Priority: Actual Problem (Circulation) vs Potential Problem (Airway)

starleviosa · May 12, 2012

I think it's because it wasn't stated that the boy with epilepsy is having seizure at the moment. So the tightness of the cast is a priority because of circulation. If it said the the boy is having a seizure then you see him first but since it wasn't stated he is considered a stable client. I think you over analyzed the question. I believe if it's not stated then do not assume. I used to do that too all the time.

I'm not sure. This is just my opinion.

diana2520 · May 12, 2012

This comes from kaplan Qbank question.
which is a top priority?
The child with epilepsy playing with small toy ball or a child who complains tightness of cast.
My answer was child with epilepsy because of possible airway obstruction though the time of possible seizure is unknown it is better to prevent it as soon as possible, right?
However, the Kaplan answer was a child who complains tightness of cast.
Im kind of consfuse why circulation is given priority in this situation.

these are Nclex kind of questions who do you see first....both answers are right but think of compartment syndrome... your pt with tightness becomes a priority.the child with the toy is also important but at least it does not state the child has the toy in the month...i would think in terms like that.... ABCs...

1jann · May 12, 2012

hello diana. thats what is killing me on nclex.who do u see first ans who will be roomed together ans who will not be..please help me and tell me what should i do about those. i would really appreciate.

MissRnToYou · May 12, 2012

I would have chosen the child c/o of tightness from the cast. I immediately thought of compartment syndrome which is a circulation issue! The young child with epilepsy is not experiencing an episode and it doesn't state that the child had a toy in his mouth.

Always remember this: If you say "what if" when deciding an answer, then that answer is wrong because you will be "looking in to" the answer.

Hope that helps!

halo212 · May 12, 2012

always go for the answer that has an ACTUAL problem. tightness of cast may impede circulation, resulting in more serious consequences for the patient. there is no indication that the child with epilepsy is experiencing any problems. just think of this: should i go see the patient who is complaining of something that may cause complications later on or go see someone who appears to have no current problems..just my 2 cents!

angelmax · May 12, 2012

yeah , i agree wit u all , pls dont over analyse the question.

Double-Helix, BSN, RN · May 12, 2012

The question doesn't state the age of the child. Are you going to be concerned about a 7 year old playing with a bouncy ball? Nope.

Tightness in a cast could indicate compromised circulation and lead to compartment syndrome- a VERY serious issue that could cause permanent damage even requiring amputation of the limb.

Actual problem beats potential problem.

diana2520 · May 12, 2012

hello diana. thats what is killing me on nclex.who do u see first ans who will be roomed together ans who will not be..please help me and tell me what should i do about those. i would really appreciate.

I will try and look for some questions that i used that was helpful to me, but if you have the la charity book its also helpful. PM me your email when you get a chance :)

DocsWifey · May 12, 2012

You have to think what is more acute RIGHT NOW. The child with the seizure disorder doesn't have an immediate problem and it doesn't state how old the child is (if it's an appropriate toy for the age). But the child with the cast has the problem right now (compartment syndrome). If you wait until the child with the ball has a seizure to take the ball away, by the time the child with compartment syndrome might be at the state that amputation is necessary.

Cannary22, BSN · May 13, 2012

I think it's because it wasn't stated that the boy with epilepsy is having seizure at the moment. So the tightness of the cast is a priority because of circulation. If it said the the boy is having a seizure then you see him first but since it wasn't stated he is considered a stable client. I think you over analyzed the question. I believe if it's not stated then do not assume. I used to do that too all the time.
I'm not sure. This is just my opinion.

I agree. The common mistake test takers do is over analyzing the question, even if sometimes the answer is obvious they still tend to end up with the wrong choice of answer. Stick with the given statement and do not question the question (you know what I mean). Good luck and God bless.

1jann · May 13, 2012

i just ordered la charity delegation book ..i ll be receiving it soon...my email is [email protected]

cuz the system is not eltting me pm due to some kinda requirement. yes please do llok for something i ll be so thankful. and thanks for replying. reinforcement teaching, rooming patients and who do u see first. these three things appear for me on nclex nothing else. and always. id dontk now waht to do. i will be waiting thanks.