nursing priorities

jadedjane, ASN, RN · Sep 1, 2011

Hi ashleyriddell :)

I can't just give you an answer to your question because you learn so much more by doing your own research. I can, however, point you in the right direction. Ask yourself: What is most important for your patient in their current condition?

For instance: maybe a patient with dysphagia would be at risk for aspiration, making maintaining patent airway a high priority, or a PT who is immobilized and elderly would be at increased risk for decub. ulcers / impaired skin integrity would be a high priority.

Note that these are just broad over simplified examples and you always want to consider the ABC's (airway, breathing, circulation) needs come first. The best tip I could give you is to look at your nursing care plan book. You can usually search by diagnosis, or at the very least identify 3-5 possible nursing diagnoses based on your patient's current diagnosis (or condition) and go from there. Does the patient show s/s of infection? Is the wound healing (no heat, pain, redness, swelling, purulence). Is there drainage? If so, what color / characteristics / how much. Is there anything out of the ordinary?

I love care plans....really (even though they are a PITA). Your nursing priorities are based on your assessment data. Maybe the wound is well approximated w/out s/s of infection, but the patient is in pain or immobilized would pain management be a priority, or maybe infection control? Is the patient nourished / hydrated enough to heal?

I hope this helps, and I'm not leading you in the wrong direction. These exercises are designed to help up develop our own critical thinking and clinical judgement. Think it through and find out what you patient needs MOST. I'm still a student (last semester of school) and this is the thought process that helped me. Hope your assignment meets your expected outcomes - lol

HouTx, BSN, MSN, EdD · Sep 1, 2011

I agree, always follow "ABCC"... airway, breathing, circulation & c-spine. In that order. Start with the most serious issue, get that stablized, then work to the next one. Pretty much any life-threatening condition involves a potential disruption of one of these 4 systems.

You can follow the same sort of process with any situation. Ask yourself, "what is the worst thing that could happen as a result of this situation/problem?" That's where you start. In the case of bleeding, your highest priority is to control the bleeding. (bleeding = circulation). In the case of sepsis, circulation is also highest priority - but interventions to stablize would be different.

After you address all of the 'worst case scenarios', you can move on to address other problems - in a Maslow-ey way. For instance, don't even try to address any psychosocial/security needs until you take care of the basics. If a patient is bleeding out, who cares if they have an altered body image???

I am glad you are focusing on this. The ability to prioritize is fundamental to both critical thinking and time management. You're gonna be a great nurse!!