclination would be to see the surgical abd first... an oral temp of 39.7 and a rigid abd would set off bells for me. I'd do a set of vitals to see where her BP and heart rate are, assessing for onset of septic shock. And a pain score of 8/10 needs to be addressed sooner rather than later.
The toddler with asthma would be next, since he's not supervised. But in my world, effective q2H nebs is considered to be rather stable, so that wouldn't necessarily be a huge factor for me. (I really don't enjoy toddlers with asthma. They are my nightmare patients.
Once they start feeling a bit better, it's like wrestling an alligator to give them their nebs.)
The big kid with the MVC injuries would be last. He has family in the room with him to maintain the suicide watch (he'd have to try awfully hard with those injuries to harm himself at this point in time). If he's shouting, then he's got an airway and a BP. Extreme pain usually produces a quite, reluctant-to-move patient who moans and groans, not someone yelling about how much he hurts. So he can wait a bit.
Just my
I agree, the belly would worry me more than the 2yo. The 2yo is not on O2, q2h nebs is not that unusual for a floor patient, and his resp status is improving, and you can get a nurses aide to sit with him, if necessary.
Would you like to comment?
