In today's society, critical thinking is of great importance to the nursing profession to provide safe care and accurate priority in which situation to address first. Critical thinking objectives are being written and updated in schools of nursing and work place orientation periods (Kaddoura, 2010). I'd like to take an opportunity to pose a few scenario to my classmates to give feedback to me on which patient they feel need addressed first. Perceive you have just received report and are ready to assess four different patients. Of the following four which would you choose first and why?
1) 42 yo (female) admitted with pyelonephritis with a temp of 102 degrees.
2) 50 yo (male) on second day of admission with feeling of tingling in arm and b/p of 160/80.
3) 65 yo (female) fresh post op appendectomy with acute SOB and confusion
4) 30 yo (male) requesting his prn xanax for severe panic attack
Yes, these are rather different scenarios...anxious for feedback!
Reference
Kaddoura, M. (2010). Effect of the Essentials of Critical Care Orientation (ECCO) program on the development of nurses' critical thinking skills. Journal Of Continuing Education In Nursing, 41(9), 424-432. doi:10.3928/00220124-20100503-05
I think I would be most concerned about #3. The 65 y/o fresh post-op with acute SOB. The confusion could be delirium but the SOB is very concerning. She could be having a pulmonary embolus or heart attack. #1 needs care but is not in an emergent situation. #2 we do not know what he was admitted with but his BP is not very far out of range, he needs continued assessment and monitoring. #4 needs his xanax as soon as possible and someone to stay with him. I always tell my students that airway issues need to be the top priority. What do you thin?
ReplyDeleteYou are correct!
DeleteI think I would start with #3 Being that she is postop and 65 she could have a PE, #1 a temp of 102 and definate infection. As nurses we have a window of opportunity to intervene before she becomes septic. Then #2 B/P is elevated, ut I don't have a baseline b/p for him. He could be having a stroke with the tingling.
ReplyDeleteSherri
You are correct!
DeleteHi ladies! You are both correct! This patient is the most urgent to take a look at. She is presenting as a post op patient with a potential PE with reflecting signs and symptoms!
ReplyDeleteThanks!