NCLEX Priority. What if there are no ABC's. Also, disaster clarification

[jcutler]

Ok I failed nclex. Priority are hard. Took kaplan and helped some but the priority questions were extremely difficult. I get ABC's BUT nclex rarely had ABC's question flat out. Was more like questions like, e.g. who to see first: Pt with:

Decreased LOC

End stage renal failure

DKA

Hyperglycemia 500 BS

How can you apply abc to that.

Is there a schematic like:

ABC's, changes in loc, electrolyte imbalances, changes in citals - or anything like that in an order?

Also, DISASTER: Is this right?

- Say there is a terrorist attack bombing - You take the people that are most critical but the highest chance of survival right? So if there is someone with Glascow of 3 with pinpoint pupils, they don't go first - it would be more like someone with a crushing chest injury or something like that. Any difference if it is peds - like a school?

And for evacuation - take ambulatory first? Any particular order.

Thanks for feedback. Trying to get over this nclex situation.

[caliotter3]

For help in this area look at the prioritization book by Linda LaCharity.

[Hope2017]

The prioritization book helps me pass.

[Dina0125]

It is not always about ABC, you have to think about what will happen to each pt if you don't see them right away. Some pt can wait an extra 5 mins and will not causes any harm but other you need to see right away. Basically ask your self which patient is more unstable in the group that they give you( if they can wait 5 mins they are stable).

[SweettartRN]

I use ABC, then Maslow's and go from there.

Just my

$0.02

[n.nclex]

Well, for the first question, I choose decreased LOC, because I look at your question:

1.End stage renal failure: it is serious but I don't overthink it:no any ABC symptoms described here right now. The atient with ESRF maybe is controled by dialysis and at least he is stable right now.

2.DKA: it is serious but I don't overthink it: no any ABC symptoms described here right now, too.

3.Hyperglycemia 500 BS:it is serious but I don't overthink it: no any ABC symptoms described here right now.

But this one "decreased LOC" : do you remember the triage nurse? Triage 1: unresponsive; tachycardia with hypotension; respiratory distress---

Triage 2: consciousness change; high risk patients; pain over 7 with vital signs change.

Triage 3:need resources more than 2

Triage 4:need one resource

Triage 5: none of resources needed

In the emergency situation, I use Emergency Severity Index (triage 1-triage 5)to sort patients because sometimes we don't have to take vital signs on those patients in the primary survey. If a patient is unresponsive, the first thing I do is to call for help (911 or a Rapid Action Team) instead of ABC.

In the patient with fluid overload, I use ABC: lift the head of bed, give O2, and stop IV.

Refering to the disaster nurse, I am not good at it either. What I know is RACE(rescue a patient close to the fire first, then activate alarm, then close the door, and last extinguish fire.)

I will evaculate the most stabled patient first.

Please correct me if I am wrong.