Help with prioritization question?

[elilop]

Can someone help me with this:

Put the nurse's following priorities in order and state why you chose that order:

___Education

___Pain management

___Fluid volume

___Infection treatment

___Allowing for play or distraction

___Monitoring

I think this is the right order but not completely sure: Fluid Volume, Infection treatment, Pain management, monitoring, education, allowing for play.

Thanks!!!

[MunoRN, RN]

Did your teacher provide any more context? In general, things that can kill you would come first, which would potentially include infection and possibly fluid volume. In terms of the Nursing Process, monitoring would come first since that falls under assessment and everything else is interventions.

Other than that the prioritization would be largely based on the patient's priorities and goals, as well as more specific assessment information. If your teacher really believes that these can be prioritized correctly without making them patient specific, my best advice would be to get a new teacher.

[Jonathank]

Did your teacher provide any more context? In general, things that can kill you would come first, which would potentially include infection and possibly fluid volume. In terms of the Nursing Process, monitoring would come first since that falls under assessment and everything else is interventions.

Other than that the prioritization would be largely based on the patient's priorities and goals, as well as more specific assessment information. If your teacher really believes that these can be prioritized correctly without making them patient specific, my best advice would be to get a new teacher.

[solneeshka, BSN, RN]

Things that can kill you go first, that's right. When I saw "monitoring," I right away thought "cardiac monitoring," as in telemetry. If I get a patient on tele, that's the first thing I look at because a dysrhythmia can kill you right now. Then I would say fluid volume because that won't kill you right now but it could kill you pretty quickly, and you can fix it almost right now (lasix is fast). Then infection treatment. Assuming we're not talking about sepsis or something, infection is probably not going to kill you as fast as fluid volume, and it might not kill you at all, plus "treatment" to me suggests ongoing maintence (things like abx and dressing changes). Next comes pain management because pain generally doesn't kill people, but it can interfere with healing, and it certainly interferes with quality of life. Last would be allowing for play/distraction because boredom never killed anybody (in spite of what a carload of children on a road trip without electronics will say). People don't go to acute care facilities to be entertained. It's not that it doesn't matter, but it's not an RNs job to provide it. (Don't say that on the NCLEX, or to your instructor, though.)

"Education" is a stupid thing to list with other priorities because it is something that you are constantly doing every time you interact with the patient in regard to the particular issue at hand. When you are dealing with the tele, you are educating about tele; when you are dealing with fluid volume, you are educating about fluid volume; when you are dealing with infection tx, you are educating about infection tx, and so on. Its priority depends entirely on what it is you are educating about. Education about preventing falls for a high fall-risk patient takes priority over pretty much anything else; education about long-term rehab does not.

The truth is that even one more layer of detail is necessary to prioritize a list like this. For a patient with sepsis, infection treatment jumps to the top of the list. For a patient on a pain pump, pain control rises. For a psych patient or for a child, the distraction is suddenly very relevant.