Prioritizing Multiple Patient Care

ADNS · Mar 19, 2012

I have an assignment to prioritize patient care for a RN charge nurse, LPN, and CNA.

The following patients are on the unit during the day shift. Discuss your rationales for your assignments to yourself the RN charge nurse, LPN, and CNA:

101: 65 year-old, total hip; day 2--on hyperalimentation, is confused, family problems, very unhappy with care.

102: 35 year-old, bowel resection; day 3--very happy that cancerous bowel was removed, ready to begin to learn home care.

103: 82 year-old, cholecystitis; day 1--patient admitted by daughter for respite care. Physician furious that emergency department physician admitted him. Patient is very stable and fun to take care of. Requires little care; will probably be sent home or to another place today if tests ok. Doubt pain is cardiac.

104: 35 year-old, total hysterectomy; day 2--very stable, requires little care, ready to go home in a.m.

105: 29 year-old, motor vehicle accident; day 3--multiple lacerations, bruises; dressings and wound care with saline/peroxide flush, takes about one hour to do wound care.

106: 19 year-old, motor vehicle accident; day 3--girlfriend of patient in room 105; r/o fracture pelvis, r/o possible pregnancy. Family upset; patient screams with pain; pain meds held due to possible pregnancy; some arguments with physician and family; r/o drug dependence.

107: 81 year-old, TURP; day 2--patient from group home for disabled, ready to return home tomorrow. Alert, friendly, understands instructions.

108: 74 year-old, TIA; day 1--CVA now evident, extending; family now discussing code decisions with physician; very unstable vital signs; q 15 minute neuro checks.

109: 71 year-old with abdominal pain; new admit; probable diverticulosis (h/o past episodes), stable. Language barrier, speaks only Vietnamese.

110: 42 year-old, pneumonia; day 4--on 2 IV antibiotics q 4-6 hours.

For the RN, I believe I should see the patients in this order: 108, 109, 110, 101, 106, 105, 107, 102, 103, 104.

Would this be an appropriate way to order the patients based on their needs for the RN? What would be the best way to delegate to the LPN and CNA?

Thanks for your help!!