Assessment – Management of Care
Prioritization is an important skill to gain as a nurse. Consider this scenario and discuss how you will prioritize your day. Complete the following using the table on page 2:
· In which order will you visit the patients after morning report? Place the patients in order in the first column – you can use the diagnosis in parenthesis for identification of patient 1, 2, etc.)
· Below the table, write a paragraph as to the rationale for the order of patient visits.
· In column 2, identify 3 priority cares/interventions for each patient
· In column 3, provide rationale as to why you are doing that activity/intervention and why it is a priority.
· In column 4, identify who the activity/intervention could be delegated to (who could be asked to complete)
Scenario: The nurse’s assignment includes five patients with the following diagnoses and conditions:
1. A 65 y/o 8 hours post-op — a partial colectomy and has a history of COPD. The patient has a urinary catheter, NG tube to low intermittent suction, and IV fluids infusing. S/he has a fever of 101 degrees F and crackles in both lung bases. (Colectomy/COPD)
2. A 48 y/o female is receiving blood transfusions for hemolytic anemia; she is currently stable. (Hemolytic Anemia)
3. A 55 y/o male was admitted through the emergency department (ED) during the night with a cough, fever, and general malaise. The patient’s history indicates possible exposure to TB; he is currently in an airborne isolation room awaiting sputum culture results. (Possible TB)
4. A 78 y/o male was transferred out of the ICU yesterday following an acute MI with complications of ventricular tachycardia and pulmonary edema. The patient is on telemetry and is currently in a normal sinus rhythm and his CHF is resolving. (MI/CHF)
5. A 16 y/o patient with new type 1 diabetes mellitus who plans on being discharged home after lunch. The diabetic education is not yet complete and discharge instructions are pending. (T1DM)
Grading:
10 points – order of visiting patients is appropriate with good rationale. (5 points order, 5 points rationale)
30 points – identifies 3 priority activities/interventions to complete with each patient and there is good rationale as to why you would do that activity/intervention (1 point each activities/interventions, 1 points each rationale)
15 points – accurately identifies persons who can be assigned to complete the activity/intervention (1 point for each activity/intervention correctly assigned)
Priorities of Visits and Activities/Interventions
| Order to Visit | Activities/
Interventions |
Rationale for the activities/interventions one is doing for the patient | RN, LPN, or UAP |
| 1st patient to visit:
|
1. | 1. | 1. |
| 2. | 2. | 2. | |
| 3. | 3. | 3. | |
| 2nd patient to visit:
|
1. | 1. | 1. |
| 2. | 2. | 2. | |
| 3. | 3. | 3. | |
| 3rd patient to visit:
|
1. | 1. | 1. |
| 2. | 2. | 2. | |
| 3. | 3. | 3. | |
| 4th patient to visit:
|
1. | 1. | 1. |
| 2. | 2. | 2. | |
| 3. | 3. | 3. | |
| 5th patient to visit:
|
1. | 1. | 1. |
| 2. | 2. | 2. | |
| 3. | 3. | 3. |
Rationale for order of visit:
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