Nursing Priorities?

[CN101, BSN, RN]

Hello, I am not yet a nursing student but I hope to be before the year ends. I am writing in here because I know a lot of you experienced nurses will probably know the answer to my question. I found this question on a forum that was created years ago and no one had answered it.

TL;DR: Who would be treated first: someone who is hallucinating from alcohol poisoning or a teen with lots of blood in their urine from a kidney infection?

Thank you.

[JKL33]

There isn't enough information to work with. Maybe that's why no one ever answered the question. It could go either way depending on supporting information.

[CN101, BSN, RN]

That makes sense. Thank you for answering.

[Flatline, BSN, RN]

I would say the alcohol poisoning.

At the point that the BAC is high enough to cause hallucinations it is is high enough to start shutting the brain down. I would consider this patient to be more emergent since the alcohol they have already consumed but not yet absorbed will only continue to be absorbed into the blood further increasing the BAC with every minute that passes. Life supporting functions will start to shut down without intervention.

The second patient, while needing care, does not appear to be time sensitive urgent. Hematuria is not an uncommon finding and "lots" is very vague and subjective leading me to think it is not gross or frank blood.

[AnnieOaklyRN, BSN, RN, EMT-P]

I would say the alcohol person since they are a danger to themselves give the confusion. The person with blood in there urine from an infection is VERY unlikely to be hypotensive. although not impossible if they are septic, but that would be reading to far into the question. The drunk goes first!

Annie

[MunoRN, RN]

The first priority is always assessment, so the answer to your question would be more assessment prior to moving on to interventions.

Hallucinations are not generally associated with alcohol poisoning, they are typically associated with a lack of alcohol in an alcoholic, that would be one place to start with further assessment.

"Lots of blood" is not a particularly useful finding, particularly when mixed in urine where only a relatively small amount of blood can make bloody urine look like "lots of blood".

[JKL33]

I would want to eyeball the alcohol poisoning patient first but it's still just a poor question that could contain catches either way. Similar to what has been mentioned, I haven't seen anyone hallucinating from solely alcohol poisoning so it's difficult to say what the real situation is with either of these patients. One could make the case that a hallucinating patient should be checked first, other questions notwithstanding.

[Here.I.Stand, BSN, RN]

Well one doesn't exactly exsanguinate from a kidney infection. EtOH withdrawal (what we associate hallucinations with, as MunoRN said) is extremely dangerous, both physiologically and the risk of injury that comes with that state.

[nursej22, MSN, RN]

Agree, that this is a poorly worded question.

For prioritization questions, always ask which will kill them first/fastest?

[CN101, BSN, RN]

Hey, everyone! Thanks for your answers. I agree that it's not very descriptive but that was pretty much what the op wrote.

My answer was the man with alcohol poisoning. My reasoning isn't as detailed as any of yours (because I am not a nurse nor a nursing student yet) but I assumed someone hallucinating is more serious than someone who has blood in their urine. The latter is serious but the cause is clear. Who knows why someone who appears to have alcohol posioning is hallucinating? Did they take some sort of drugs? What's the major issues?

Again, thanks for responding everyone!