A new registered nurse working for a busy unit of an acute care teaching hospital begins the shift with four patients. Which patient should the nurse attend to first?

Question

a. Patient who needs assistance in ambulat-ing the hall
b. Patient whose blood pressure suddenly drops and who passes out (faints)
c. Recovering stable surgical patient whose family has just arrived
d. Recovering patient who is resting quietly watching television

Answer 1

B
A patient's whose blood pressure drops and faints needs to be addressed first. Critical thinking and clinical decision making are complicated because nurses care for multiple patients in fast-paced and unpredictable environments. When you work in a busy setting, use criteria such as the clinical condition of a patient (stable vs. unstable), Maslow's hierarchy of needs (patient's blood pressure is an active lower need problem), the risks involved in treatment delays (if the blood pressure is not treated the patient's condition could get worse), and patients' expectations of care to decide which patients have the greatest priorities. A patient who needs assistance in ambulating the hall can be delegated to the nursing assistant personnel. The surgical patient is stable so does not need to be addressed first. The recovering patient resting quietly is not a prior-ity.