After receiving the hand-off report from the day shift charge nurse, which patient should the evening charge nurse assess first?
a. A patient with meningitis complaining of photophobia
b. A mechanically ventilated patient with a GCS of 6
c. A patient with bacterial meningitis on droplet precautions
d. A patient with an intracranial pressure ICP of 20 mm Hg and an oral temperature of 104° F
D
The charge nurse should assess the patient with an ICP of 20 mm Hg and a temperature of 104° F as this is an abnormal finding and should be investigated further. A patient with a GCS of 6 being mechanically ventilated has a secure airway and there is no indication of distress. Photophobia is an expected finding with meningitis and droplet precautions are appropriate for a patient with bacterial meningitis.
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