Patient Prioritization Questions

Nursing Students NCLEX

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I took a practice exam that had a ton of patient prioritization questions which included several with COPD patients. I think I'm confused about what is an okay oxygentation saturation for a COPD patient. I was taught that it depends on their baseline, but that below 90 is not good. Obviously they don't give you a baseline in these types of questions, and I'm not sure that my below 90 rule is correct by ATI testing standards. Can someone help?

Thanks in advance!

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Specializes in Trauma Surgical ICU.

Some COPDers live in the upper 80s to low 90s range but the priority comes from what the question is asking and the answers provided. Is the COPDer having noted issues outside the norm, is there another pt that is worse or has the high probably to get worse.. That is what you must decide based on the limited information you have..

Keep doing these type questions and read the rational, it will help you..

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Thanks, Sun! Unfortunately, these particular questions didn't have an accompanying rationale. I was thinking in terms of airway, breathing, circulation, but I think I'm getting caught up in the red herrings :-/ Regardless, that reference range really helps!

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Specializes in Trauma Surgical ICU.

Don't get soo stuck on the numbers unless its something crazy wrong.. Look for clues in the questions or answers to help lead you to the correct answer. I've seen COPDers in the 88 range and doing "fine" for them but others are having issues like confusion, agitation etc.. So look for clues. If the assessment finding is within normal range for that DX, its out; depending on what its asking of course..

If you can swing it, get a book that has the rationals, it will help :)

You expect a COPDer to have lower than normal sats, you expect a renal pt to produce little to no urine and have high BUN and creatinine but if you have a K of say 7, that a huge difference and a dangerous number for anyone to have, you want to act on that K..

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suggests three levels of priority setting:

1. the first ABC plus V ( airway,breathing,cardiac&circulation,vital signs)

2. concerns mental status changes,untreated medical issues,acute pain,acute elimination problems,abnormal laboratory results,and risks.

3. more long-term issues in health education,rest,coping,and so on.

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Specializes in Public Health Nurse.

To the original poster, the book by LaCharity on Prioritization and Delegation has a chapter on this. It is a must to pass the boards. It is not a very thick book, but what you learn is invaluable.

Each chapter has an average of 15 - 20 questions at the end, with immediate answers following. And at the end of the book a cumulative.

Get this book, you will not regret it and it is not very expensive either. Try E-Bay, that is where I got mine.

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To the original poster, the book by LaCharity on Prioritization and Delegation has a chapter on this. It is a must to pass the boards. It is not a very thick book, but what you learn is invaluable.

Each chapter has an average of 15 - 20 questions at the end, with immediate answers following. And at the end of the book a cumulative.

Get this book, you will not regret it and it is not very expensive either. Try E-Bay, that is where I got mine.

Which one:

Prioritization, Delegation, and Assignment: Practice Exercises for the NCLEX Examination, 2e (Paperback)

Or

Prioritization, Delegation, and Assignment: Practice Exercises for Medical-Surgical Nursing, 1e (Paperback)

Thanks!

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Specializes in Public Health Nurse.

To cjr2619 .... Good question...I no longer have the book, so I cannot give you the ISBN, but I believe is the first one you mentioned.

I found the title of the book by searching Ebay and I recognize the photo as the book I had, it is called: Prioritization, Delegation, and Assignment By LaCharity, Linda A., Ph.D./ Kumagai, Candice K./ Bartz, Barbara/ Hansten, Ruth.

Good luck, the book was just awesome in my view.

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To cjr2619 .... Good question...I no longer have the book, so I cannot give you the ISBN, but I believe is the first one you mentioned.

I found the title of the book by searching Ebay and I recognize the photo as the book I had, it is called: Prioritization, Delegation, and Assignment By LaCharity, Linda A., Ph.D./ Kumagai, Candice K./ Bartz, Barbara/ Hansten, Ruth.

Good luck, the book was just awesome in my view.

Thank you so much! I am always looking for good reads while I am sitting on a wait list for nursing school!

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