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Chapter 23: Problem 1

The nurse is caring for a team of patients. After completing morning rounds, which of the following patients require priority care? 1\. A patient who is 2 days postsurgery reporting severe constipation. 2\. A patient with a DVT has peripheral edema. 3\. A patient with aortic stenosis who is reporting chest pain. 4\. A patient with mitral valve prolapsed has lost 2 pounds of weight this morning.

Short Answer

Expert verified
Patient 3 requires priority care.

Step by step solution

01

Understand the Criteria for Priority Care

Priority care is required for patients who are experiencing life-threatening conditions or symptoms that could rapidly deteriorate. Assess each patient's condition based on urgency and potential impact on their health.
02

Evaluate Patient 1

Patient 1 is 2 days postsurgery and is reporting severe constipation. While discomforting, constipation is not typically life-threatening and can be managed with medication and diet.
03

Evaluate Patient 2

Patient 2 has a deep vein thrombosis (DVT) and peripheral edema. DVT can lead to pulmonary embolism, which is a serious condition. However, the presence of peripheral edema alone does not indicate immediate life-threatening risk without further symptoms like breathing difficulty or chest pain.
04

Evaluate Patient 3

Patient 3 has aortic stenosis and is reporting chest pain. Chest pain in someone with aortic stenosis could indicate angina or heart failure, which are immediate and potentially life-threatening conditions requiring urgent evaluation and intervention.
05

Evaluate Patient 4

Patient 4 has a mitral valve prolapse and has lost 2 pounds in weight. Rapid weight change could indicate fluid loss or other metabolic issues, but without additional severe symptoms, it generally does not surpass chest pain in urgency.
06

Determine Priority

Based on the evaluations, Patient 3 requires priority care due to the immediate and life-threatening possibility associated with chest pain and aortic stenosis.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

patient evaluation
Patient evaluation is the first crucial step in determining the priority care for patients. It means assessing each patient鈥檚 symptoms and medical history to evaluate the severity and urgency of their condition.

For students, it is important to understand that effective patient evaluation involves:
  • Observing clinical signs and symptoms
  • Reviewing the patient's medical history
  • Listening to patient complaints
  • Conducting necessary physical examinations
By analyzing these factors, nurses can decide which conditions need immediate medical intervention and which can be managed with routine care.
life-threatening conditions
Identifying life-threatening conditions is a critical nursing skill. Such conditions pose an immediate risk to a patient鈥檚 life and require prompt and decisive action.

In the provided exercise, life-threatening conditions include:

  • Aortic stenosis with chest pain - This could lead to heart failure or angina.
  • Deep vein thrombosis (DVT) - Although in the exercise, the presence of peripheral edema alone might not indicate an immediate threat, DVT can lead to a pulmonary embolism, especially if accompanied by other symptoms like chest pain or shortness of breath.
Recognizing these conditions accurately can save lives and help in providing timely and appropriate care.
nurse decision-making
Nurse decision-making is pivotal in prioritizing patient care. Nurses must make critical decisions based on the severity of conditions. This involves:
  • Using clinical judgment
  • Prioritizing care based on patients' needs
  • Applying knowledge of medication and treatment options
  • Communicating effectively with the healthcare team
For instance, in the exercise, the nurse decides that a patient with aortic stenosis and chest pain is in more immediate danger compared to a patient with severe constipation. Such decisions help in allocating the proper resources and care timely.
aortic stenosis
Aortic stenosis is a condition characterized by the narrowing of the aortic valve opening, which restricts blood flow from the heart to the rest of the body.

Key points about aortic stenosis include:
  • It can lead to symptoms like chest pain, shortness of breath, and fainting.
  • If left untreated, it can result in heart failure.
In the exercise, the patient reporting chest pain along with aortic stenosis is at significant risk, indicating an urgent need for medical evaluation and possible intervention. It鈥檚 vital for nurses to recognize these signs to prevent possible severe outcomes like heart failure.
deep vein thrombosis (DVT)
Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein, typically in the legs.

Essential points concerning DVT are:
  • Symptoms include swelling, pain, and redness in the affected area.
  • There is a risk of the clot breaking loose and traveling to the lungs, causing a pulmonary embolism, a potentially life-threatening condition.
In the exercise, while peripheral edema due to DVT is noted, the immediate threat is gauged based on the presence of more severe symptoms like chest pain or breathing difficulty. Monitoring and prompt action are crucial to prevent the advancement of the condition.

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Most popular questions from this chapter

The nurse reviews medication orders and is to give warfarin (Coumadin). Which of the following actions should the nurse take first? 1\. Obtain a glass of water. 2\. Prepare the medication for administration. 3\. Review international normalized ratio result. 4\. Document the medication administration.

The nurse evaluates the patient as understanding how to prevent rheumatic fever if the patient states that rheumatic fever can be prevented by treating streptococcal infections with which of the following? 1\. Penicillin 2\. Prednisone 3\. Cortisone 4\. Cyclosporine

The nurse is evaluating a patient's preoperative teaching for a commissurotomy. The patient shows understanding of the purpose of this procedure by stating which of the following? 1\. "Fused valve flaps are separated to enlarge the valve opening." 2\. "A mechanical valve is inserted to replace a valve." 3\. "The valve flaps are repaired or reconstructed." 4\. "A biological valve is inserted to replace a valve."

The nurse is evaluating patient teaching for mitral valve prolapse. The patient shows understanding of the prognosis of MVP by stating which of the following? 1\. "The prognosis is poor." 2\. "There are often no symptoms." 3\. "Heart failure often occurs." 4\. "Symptoms quickly progress."

The nurse is caring for a patient with cardiomyopathy. Which of the following symptoms, if reported by the patient, require priority action by the nurse? 1\. Left great toe pain 2\. Dyspnea 3\. Headache 4\. Decreased appetite
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