Prioritization Exercise

  1. I have a prioritization exercise that I'm having trouble with I was hoping to get some advice on what others think.

    I'm caring for 8 residents. I just received report and information on the clients, and I need to prioritize my day who I would see first, second, and so on.
    starting with room # These are the residents on my unit

    101 - Sally 97 y.o. history of dementia. Wandered all night
    102 - Lisa 75 y.o. Parkinson's. Tremors persist. Slow gait and wandering.
    103 - Sam 86 y.o with CAD. Complaining of chest pain at midnight awake most of the night. He received 2 nitro tabs.
    104 - Jeff 89 y.o left above the knee amputation and diabetes. His Blood sugar at HS was 293. On sliding scale and scheduled insulin BID
    105 - Mary 93 y.o who just fell. CNA reported no apparent injuries.
    106 - Sandra a 100 y.o, bedridden, DNR, asking to die
    107 - Melody a 67 y.o in for rehabilitation for a left total hip surgery. Planning on being discharged today.
    108 - Allen 88 y.o. history of diabetes on oral agents.

    In order I would see
    105 - I need to assess Mary, the CNA can not assess
    103 - I would then assess Sam for heart rhythm and rate and remaining chest pain.
    104 - Checking on the amputation and any s/s of hypo/hyper diabetic reactions
    101 - Sally to assess why she was wandering all night
    106 - Assessing Sandra for depression
    102 - Assessing if the tremors are progressing
    108 - Check Allen's Blood Glucose levels and check for hypo/hyper diabetic reaction
    107 - Make out discharge teaching plans for Melody
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  3. by   suni
    I think chest pain is always seen first, however you do not say if he is currently having pain or if he had pain and the nitro resolved it, or does the beginning of your post mean you are just starting day shift.
  4. by   Joni's Mom
    Thanks for the reply. I'm just starting my day and this is the report that I received, so I assume the nitro tabs were successful? Don't know, doesn't say.
  5. by   abbythetabby
    Always follow your ABC's. Priorities are Airway, Breathing and Circulation, in that order.
  6. by   Joni's Mom
    That's whats confusing me.
    Wouldn't you assess a patient that JUST FEll 1st because you dont know if the woman broke a rib and the rib is restricting her breathing?
  7. by   suni
    Always your ABC's but if the fall patient were unconsious, had hit her head had a deformity, there are so many varibles, bottom line chest pain and breathing difficulties are first.
  8. by   Joni's Mom
    Ok, I'm still having doubts, but this is the order that I prioritied my patients
    Hopefully this is correct.
  9. by   Joni's Mom
    Letting everyone know that my instructor said SAFTY comes first and I should have seen Mary the woman that fell first. My first instincts were right always go with your first instincts.
  10. by   Kim O'Therapy
    Neat exercise. Thanks for sharing it with us.