MODULE 1 AM ACTIVITY ON PRIORITIZATION

You are an RN providing total patient care to four patients on an orthopedic unit
during the 7 am to 3 pm shift. Given the following patient information, prioritize your
activities for the 8-hour shift. Be realistic about what you can accomplish.
1. Prioritize your patients.
2. What is time for reports, planning your day’s activities, breaks, and lunch.
(Account your 8-hour shift given the activities you need to accomplish for your
patients.)
3. What activities will you delegate to the next shift?
4. Give 3 overall goals that have guided your time management?
5. What personal VALUES were factors in setting your goals in prioritization? (You
can refer to your lecture notes on PLANNING).

1. Room 101 A Ms. Bernardo 84 years old.

Fractured left hip, secondary to fall at home. Disoriented since admission,
especially at night. Fall precautions ordered. Moans frequently. Being given IV pain
medication every 2 hours prn. Vital signs and checks for circulation, feeling, and
movement in toes ordered every 2 hours. Scheduled for surgery at 10:30 am. Preoperative
medications scheduled for 9:30 am and 10:00 am. Consent yet to be signed. Family
members will be here at 8:00 am and have expressed questions about the surgery and
recovery period. Patient to return from surgery at approximately 2:30 pm. Will require
postoperative vital signs every 15 minutes.

2. Room 101 B Ms. Lustre 26 years old.

Compound fracture of the femur with postoperative fat emboli, now
resolved. 10 lbs Buck’s traction. Has been in the hospital 3 weeks. Very bored and
frustrated with prolonged hospitalization. Upset about roommate who calls out all night
and keeps her from sleeping. Wants to be moved to new room. Has also requested to
have hair washed during bath today. Has IV medication running at 100 mL/h. IV
antibiotic piggybacks at 8:00 am and 12:00 pm. Oral medications at 8:00 am, 9:00 am,
and 12:00 pm.

3. Room 102 A Mr. Gonzales 47 years old.

T-6 quadriplegic due to diving accident 14 years ago. Two days postoperative
above-knee amputation due to osteomyelitis. Cultures show methicillin-resistant
Staphylococcus aureus (MRSA). Strict wound isolation. Has been hospitalized for 2
weeks. Expressing great deal of anger and frustration to

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anyone who enters room. IV site red and puffy. IV needs to be restarted. Dressing change
of operative site ordered daily. Heat lamp treatments ordered b.i.d. to small pressure sores
on coccyx. IV antibiotic piggybacks at 8:00 am, 10:00 am, 12:00 pm, and 2:00 pm. Main IV
bag to run out at 10:00 am. 6:00 am laboratory results to be called to physician this
morning. Needs total assistance in performing activities of daily living, such as bathing and
feeding self.

4. Room 103 A Mr. Melendez 19 years old.

Severe tear of rotator cuff in left shoulder while playing football. One-day
postoperative rotator cuff repair. Very quiet and withdrawn. Refusing pain medication,
which has been ordered every 2 hours prn. Says he can handle pain and does not want
to “mess up his body with drugs.” He wants to be recruited into professional football after
this semester. Nonverbal signs of grimacing, moaning, and inability to sleep suggest that
moderate pain is present. Physician states that likelihood of Mr. Novak ever playing
football again is very low but has not yet told the patient. Girlfriend frequently in room at
patient’s bedside. IV infusing at 150 mL/h. IV antibiotics at 8:00 am and 2:00 pm. Has not
had a bath since admission 2 days ago
 A. PATIENT PRIORITIZATION:
PATIENT
1. Mr. Gonzales 47 years old
2. Mr. Melendez 19 years old
3. Ms. Bernardo 84 years old
4. Ms. Lustre 26 years old
JUSTIFICATION
Mr. Gonzales is the prioritized patient hence as
reference Maslow’s Hierarchy such it falls under
physiological needs, such it must be met at least
minimally to maintain life, as these needs are the
most basic in the hierarchy as these are one of the
most essential to life therefore it gained the highest
priority, thus the main problem is the disease
condition which is quadriplegic, refers to paralysis
from the neck down, including the trunk, legs and
arms. The condition is typically caused by an injury
to the spinal cord that contains the nerves that
transmit messages of movement and sensation
from the brain to parts of the body. Helping the
patient on his activity intolerance will improve the
patient's ability to use energy conservation and
management techniques and maintain the
patient's respiratory and cardiovascular functions
during activities.
Ms. Melendez has been the second prioritized
patient. According to Maslow, physiological needs
to be prioritized. Pain can affect the treatment
and cooperation of the patient it can also adhere
his difficulty of breathing due to panic. It also limits
his movements as stated by the client, thus slowing
down his recovery.
Ms. Bernardo is the third prioritized patient. Pain
hinder or limits physical activity such is
physiological needs that should be achieved
hence it is accomplished by intact and
functioning system, in such pain must be relieved
or eliminate to that so.
Ms. Lustre is the least prioritized patient. Since she is
now been hospitalized for 3 weeks, little by little
she is now recovering from her disease condition.
According to Maslow's hierarchy of needs, rest is a
basic physiological need, categorized rest in the
first set of needs, at the bottom of the pyramid or
hierarchy of needs.
 B. ACCOUNT OF ACTIVITIES:
TIME TASKS
6:45 AM Receive endorsement
7:15 AM Rounds
7:30 AM Prepares medications
8:00 AM Administering morning medications
8:30 AM Monitor vital signs
9:00 AM Consulting with other health care providers
10:00 AM Educating patients on how to manage their conditions and providing emotional support
to patients and their families
11:00 AM Consulting with other health care providers
12:00 PM Lunch break
1:00 PM Maintaining accurate and detailed records (Charting); Administering afternoon
medications
2:00 PM Requesting and conducting diagnostic tests
3:00 PM Sharing relevant patient information at shift change such as admissions, discharges and
changes in patient's conditions

C. ACTIVITIES TO BE DELEGATED TO THE NEXT SHIFT:

1. Taking patient vital signs, measurements and medical histories
2. Monitoring intake and output of every patient
3. Instructing on what medications to be given
4. Telling to the next shift nurse what activities you have done to every patient
5. Instructing to check new Doctor’s order
6. Setting up treatment rooms
7. Sanitizing and assembling medical equipment
8. Checking and counting medication
9. Completing patient assessments
10. Administering wound care
11. Changing dressings
D. PERSONAL VALUES AS FACTORS IN PLANNING GOALS IN PRIORITIZATION
1. Client values - to plan effective care, the nurse needs to identify the client’s values as they relate to
health problems.
2. Compassion - Compassion encompasses empathy, caring and the promotion of each patient’s
dignity.
3. Trustworthiness - nurses are among the most trusted groups of people, making trustworthiness one of
the most essential nursing values and vital to your integrity and ethical behavior.
4. Humility - nursing is one of the most rewarding, fulfilling career paths. With it comes a wealth of
medical knowledge and skills that allow you to facilitate healing and alleviate suffering through
diagnosis and treatment, but humility should also be your companion.
5. Accountability - being answerable for the decisions made in the course of one's professional
practice.
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transmitting in any form or by any 2
means, electronic, mechanical, photocopying, recording, or otherwise of any part of this document, without the prior written permission
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