I am confused on priority on nclex. DKA, Renal Fail, Head injury?

[jcutler]

Is severe hyperglycemia is priority condition. Say BS 550. What about chronic renal failure end stage?

If a client has a closed head injury 12 hours ago, and is continuously having problems remembering the accident, is this an emergency.

I guess it is just a problem for me when you cannot go by airway, breathing, circulation. Everybody is dying. Is there any strategies to go by to filter through priority questions on NCLEX? Is DKA considered breathing priority?

[HouTx, BSN, MSN, EdD]

End-stage anything is not a priority unless the question is about pain mgt. Rapid resp with DKA are not an indication of airway or breathing pblms - resp rate is being driven by the acidosis... compensatory to 'blow off' acidosis. Of the three, I would say the head injury is the highest priority - decompensation will shut down cardio-resp function & CNS damage is irrevocable. Rationale is always based on preserving vital functions or keeping the patient 'safe'.

[anonymousstudent]

ITA w/ HouTX, and for the same reasons. The head injury could decompensate into something much worse easily and initiate ABC problems.

[jcutler]

Ok well, how about Hyperkalemia 6.0, vomiting, Decrease loc, and DKA, decrease BP 80/50. Who would priority in order? So should I go by the ABCNE - Airway breathing circulation Neuro Electrolytes & VS changes for priority schematic?

[HyperSaurus, RN, BSN]

Ok, so what are the options again?

K+ of 6.0?

vomiting

Decrease LOC

DKA

BP of 80/50?

Or are some of these supposed to be lumped together. In the original question, I'd go with the closed head injury as priority, followed by the BS of 550

[Spoiled1, MSN, RN]

Ok well, how about Hyperkalemia 6.0, vomiting, Decrease loc, and DKA, decrease BP 80/50. Who would priority in order? So should I go by the ABCNE - Airway breathing circulation Neuro Electrolytes & VS changes for priority schematic?

I am confused with what the question is exactly. Could you write the whole thing as it's written? I would say Hyperkalemia would be the priority. You don't play with Potassium as it effects the heart. Hyperkalemia can also be a cause of DKA. So if you fix the problem -increased potassium, that will fix the the other problem-- DKA.

[birthrevolution]

I am confused with what the question is exactly. Could you write the whole thing as it's written? I would say Hyperkalemia would be the priority. You don't play with Potassium as it effects the heart. Hyperkalemia can also be a cause of DKA. So if you fix the problem -increased potassium, that will fix the the other problem-- DKA.

I am also confused. I need the context of the full question. Who has decreased LOC? Who has a K+ of 6.0?

[2ndyearstudent, CNA]

Ok well, how about Hyperkalemia 6.0, vomiting, Decrease loc, and DKA, decrease BP 80/50. Who would priority in order? So should I go by the ABCNE - Airway breathing circulation Neuro Electrolytes & VS changes for priority schematic?

What does hyperkalemia cause and is it serious according to ABC or Maslow?

[JROregon, ASN, BSN, RN]

It can lead to ventricular fibrillation or asystole. A lab value of 6.0 is mild and may be a reaction to the DKA.

[Yuppers21]

Ok well, how about Hyperkalemia 6.0, vomiting, Decrease loc, and DKA, decrease BP 80/50. Who would priority in order? So should I go by the ABCNE - Airway breathing circulation Neuro Electrolytes & VS changes for priority schematic?

Are you listing 5 new patients to prioritize, or are you increasing the severity of the DKA to see at what point it becomes more important that the head trauma? Someone also mentioned than hyperkalemia can cause DKA, is this true? I was only aware that DKA causes hyperkalemia because of K+ leaving the cells...