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Discussion

Prioritization

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.

Featured Replies

From a viewpoint of problem-solving strategy, I'd generally prioritize "acute" anything more highly.

With no other information...

A diabetic with a blood sugar of 200 (or 250) is perhaps not controlling their diabetes optimally and may be in need of education and perhaps a check of their glycosylated hemoglobin level.

A person in ARF is at risk for rapid deterioration and may need immediate interventions perhaps including emergent bedside dialysis.

From a viewpoint of problem-solving strategy, I'd generally prioritize "acute" anything more highly.

With no other information...

A diabetic with a blood sugar of 200 (or 250) is perhaps not controlling their diabetes optimally and may be in need of education and perhaps a check of their glycosylated hemoglobin level.

A person in ARF is at risk for rapid deterioration and may need immediate interventions perhaps including emergent bedside dialysis.

Agree! Acute before chronic!

From a viewpoint of problem-solving strategy, I'd generally prioritize "acute" anything more highly.

With no other information...

A diabetic with a blood sugar of 200 (or 250) is perhaps not controlling their diabetes optimally and may be in need of education and perhaps a check of their glycosylated hemoglobin level.

A person in ARF is at risk for rapid deterioration and may need immediate interventions perhaps including emergent bedside dialysis.

Agreed. I would definitely see the ARF pt first. What other systems might not be adequately perfused if you are seeing symptoms of decreased urinary output?

We are all taught not to read into NCLEX questions, so you can only go with the info provided. For the vast majority of diabetics, 200 doesn't cause emergent problems. But for most people, inadequate kidney perfusion AEB

moved for best response.

In the real world.....tha tdepends on whether or not the U/o has been running that low on that patient and whether or not they have been showing signs of failure/fluid over load....what they have been trending.... and what the glucose has been trending on the diabetic. However which can hurt you first.....the u/o and cause fluid over load and pulmonary edema. I'd check on the u/o first.

Hi Esme,

why is oliguria an alarming finding when it is an expected findings in Oliguric phase of Acute Renal Failure ?

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