A patient says, "Ever since I changed jobs I just don't feel as good. I think my heart medicine is not working." What nursing assessment questions are priority?
1. "How well are you sleeping?"
2. "How did your new job change your work schedule?"
3. "How did your new job change your insurance coverage?"
4. "How has your job change affected your home life?"
5. "In what way do you not feel as well?"
2,3,5
Rationale 1: Sleeping is always of concern but is not the highest priority in this assessment.
Rationale 2: If the patient has had a change in work schedule, it may be that medications are being taken at a different time or at various times during the week. This would affect their efficacy.
Rationale 3: If a change in insurance coverage has occurred, it may be that the brand of medication covered is changed. The patient who is doing well on one brand of medication should not change brands.
Rationale 4: While this question may reveal information about stressors at home, it is not of the highest priority in this conversation.
Rationale 5: The nurse's first question should clarify what the patient means by not feeling as well.
Global Rationale: The nurse's first question should clarify what the patient means by not feeling as well. If the patient has had a change in work schedule, it may be that medications are being taken at a different time or at various times during the week. This would affect their efficacy. If a change in insurance coverage has occurred, it may be that the brand of medication covered is changed. The patient who is doing well on one brand of medication should not change brands. Sleeping is always of concern but is not the highest priority in this assessment. While this question may reveal information about stressors at home, it is not of the highest priority in this conversation.
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