focus assessment/prioritizing

[trayyhawk03]

I am a first year nursing student and right now we are learning how to do a focu assessment and how to prioritize when you go into a patient's room. The scenario that my teacher gave us was, You have a patient yelling that he can't breathe, another patient, who's blind but needs to get up and go to the bathroom, and the third patient is a diabetic who's hungry but needs his blood sugar checked before he eats...the problem that i'm having is trying to prioritize on what to do first. Can anyone give me any advice on how to prioritize? Please? By the way this is for LVN program

[txnursingqt]

I would attend to the diabetic first because of their blood sugar needing to be assessed. Blood sugar assessments are done on a regualr schedule. The last time I was hospitalized I waited for over half an hour while my dinner tray was getting cold for someone to come and take a Glucometer reading on me. I don't know what the holdup was but if it was a blind guy who needed to be walked to the bathroom he better have been busting at the seems to pee. Helping a blind person is a safety issue and can wait a few more minutes over a diabetic that needs food and blood sugar control.

That is what I figured after reading the Hierarchy of needs. Thanks for answering.

[sdjohnso]

Great Prioritizing! That never occured to me that they wouldn't be yelling if they couldn't breath, lol, but it makes so much sense.

[keno138]

I still think I would first get a visual of the man yelling that he can't breathe.

[Daytonite, BSN, RN]

I still think I would first get a visual of the man yelling that he can't breathe.

I agree. . .as I was going by his room to do the blood sugar on the guy who is hungry and waiting to eat. Multi-tasking is what we do. I can't tell you how many COPDer's were screaming "Help me! I can't breathe!" at the top of their lungs right after Respiratory Therapy left their room after giving them a breathing treatment. :smackingf Mostly, many of them are afraid to be alone. Fear of suffocation. I spent many hours sitting at their bedside doing my charting just to keep them company.

[Veronica22715]

I would still check the man who says he can't breathe. I had a downs syndrome pt who kept turning on the call light telling me he couldnt breathe, I did assess and his sat we ok, he was talking , not huffing, lungs sounded clear, so I gave him an antivan and he continued to say he was sob and about 30 min later his sats dropped and he had decreased conciousness ultimately he had a PE. So, he obviously knew something I couldn not see, you will have the annoying patients that seem to eat up your time but don't write them off.

ABC's every time. The diabetic may be waiting to eat but he is not going to die if he has to wait 10 minutes, and the blind patient may need to use the bathroom but you can either send an aide or ask the patient to wait while you assist another patient. Then he knows you are coming back and will wait for assiatance.

[Awesomemiss]

not sure I agree with generalizing / pre-determining the cause of the 'yelling not breathing guy'S/sx of hypoxia or impending MI can look(or sound) like this guy.... Or maybe his face/throat/tongue are swelling due to severe allergic rxn? My point is that there r too many variables or causes to a pt yelling 'help I can't breathe' that could lead to injury of the pt to risk it.... Plus, how long would it take to get that blind guy who is POD 1 bilateral TKA 's out of bed and to the bathroom before u could run back and check on the person yelling? (that's a joke of coorifice! But true too)Lastly I think it's awesome u copied maslows to the thread... It's a great refresher! Thanks!!!

[all517]

Personally, it would not assure me enough to rationalize that "if he's yelling he's breathing"... I would definitely go to him first. Sure, he's breathing, but what's he look like? Theres many things that could be going on like previously said... allergic reaction, flash pulmonary edema, MI, PE... yes those are worst case scenarios, but I would assess him first. Anxiety? Could still lead to problems if you just let him hang on his own! DM guy... He can wait to eat until I assess breathing guy. It's not like he's hypoglycemic and unresponsive, or has dysphagia and is an aspiration risk. Blind guy... Barring he has no cognitive impairments and is oriented, I'd stick my head in quick and tell him to stay in bed and not get up, and I'd have a nursing assistant or CNA help ambulate him. My order would be breathing, ambulating, and DM!