Patients on an Intermediate Medical Care
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?
Sample Solution
- Assess the patient with the impending stroke. This is the most urgent patient, as they are at risk of having a full-blown stroke. I would assess their vital signs, neurological status, and any other potential signs of stroke. I would also order a CT scan of the brain to rule out a stroke.
- Assess the patient with the drastic blood sugar fluctuations. This patient is also at risk of complications, such as hypoglycemia or hyperglycemia. I would assess their blood sugar levels frequently and make sure that they are receiving appropriate treatment. I would also monitor their mental status for any changes.
- Assess the patients with MIs. These patients are also at risk of complications, such as arrhythmias or heart failure. I would assess their vital signs, cardiac rhythm, and any other potential signs of complications. I would also order an ECG to assess their heart function.
- Assess the patient with dizziness. This patient is not as urgent as the others, but they should still be assessed. I would assess their vital signs, neurological status, and any other potential causes of dizziness.
- Identify the patients who are at the highest risk of complications. These are the patients who should be assessed first.
- Consider the urgency of the patient's symptoms. Patients with more urgent symptoms should be assessed first.
- Consider the patient's overall condition. Patients who are more stable can be assessed later.
- Consider the patient's wishes. If the patient has any specific requests, I would try to accommodate them.
- It is important to be flexible and adjust the plan of care as needed. The patient's condition may change, so it is important to be able to adapt to those changes.
- It is also important to communicate with the other members of the healthcare team. This will help to ensure that everyone is on the same page and that the patient receives the best possible care.