To airway or not?

[Tonyia524]

Ok, I am in third semester and we had our first fluid and electrolytes test today. I went in feeling so cool and confident! I left feeling like it was my first day of the program. Like I knew nothing! Anyway, there was a question about coming into a patients room and you see that his gown is covered in blood and the blood is pooling on the bed. The two I can remember in the options were "maintain patent airway and Find the source of the blooding."I have never left a test room so lost after studying so much!

[bgxyrnf, MSN, RN]

Without an airway, everything else is moot... if they are breathing, though, deal with the bleeding. Short of a bleed from a large arterial wound, you have some time to address bleeding. In both cases, the first choice would be "Get Help"

Don't stress about these stupid questions; take your best shot and move on. They have no relevance to the real world. I've never seen a situation where both issues were present and I was the only staff available.

[smf0903]

I don't think I ever had a test question in school with the option of "maintain patent airway" and it wasn't the answer.

"Jane received a haircut on Friday and decided to treat herself to a set of acrylic nails. Saturday morning she noticed her pinkie finger was tender and swollen. As happens, her PCP was not available on the weekend so Jane drove herself to the local ED where you are working. What is your primary goal?"

...maintain that airway :)

[DayDreamin ER CRNP]

Always, always, ALWAYS ABCs. Airway, airway, airway.

You address A before you move to B. You make sure you have A and B before you move to C.

[thehyruler]

I agree with everybody who is emphasizing ABCs. However, I have come across a few similar questions where the answer was not airway because the airway was not compromised. In the case of your test question, we would have to read it but the answer could be to look for the source of bleeding because there is nothing in the question that indicates the airway is compromised.

[/username, BSN, RN]

What good do fluids or electrolytes do for your patient if they're dead...?

[Triddin]

although A few pieces of assessment data could make me change my mind, if I saw a mass pool of blood, I would prioritize finding the source of the bleed.

[DayDreamin ER CRNP]

although A few pieces of assessment data could make me change my mind, if I saw a mass pool of blood, I would prioritize finding the source of the bleed.

Right!! If there is obvious bleeding you need to address A C B. In the situation of the OP, I would have to read the full content of the question but you still need to maintain an airway for about 99% of all nursing school test questions anyway.

If the question read something like, Farmer Joe arrives to your ED with his RLE amputated from the knee down. He is able to tell you his full name and describes what happened on his farm today. His vitals are WNL. What is the priority?

A. Establish a patent airway

B. Establish a large bore IV

C. Call the ortho trauma MD on call

D. Control the bleeding

The answer is D.

If the question reads something to the effect that Farmer Joe fell off his tractor and has a large hematoma on his head and you notice crepitus in his chest. He is pale, diaphoretic and only speaking in one word answers and only states, "tired" my answer would be

A.

[Ladyscrubs]

[quote"Jane received a haircut on Friday and decided to treat herself to a set of acrylic nails. Saturday morning she noticed her pinkie finger was tender and swollen. As happens, her PCP was not available on the weekend so Jane drove herself to the local ED where you are working. What is your primary goal?"

...maintain that airway :)

HA, HA, Love it!

[Tonyia524]

The answer was airway. I should have know it was airway but could hear my instructor from last semester in the back of my head "it's not always gonna be airway". 🙄 Oh well, I ended up with a B on the test so I'm not going to stress that one. Lesson learned. Lol thanks for all of your input!

[bgxyrnf, MSN, RN]

The answer was airway. I should have know it was airway but could hear my instructor from last semester in the back of my head "it's not always gonna be airway". í ½í¹„ Oh well, I ended up with a B on the test so I'm not going to stress that one. Lesson learned. Lol thanks for all of your input!

About the only way that it won't be airway is if either (a) that's not a listed option, or (b) the airway is clearly demonstrated to be intact.

For example, an ambulance is delivering a trauma patient. As you approach you can hear the patient screaming, "that SOB shot me!!! Look at the blood!! I'm going to kill that $$#* after I get out of here!." The airway is clearly intact and the patient is breathing. Move on to circulation and look for the blood.

It always goes back to ABCD...

[bgxyrnf, MSN, RN]

The answer was airway. I should have know it was airway but could hear my instructor from last semester in the back of my head "it's not always gonna be airway". 🙄 Oh well, I ended up with a B on the test so I'm not going to stress that one. Lesson learned. Lol thanks for all of your input!

About the only way that it won't be airway is if either (a) that's not a listed option, or (b) the airway is clearly demonstrated to be intact.

For example, an ambulance is delivering a trauma patient. As you approach you can hear the patient screaming, "that SOB shot me!!! Look at the blood!! I'm going to kill that $$#* after I get out of here!." The airway is clearly intact and the patient is breathing. Move on to circulation and look for the blood.

It always goes back to ABCD...