MCS,RN

hello all - i'm a new bsn graduate in the process of applying to a critical care internship, as my senior practicum with within an icu and i fell in love with it. part of the online application for the critical care internship involves responding to a scenario and listing out how i would prioritize care for four patients. like most hypothetical prioritization questions, not nearly enough information is provided on each patient for me to feel confident about my selection. prioirtizing is one of my biggest weaknesses right now and one of the things i'm hoping the internship will help me gain a better handle on. if you happen to have some free time, i would greatly appreciate the input from some experienced rns. i don't want anyone to answer the problem for me, but i'd just like to know if you think i am on the right path. here is the scenario: ------------------------------------------------------------------------------------------ you are working your first week of night shifts on progressive care unit. you have received a report on four patients, and are prioritizing and organizing your plan of care for the night. your patients include: 52-year-old male who is six hours post ptca (percutaneous transluminal coronary angioplasty) with two stents placed in his lad (left anterior descending artery) 83-year-old female who just received a permanent pacemaker for third-degree heart block 34-year-old female type 1 diabetic recovering from dka (diabetic ketoacidosis). she is still on an iv insulin drop, and was transferred out of the icu earlier in the day 78-year-old male in for chf (congestive heart failure) exacerbation suddenly, you hear a three-star alarm on the central monitor. you quickly see it is your chf patient and the rhythm appears to be asystole. upon entry into his room, you find everything a mess. patient is trying to get out of bed, his oxygen is off, his iv is out and he is bleeding all over his gown and bed sheets. you see that all of his telemetry leads are off, his oximeter is off and he is pulling at his foley catheter while yelling he needs to go to the bathroom. between every two or three words, patient pauses for a labored breath and you can hear him audibly wheezing from across the room. his frail little wife is crying while attempting to quiet him down and keep him in bed. in detail, explain your priorities and describe your interventions for this group of patients. ------------------------------------------------------------------------------------------ i'm leaning towards prioritizing care as 4, 1, 2, 3. here is the rationales for this ordering: patient number 4, the 78-year-old male in for a chf exacerbation, is my top priority for this group of patients because he is currently experiencing airway and breathing complications. patient number 1, the 52-year-old male who is six hours post ptca with two stents placed in his lad, is my second priority because of the risk for impaired cardiac and cerebral tissue perfusion should he experience a stroke. patient number 3, the 34-year-old female type i diabetic recovering from dka, is my third priority because she will continue to require frequent cbg checks and insulin drop rate adjustments until her blood glucose has been returned to between 70 and 130 mg/dl. patient number 2, the 83-year-old female who just received a permanent pacemaker for third-degree heart block, is last on my list of priorities at this moment. though she is at risk for decreased cardiac output should the pacemaker malfunction as well as at risk for infection with the risk factor of an invasive procedure, the patient's primary concern at this time is likely acute pain at the surgical site. i can come up with the individual care plans no problem but i keep second guessing my prioritization order. should the diabetic have higher priority over the ptca post-op? thank you in advance for any input or words of wisdom you might be able to provide! [color=#888888]