Patient Scenarios: The following patients are currently admitted on your assigned unit. It is 0700 and you have just started your shift. Prioritize and Delegate in order of what is of most importance. You are the charge nurse. Current available staff to assist you include: 1 Registered Nurse, 1 nursing assistant, and 1 unit clerk (cannot perform clinical skills).
76 y.o. post-op day 3 from CABG; patient ringing call bell; IV pump in the room is alarming because IV bag is empty. Pt has an order to receive NS @ 75 ml/hr.
47 y.o. diabetic, post-op day 1 from lower extremity amputation (BKA); patient is requesting toileting assistance and needs a bath. Pt has not been out of bed since surgery.
64 y.o. transferred from PACU s/p hip replacement; patient arrived 15 minutes ago and is currently being boarded in the hallway awaiting an available room. Last set of vitals: BP 110/70, P 80, R 16, T 98, O2 sat 97% on 2L NC.
33 y.o. admitted this morning from the ED with new onset seizures; last seizure occurred prior to arrival in ED; seizure medication was administered in the ED. Patient has been sleeping.
58 y.o. with small bowel obstruction. Pt has new onset confusion with a change in vital signs: BP 110/68, HR 100, R 20, T 101, O2 sat 96% on RA. Pt keeps ringing the call bell.
51 y.o. admitted for chest pain earlier; initial EKG showed no STEMI, so patient has been admitted for observation; needs repeat troponin drawn in 1 hour. Pt has been pain free since admission. Last set of vital signs: BP 150/88, HR 80, R 16, T 98.4, O2 sat 99% on RA.