Assessing patients

You have been assigned 4 patients on an Intermediate Medical Care Unit. Two of the patients are post myocardial infarctions at various stages of their infarctions with multiple types of arrhythmias, the third patient is having drastic blood sugar fluctuations 218 down to 50 within minutes and its rebounds back up with changes in mentation and the fourth is reported to be having frequent TIA’s. One of the MI patients is having some dizziness and your TIA patient is presenting signs of impending stroke.

How would you prioritize your assessments and activities? How would you describe your critical thinking process and how do you organize and prioritize implementation of care?

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Sample Answer

The priority of my assessments and activities would be to assess the patients who are in the most immediate danger. This would include the two patients who are post myocardial infarctions and the patient who is presenting with signs of impending stroke.

I would start by assessing the patient who is presenting with signs of impending stroke. I would check their vital signs, including their blood pressure, heart rate, and respiratory rate. I would also assess their level of consciousness and their neurological status. If I found that the patient was indeed having a stroke, I would immediately call a code stroke and start the appropriate interventions.

Once I had assessed the patient who is presenting with signs of impending stroke, I would assess the two patients who are post myocardial infarctions. I would check their vital signs, including their blood pressure, heart rate, and respiratory rate. I would also assess their chest pain and their cardiac rhythm. If I found that either of the patients was having a complication of their myocardial infarction, I would immediately intervene.

Full Answer Section

The third patient, who is having drastic blood sugar fluctuations, would be my lowest priority. However, I would still need to assess them and make sure that their blood sugar is stable. I would also need to educate the patient about how to manage their blood sugar at home.

I would use the following critical thinking process to prioritize my assessments and activities:

  1. Identify the patients who are in the most immediate danger.
  2. Assess the patients who are in the most immediate danger.
  3. Intervene as needed for the patients who are in the most immediate danger.
  4. Assess the other patients.
  5. Intervene as needed for the other patients.

I would organize and prioritize implementation of care by first completing the interventions that are most urgent. I would then complete the interventions that are less urgent. I would also make sure to document my assessments and interventions in the patients’ charts.

Here are some additional tips for prioritizing my assessments and activities:

  • Use the ABCDE approach to triage patients. This approach prioritizes patients based on their airway, breathing, circulation, disability, and exposure.
  • Use the patient’s presenting symptoms to prioritize your assessments. For example, if a patient is complaining of chest pain, you would prioritize assessing their cardiac status.
  • Use the patient’s past medical history to prioritize your assessments. For example, if a patient has a history of myocardial infarction, you would prioritize assessing their cardiac status.
  • Use the patient’s laboratory values to prioritize your assessments. For example, if a patient has a low blood sugar, you would prioritize assessing their glucose levels.

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