A nurse has been assigned 4 patients to care for at the beginning of their shift. Using the Safety and Risk Reduction priority setting framework, which of the following patients should be the priority to see first by the nurse?
A.
A patient who is a fall risk, has a bed alarm in place and is sleeping.
B.
A patient who is complaining of pain at a level 7 on the pain scale and is due for pain medication
C.
A patient with a tracheostomy who is wheezing, has increase secretions and is due for tracheostomy suction.
D.
A patient with a pressure ulcer (wound) to the sacrum who was just turned on their left side an hour ago.
The correct answer and Explanation is :
Using the Safety and Risk Reduction priority setting framework, the nurse should prioritize the patient who is experiencing immediate respiratory distress or complications. Therefore, the correct answer is:
C. A patient with a tracheostomy who is wheezing, has increased secretions, and is due for tracheostomy suction.
Explanation:
1. Safety and Risk Reduction Framework:
This framework emphasizes addressing issues that pose the highest risk to the patient’s immediate safety. It involves prioritizing actions that prevent or minimize harm, focusing on the most critical needs first.
2. Patient C’s Condition:
The patient with a tracheostomy is experiencing wheezing and increased secretions. This indicates that the airway may be compromised, which is a critical situation. Tracheostomy suctioning is essential to ensure that the airway remains clear and unobstructed. If this patient is not suctioned promptly, they are at high risk for respiratory distress, decreased oxygenation, and potential respiratory failure.
3. Comparison with Other Patients:
- Patient A is a fall risk and is sleeping with a bed alarm in place. While this patient requires monitoring, they are currently asleep and have a safety measure (the bed alarm) in place. Their condition does not present an immediate threat compared to respiratory distress.
- Patient B is in pain at a level 7 and is due for pain medication. Pain management is important, but it does not take precedence over a life-threatening situation such as compromised airway, which could rapidly deteriorate.
- Patient D has a pressure ulcer and has been turned on their side an hour ago. While pressure ulcer management is important, the patient is not currently facing an immediate and severe risk like respiratory compromise.
In summary, addressing airway issues with the patient with a tracheostomy is the highest priority because it directly impacts the patient’s ability to breathe and maintain adequate oxygen levels, which is crucial for survival.