PRIORITIZATION TIPS Flashcards
ACRONYM for PRIORITIZATION (who should the nurse see first)?
F = Find Hypoxia
(I-irritability; R-restlessness; C-confusion)
I = Immunocompromise
asthma with quiet breathing
communicable disease
wound care
R = Real Bleeding:
Dark red Bleeding
Bright red Bleeding
S = Safety:
Cerebral Palsy
Child Abuse
Old Lady
Spouse Abuse
T = Try Infection - ABC
When do you NOTIFY the DOCTOR?
1) Client with MEDICAL EMERGENCY (Inc. ICP, Ectopic, Appendicitis, Prolapse Cord)
2) Client with SURGICAL EMERGENCY
3) ALTERATION IN VITAL SIGNS
4) NEUROMUSCULAR COMPROMISE
5) TOXICITY LEVEL DRUGS (Compartment Syndrome, Toxicity Experience of Drugs, Lithium VANDA
6) ALTERATION in DRUG DOSSAGE
RESCUE DISCHARGE
A = Ambulatory B = Bed ridden C = Critically ill (Comatose, Fix-dilated Pupils)
TRIAGE
RED = Emergent YELLOW = Urgent GREEN = Non-urgent (slight cut bruises) BLACK = Expectant = Critically Ill client, Fix-dilated pupil, 2 months old Half Body Injury
What do you pay ATTENTION in PRIORITIZATION?
DIAGNOSIS and MODIFYING PHRASE
What is MORE IMPORTANT in PRIORITIZATION?
MODIFYING PHRASE
If the patient had ANGINA PECTORIS versus MYOCARDIAL INFARCTION. Who is the HIGHER PRIORITY person?
MYOCARDIAL INFARCTION
ANGINA PECTORIS with UNSTABLE BP versus MYOCARDIAL INFARCTION with STABLE Vital Signs. Who is a PRIORITY person?
ANGINA PECTORIS ( because of the UNSTABLE BP)
What are the 4 RULES in PRIORITIZATION?
1) ACUTE BEATS CHRONIC
( COPD, CHF and Acute Appendicitis) Which one has a higher PRIORITY?
= Acute Appendicitis.
2) FRESH POST OP ( 12 hours) BEATS MEDICAL or OTHER SURGICAL
COPD, CHF, ACUTE APPENDICITIS, 2-HR. CHOLECYSTECTOMY and a 2nd day CORONARY BYPASS GRAFT? Who is the HIGHEST PRIORITY?
=2-HR. CHOLECYSTECTOMY
(No matter how bad the surgery, if you AREN’T 12 HOURS IN, you are NOT A HIGH RISK)
3) UNSTABLE BEATS STABLE
4) ( Caution: Tie Breaker) THE MORE VITAL THE ORGAN, THE HIGHER THE PRIORITY
(talking about the organ of the “Modifying Phrase”)
What are the LIST of THINGS (words) that make the patient STABLE?
1) If They say THEY’RE STABLE, THEY ARE STABLE (Do not argue, you have to anwer it AT THIS MOMENT in time)
2) CHRONIC ILLNESS MAKES YOU STABLE.
3) POST-OP GREATER THAN 12 HOURS
4) If you have a procedure using a LOCAL/REGIONAL ANESTHESIA, you are STABLE
(General Anesthesia is UNSTABLE only on the 1ST 12 HOURS)
5) LABORATORY ABNORMALITIES of an A or B LEVEL
(Unstable: Lab Abnormalities of a C or a D)
e.g. who is Unstable, a client with a CREATININE of 17.8 or a client with a Potassium of 6.1? = Potassium)
6) The phrases READY FOR DISCHARGE, TO BE DISCHARGE or ADMITTED LONGER THAN 24 HRS. AGO.
(Unstable: Not ready to be Discharge, NEWLY Admitted, NEWLY Diagnosed or Admitted LESS than 24 HOURS)
7) UNCHANGED ASSESSMENTS
8) Patients EXPERIENCING the TYPICAL, EXPECTED SIGNS and SYMPTOMS of the DISEASE with WHICH they WERE DIAGNOSED.
(If somebody has kidney stones and experiencing a severe colic pain, is stable. but somebody who experience a MILD PAIN with a chest x-ray is UNSTABLE)
Who is a HIGH PRIORITY:
1) 16 y.o, female with Meningococcal Meningitis Who Has Had a temp. of 103.8 since admission 3 Days Ago
2) 67 y.o. male with IBS who spike a Temp. of 100.3 This Afternoon.
2 = Because patient Admitted LESS than 24 HRS. and
FEVER NOT TYPICAL for IBS (Irritable Bowel
Syndrome)
4 THINGS that are ALWAYS UNSTABLE regardless if it is EXPECTED or not, is a PRIORITY
1) HEMORRHAGE = even if you expect it, it’s still
UNSTABLE
e.g. DIC and Hemophilia
hemorrhaging is different from bleeding
Hemorrhage = always a PRIORITY
Bleeding = depends on if expected or not
2) HIGH FEVERS over 105*F = expected or not can
result to Seizure
3) HYPOGLYCEMIA =
4) PULSELESSNESS and BREATHLESSNESS = Asystole
or VFib
When is breathlessness and pulselessness a LOW PRIORITY?
At the SCENE of UNWITNESS ACCIDENT
What are the 3 THINGS that result in a BLACK TAG in UNWITNESS ACCIDENT?
1) Pulselessness
2) Breathlessness
3) Fixed and Dilated Pupils
What are the ORDERS of the ORGAN of VITALITY?
1) BRAIN
2) LUNG
3) HEART
4) LIVER
5) KIDNEY
6) PANCREAS
