Quote from studentnurseASN
I struggle with prioritizing questions that are not related to airway, breathing, and circulation. I got a question that was asking about prioritizing eczema, healing laceration, and stage 1 ulcer. The question was asking which was important.
Another question that I struggled with was picking the client to see first among clients who have two or 3 different diagnoses and a complaint. All were airway concerns. A patient with advanced TB, and PVD who has shortness of breath. A patient who has COPD, and vascular insufficency with shortness of breath (so stressed that I can't spell). A patient with HIV and TB with difficulty breathing.
Another question that I had trouble with. During a fire which of the following should be done: close all the doors, tell the person in charge of the building, or use the fire extinguisher.
I'll tell you how I would have answered those three and why. I've never been an A+ student, though!
The first one seems pretty straight forward. Eczema is a chronic condition. I'm not feeling a sense of urgency. The healing laceration is also easy to rule out. It's improving, and the patient who's getting better is rarely the priority. A stage one pressure ulcer may not sound too significant, but the patient is declining from intact skin. Patients who develop pressure ulcers are typically limited in their mobility, have poor nutrition, and may have cognitive deficits. They're vulnerable, in other words ...and that ulcer will quickly progress if it's allowed to. It might progress even if you do everything "right".
The second question is a little trickier, but I would choose the patient with COPD and vascular insufficiency. I'm thinking possible DVT or PE?? A patient with advanced TB would be expected to have some shortness of breath. The other TB patient seems like a distraction because they threw in HIV which has nothing to do with anything.
For the fire question, I would first notify the person in charge of the building. Fire plans are system wide. EVERYONE needs to know what's going on so that they can react properly. That doesn't mean you need to go look up the number, sit on the phone and have a ten minute conversation. Maybe you just yell at another nurse to call the operator and get acknowledgement before moving on the the next step. Kind of like yelling for help before you start CPR.
Anyway, those are my thoughts. I'd like to know what the actual answers are.