Look at the question to determine what it is asking, then figure out what the answer is BEFORE you look at the answers. Try to determine from the question what is need: do you need additional information (assessment), do you need to do something (implementation), apply ABC's, apply Maslow, pain is psycho-social and physical needs take priority, look at the pt. scenario and get rid of unnecessary information. This sounds like a lot but it makes sense if you think about it; i.e. "Mrs. A, a 36 YO with a PMH of 2 term pregnancies, one preterm still birth, asthma, a T&A, and IDDM is 4 hours out of surgery to remove an ectopic pregnancy. She calls you to her room an reports pain at 7 at her incision site. On assessment you find her grimacing, guarding, diaphoretic, with a RR of 32, and slurred speech with difficulty concentrating. The nurses priority is:
A) Call the MD for orders for pain relief
B) Assess pts emotional response to losing a pregnancy.
C) Assess the patient for abd. tenderness, guarding, and distension.
D) Perform an accu check.
First: what is the question asking? What is the PRIORITY?
Second: What information do you NOT need right now? That she had a T&A, that she has two living children and that she had a still birth may be relevant later BUT they are unimportant right now, that she has a PMH of asthma is important but not in this case, she is not in resp. distress. The pt. is an IDD this should remain as it is physical. The pt. is reporting pain at 7 BUT remember, pain is psycho-social.
Third: Apply Maslow- physical first, psycho-social later. IDDM is physical, pain is psycho-social.
Your answer HAS to be get an accucheck, the symptoms MAY be pain related but you have to eliminate physical causes- these symptoms may be related to low blood sugar. The question is OB focused but your first response is to look at the pain issue, the second response is to look at the OB aspect of the question, but the REAL priority is that this woman is an IDD who was pregnant, just came out of surgery which changes insulin needs and blood sugar and also leads you to believe she has been NPO for several hours. Her blood sugar must be assessed before anything else. Blood sugar regulation is a priority in a diabetic. See, it's not what you know it's how you think.