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?
As a healthcare provider, my first priority would be to stabilize any patient with an immediate life-threatening condition. In this scenario, the patient with blood sugar fluctuations, which are causing changes in mentation, would be my priority. I would closely monitor the patient’s blood glucose levels and initiate appropriate treatment to prevent any further fluctuations, which can be dangerous to the patient’s brain function.
Next, I would focus on the patient with the signs of impending stroke. As time is of the essence in stroke care, I would quickly assess the patient’s neurological status, including motor and sensory function, speech, and mental status. I would also perform a quick physical exam to check for any other potential stroke symptoms. Depending on the severity of the symptoms, I may need to call a Code Stroke and initiate emergency stroke interventions.
After these two patients are stabilized, I would assess and manage the two post-myocardial infarction patients. I would closely monitor the vital signs and heart rhythm of both patients, and administer appropriate medications to control any arrhythmias. I would also assess any symptoms of chest pain, shortness of breath, or dizziness and initiate appropriate treatment as necessary.
My critical thinking process involves assessing each patient’s condition, identifying potential risks, and determining the appropriate interventions. I prioritize care based on the urgency of the patient’s condition and the potential impact on their health outcomes. I use a systematic approach to organizing and prioritizing care, starting with the patient with the most urgent need and working my way down the list as I address each patient’s needs. Communication and collaboration with the healthcare team is also essential in ensuring timely and effective care for all patients.