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Purpose: To allow the study the opportunity to respond to a situation that will likely occur in their own practice and explore the concepts of the chapter. To demonstrate effective clinical reasoning skills of holistic nursing care of complex patients using a collaborative interdisciplinary team approach.

Case Scenario:

It is 7:30 am. You are the day shift nurse and have received the following data from the night shift report:

    132: 66 y/o congestive heart failure patient scheduled for an angiogram today at 10 am. Vitals stable. Patient requests information about the procedure before signing the consent.

     

    133: 42 y/o post-emergency colostomy from yesterday. Vitals stable. Patient was unable to sleep during the night, feeling upset and emotional. Midnight nurse states that the patient refused to discuss feelings.

     

    134: 67 y/o GI bleed admitted yesterday. At midnight BP 120/70 and HR 80. At 6 am, BP 80/50 and HR 102. Physician notified and ordered a complete blood count for this morning.

     

    135: 58 y/o post-femoral popliteal bypass 2 days ago. Vitals stable since surgery. Patient complains of incisional pain. Midnight nurse states the site is clean and dry with good bilateral pedal pulses.

Questions:

1.    Prioritize these four patients based on Maslow’s Hierarchy of Needs.

 

2.    During your assessment, the patient in Room 133 is noted to have a blood pressure of 84/50 mm Hg, with a heart rate of 102 beats/min and respirations of 32/min. How would this change your prioritizing of the patients?

 

 

3.    How would you reprioritize your patients based on the new data and the ABCs?

 

4.    Using the work organization sheet below, plan your day by scheduling these basic nursing activities for each of your four patients.

 Work Organization Sheet

Time Activity Room 132 Room 133 Room 134 Room 135

7-8

8-9

9-10

10-11

11-12

12-1

1-2

2-3

SCIENCE
HEALTH SCIENCE
NURSING
LEADERSHIP 305

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