Prioritization

Good day:

Who will be harmed more if they are not treated sooner?

I know people who don't take care of their diabetes as well as they should, and have had levels over 600 with their only complaint being they have trouble focusing (patient was 19 years old at the time).

I'm not stating every person can handle high blood sugar, but what level of 200? What are their symptoms? What's the assessment?

(I'm in pre-nursing, so please excuse my not knowing the answer), but how low is a urinary output of

Thank you.

I agree with the above post..what do the patients look like? Neither of these patients appear to be in any emergent distress without knowing anything else. If they are both asymptomatic, then I would treat the high blood glucose. If the decrease in urine output was a change in status I would address that first.

What pt would you see first.. So what is the harm in the BS of 200?? Now what is the harm in the U/O less than 30??

What are the causes of acute renal failure and what will happen if it is not fixed??

This should give you a good place to start. With only the info provided from the question and what you know about high BS and low U/O, which would you see first ??

my thing is the OP says UOP «30. So what if it was 28 mL/hr and a 120 lb patient. There technically is adequate UOP for that patient. I guess I would need for info on patient but if it was a.nursing school question I would have to pick UOP?

The question above was an NCLEX type question. That is why there is no more information to give. As vague as it is, I would say that knowing that a person who has Acute Renal Failure is expected to have a low urinary output (UOP that is how we learned to abbreviate it in nursing school) then the person with diabetes and a blood glucose reading of 250 should be checked out first. Although, every person who has diabetes is different and they could be functioning fine without the need for immediate attention. Does a diabetic take priority over a person who has ARF?

We did, however, learn in nursing school that a person should be putting out at least 30 ml/hr no matter the weight.

It should be clear that I did post this question under the wrong topic. I am new to the site.

actually, the more specific equation for UOP is 0.5ml/kg/hr..anyway For NCLEX ID go with UOP.yep

I'd go with the UOP. It's not as easy as Diabetes takes priority over ARF or vise versa. It's the s/s that show that person is more critical than the other.

While decreased UOP is a sign of ARF, occasionally urine output remains normal for a time.

My thought are if a person is in acute renal failure then a low urinary output is expected, therefore, the diabetic should be seen first.

The same can be said of a blood glucose of >200 of a diabetic. Flucuations (highs and lows0 can be expected in someone with diabetes.

I would check the Arf pt first on the basis that the low urinary out put would be more likely to kill the pt if I did nothing as opposed to a pt with a blood sugar of 200.

Hello world,

My question is about prioritization. I would like to know if a person (who is a diabetic) with a blood glucose of 200+ deserves prioritization over a person with a low urinary output (

My thought are if a person is in acute renal failure then a low urinary output is expected, therefore, the diabetic should be seen first.

I would prioritize the patient with ARF putting out less than 30 ml. Acute renal failure can many times be reversed and dealing with them would be the more emergent priority.

I would think about the diabetic with 200+ as someone that needs to be seen quickly but it could be fairly normal for them.

If you're struggling with prioritization there is an awesome book called "Prioritization, Delegation, and Assignment" by LaCharity. I used this throughout the last year of nursing school, as well as preparing for the NCLEX. Good luck!

diabetic should be seen first. as to the urine ouput that can be delayed and could do no much harm as compared to elevated BS. the condition is hyperglycemia and remember there will be increase in potassium in that condition which needs to be attended urgently. one thing still to consider if BS is high the insulin is deffcient which results in high glucose thus this causes possibility of polyuria-- leads to dehydration --DKA and this conditions should be attended ASAP. a BS of 200 may shoot up even higher in minutes is not treated immediately. so my answer is attend the BS of 200 rather than the urine ouput of less than normal because as ive said that can be delayed but not the increased BS

Thanks for all of the GREAT replies to the question! I've ordered the book by LaCharity because I've seen that it has helped many with PDA. I am scheduled to take the NCLEX next month.

lloi a person who is not putting out enough urine and are in renal failure are at risk for hyperkalemia as well as hypervolemia. Too much K+ and too much volume can cause cardiac problems as well. This situation I have come to the conclusion would deserve priority over a person who has an elevated blood glucose reading. I do appreciate you reasoning behind the answer that you gave.