Prioritization Question

mitchsmom · Oct 12, 2005

I have no idea, I was going to say c also... some side effect could have kicked in... then again if he was too sedated he probably wouldn't be hitting the call button... he could be barfing or something...

if not him then the guy that needs to go potty... when ya gotta go ya gotta go

the other two just seem out - b) is not a priority, d) really doesn't give me enough info to prioritize

but what do I know? :)

Darlene K. · Oct 12, 2005

I thought that it's C also. I think we all try to read too much into the question. Like is there family members with the person who received morphine? The pt that needs to go to the bathroom is he on fall precautions and going to try and go on his own? So on and so on. :rolleyes:

VickyRN, MSN, DNP, RN · Oct 12, 2005

You are in charge of four patients all who have pushed their call light. Who will you see first?
Patient A has to use the toilet
Patient B doesn't have his glasses or hearing aid
Patient C has just been given a morphine injection
Patient D has a restraint vest on in a geri chair
I'm going through the ABC's and Maslow and can't figure this one out. I think I'm reading too much into the question. I was thinking Patient C since he was administered meds but was told that the injection would have been monitored.. Help :)

I agree with you in choosing "C." Morphine can cause respiratory depression as well as sedation and this patient needs close monitoring. Therefore "C" takes priority (ABC's). Gotta' love these prioritization questions :rolleyes: Our graduates report the NCLEX is full of them....

tiffanycmt · Oct 12, 2005

hmmm tricky question it would be between c and d the other two seem to be the least priorty in my opinion. Although D would be unlikely you know how state loves the word restraint.

Daytonite, BSN, RN · Oct 13, 2005

Morphine Man first. He may be having symptoms of an allergic reaction. Geri chair patient next. He/she may be hanging themselves in the vest.

button2cute · Oct 13, 2005

You are in charge of four patients all who have pushed their call light. Who will you see first?
Patient A has to use the toilet
Patient B doesn't have his glasses or hearing aid
Patient C has just been given a morphine injection
Patient D has a restraint vest on in a geri chair
I'm going through the ABC's and Maslow and can't figure this one out. I think I'm reading too much into the question. I was thinking Patient C since he was administered meds but was told that the injection would have been monitored.. Help :)

I would go through the ABC .......and Safety.

Patient C....morphine can supress breathing and death can occur.

Patient D ....Restraint vest.....safety and to make sure the vest is appropiately secure. Also, checking circulation and skin assessment.

Patient A....because urine on the floor can be a hazard and place on the toilet.

Patient B ....will hopefully will be safe in bed until the glasses and hearing aid are located.

Airway, breathing, circulation, safety my method....

What are the correct sequence of answers?

Buttons

nursemaa · Oct 13, 2005

I would definitely go with patient C, then patient D. Of course, patients A & B would then complain to the nurse manager that their call lights weren't answered in a timely manner, and the patient satisfaction scores would drop ! :chuckle

Win98 · Oct 22, 2005

First of all, I would need a bit more info on each of these patients, but I'm going to rock the boat.

I would first go the patient who needs the toilet. If he/she is ringing bell to go the toilet, he/she obviously need help to get there, and I would go there first - safety issue - don't want them to try to get there themselves if they may fall, don't want them to soil themselves or the bed, as they would be upset, and it would take you extra time to clean them up and change the bed, keeping you away from the other patients. If the patient can ring to go to the toilet, you can put them in there and tell them to ring the bell when they are done. On the other hand, if this pt is bedridden and needs a bedpan, it would only take a minute to slip it under them, and ask them to ring when they are done.

The other three I find hard to prioritize.

morphine patient. Why are they ringing? It could be anything. It's not likely to tell you that they are comatose and have respiratory depression. Is this patient a complainer? They may be impatient the drug hasn't worked yet and they want more. Is this patient confused? They may have forgotten you gave them an injection. They may want the toilet, their glasses or hearing aid, a drink of water, they may have dropped something onto the floor - they could have rung the bell for a million reasons. Did you leave the syringe in the bed?

glasses and hearing aid. Safety issue. Are they going to get themselves and fall or injure themselves if you don't go to them soon?

Pt in restraints - likely confused, or at least forgetful, or would not be restrained. Like the morphine patient, we don't know what he wants. This patient could be a frequent bell ringer. Again, could be lots of reasons besides confusion. Same reasons as morphine patient. Lets hope it's not because they are being strangled by trying to get out of the restraints. In the place where I work, we have "least restraint" policy, and would get a "sitter" rather than restrain a patient. If we have to restrain them, we have to document frequent checks and release the restraints for a short time at certain intervals.

So, in a nutshell, without more information I can't prioritize apart from saying I would first go to the patient that needs the toilet.

And, why do you know exactly what two patients want, but not the other two? I think this makes it a bad question. If you have an intercom, why can't you ask the morphine patient and the restrained patient what they want, and tell the guy who wants the glasses and hearing aid that you will be there in a few minutes. If you actually know what each of them wants, it's much easier to prioritize. You can see how easy it is to prioritize between the toilet and the glasses/hearing aid.

In case you haven't figured it out, I HATE this kind of question. It's apples and oranges. It's

txdude35 · Nov 18, 2005

Win98, I used to beat my head against the wall on questions like this until my professors beat it into me to take the question for what it says, no "woulda, coulda, shoulda"... the question is what it is, and I've seen a million like it.

I'm going with C. Yes, the toilet guy may be mad if he makes a mess, but the morphine is the only choice here that could have a life threatening adverse effect.

Win98 · Nov 18, 2005

I still don't think the morphine patient would be ringing to tell you about serious side effects, when the main side effects are respiratory depression and being comatose.

txdude35 · Nov 18, 2005

I still don't think the morphine patient would be ringing to tell you about serious side effects, when the main side effects are respiratory depression and being comatose.

You're right, of course, but this is "questionland" not real life.

After many battles over questions like this with my profs, they keep telling me that the writers want to know that you know that respiratory depression is more important than going to the bathroom. Of course, I could be wrong, but that's the answer I would go with and the rationale behind it.