A practical nurse (PN) working in a skilled nursing facility has just received the morning hand-off report for a group of assigned clients. Arrange the following clients in the order the PN should prioritize their care, from highest priority (first) to lowest priority (last).
- 1A client with type 2 diabetes who has a morning capillary blood glucose of 65 mg/dL and is reporting mild tremors.
- 2A client who is 2 days post-operative following a hip arthroplasty, reporting pain at a 6 on a 0 to 10 scale, and requesting analgesia before physical therapy.
- 3A client receiving continuous enteral tube feedings who requires a routine residual check prior to scheduled morning medications.
- 4A client scheduled for discharge this afternoon who requires reinforcement of home wound care instructions.
Answer
The correct priority sequence is: 1) The client with hypoglycemia, 2) The post-operative client in pain, 3) The client needing a tube feeding residual check, 4) The client awaiting discharge instructions.
Prioritization relies on addressing unstable, acute, or life-threatening physiological needs first. The client with symptomatic hypoglycemia requires immediate intervention to prevent severe complications. Once stabilized, the nurse addresses time-sensitive moderate needs, such as administering pain medication to the post-operative client before physical therapy. Routine physiological care, such as checking gastric residuals, follows. Finally, stable clients with psychosocial or educational needs, such as discharge teaching reinforcement, are seen last.
Step-by-Step Solution
Key Concept
Prioritization of care based on acuity, physiological instability, and time sensitivity.