Prioritization Question

Nursing Students Student Assist

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Mr. Charles is a 59 year old patient with a history of emphysema. The patient smokes 3 packs of cigarettes per day, drinks alcoholic beverages 4 times per week, consumes a high fat diet, and leads a sedentary lifestyle. Over the last two days, Mr. Charles has been complaining of increasing shortness of breath, periods of dizziness, and fatigue. Prioritize the following list of activities you would use to safely manage this patient and explain the rationale for each.

1.Request a nutritional consult

2.Request a psychiatric consult

3.Do extensive blood work analysis

4.Implement a falls precaution protocol

5.Schedule early social work intervention

6.Perform a complete physical examination

7.Attach the patient to a cardiac monitor and pulse oximeter

Where would putting the pt on a smoking cessation fall in here? I thought at first it was under social work (#5), but then I realized, that would be our job as RNs (to at least give the pt info on it). So would that be after nutrition consult? Or where... Thoughts?

Specializes in med/surg, telemetry, IV therapy, mgmt.
Where would putting the pt on a smoking cessation fall in here? I thought at first it was under social work (#5), but then I realized, that would be our job as RNs (to at least give the pt info on it). So would that be after nutrition consult? Or where... Thoughts?

Somewhere at the end. At this point, it is not a priority.

Specializes in student nurse.

This is for daytonite's prioritizationI am still a student nurse but for some reason i think you would put the patient on the ekg and pulse ox first knowing his history has BIG problems associated with respiratory.

Specializes in med/surg, telemetry, IV therapy, mgmt.
This is for daytonite's prioritizationI am still a student nurse but for some reason i think you would put the patient on the ekg and pulse ox first knowing his history has BIG problems associated with respiratory.

But, you wouldn't know to do that until you did your physical assessment of their pulses first. An EKG requires calling a physician and getting an order. You cannot just hook a patient up to an EKG without a physician's order first.

Daytonite - I'm just curious why a nutrition precaution would come before a safety precaution. It sounds like the pt. already has COPD so wouldn't you want to secure the immediate need of the safety before a nutrition consult? I'm just curious. Otherwise, I would have ordered the exact same way. Thanks for your input!

Specializes in med/surg, telemetry, IV therapy, mgmt.
Daytonite - I'm just curious why a nutrition precaution would come before a safety precaution. It sounds like the pt. already has COPD so wouldn't you want to secure the immediate need of the safety before a nutrition consult? I'm just curious. Otherwise, I would have ordered the exact same way. Thanks for your input!

It requires a physician's order (collaborative intervention). Safety precautions are an independent nursing intervention.

Specializes in IMCU.

Has anyone considered putting daytonite on the Allnurses payroll?

Daytonite - Thanks. That makes more sense now!

Has anyone considered putting daytonite on the Allnurses payroll?

I love reading Daytonites responses. She is very knowledable!!! :yeah: Yes, I think she actually should get payroll. She teaches us so much! I don't care how much experience a nurse has, she/he can learn something new everyday.

That's what happens skittlebear. Sometimes, it feels like you have to study your instructor, and tailor your responses based on his/her personality!

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