You have been assigned 4 patients on an Intermediate Medical Care Unit. Two of the patients are post myocardial infarctions at various stages of their infarctions with multiple types of arrhythmias, the third patient is having drastic blood sugar fluctuations 218 down to 50 within minutes and its rebounds back up with changes in mentation and the fourth is reported to be having frequent TIA's. One of the MI patients is having some dizziness and your TIA patient is presenting signs of impending stroke.
How would you prioritize your assessments and activities? How would you describe your critical thinking process and how do you organize and prioritize implementation of care?
Critical Thinking And Clinical Judgment Scenario
The patient with the TIA is not as urgent, but I would still need to monitor them closely. I would need to assess for any changes in their mental status or vision. I would also need to make sure they are taking their medications as prescribed.
Once I have assessed all of the patients, I would develop a plan of care for each one. I would prioritize the interventions that need to be done first and make sure that I am organized and efficient in my care.
I would also communicate with the other healthcare professionals on the team so that everyone is aware of the patients' conditions and the plan of care. This would ensure that the patients receive the best possible care.
Here is my critical thinking process for prioritizing my assessments and activities:
- I first identified the patients who were most unstable and needed immediate attention.
- I then assessed the patients' vital signs, mental status, and ECGs.
- I also reviewed their lab results.
- Based on this initial assessment, I prioritized the patients who were most at risk of further complications.
- I then developed a plan of care for each patient, prioritizing the interventions that needed to be done first.
- I communicated with the other healthcare professionals on the team so that everyone was aware of the patients' conditions and the plan of care.
I would organize and prioritize the implementation of care by:
- Starting with the patients who are most unstable and need immediate attention.
- Delegating tasks to other healthcare professionals as needed.
- Staying organized and efficient in my work.
- Communicating with the other healthcare professionals on the team so that everyone is aware of the patients' conditions and the plan of care.
I would also make sure to document my assessments and interventions so that the other healthcare professionals on the team have a clear understanding of the patients' care.
The first thing I would do is assess the patients' vital signs and mental status. I would also check their ECGs and lab results. Based on this initial assessment, I would prioritize the patients who are most unstable and need immediate attention.
The patient with the impending stroke is the highest priority. I would immediately call a code stroke and start the appropriate interventions. The patient with the drastic blood sugar fluctuations is also a high priority. I would need to stabilize their blood sugar levels and assess for any underlying causes.
The two patients with MIs are also a priority, but they are not as unstable as the patient with the impending stroke. I would need to monitor their ECGs closely and assess for any changes. I would also need to keep an eye on their pain levels and make sure they are taking their medications as prescribed.