Walkthrough: Reduction of Risk Potential Q13 – NCLEX-RN®

00:00 The nurse is caring for clients diagnosed with diabetes mellitus. Which client must the nurse see first? Well, this is another one of those prioritization type questions.

00:11 You're looking for the patient that's in the most danger who requires the nurse to see them. Now, emotionally prepare yourself, all patients deserve to be seen, all patients will be seen. That is not the purpose of this question. The purpose is they're trying to test your ability to recognize who's in the most imminent danger, the most risk of something unsafe happening, that's what they're looking for. Now, I'm going to warn you before you look at these answer choices, you're going to see things that seem very similar. So don't let your mind kind of go cross side, what I want you to do is use the same strategies I recommend on the other questions as far as use scratch paper, write the numbers down, go slowly and make sure you compare one patient to another one until you see who's at the most risk. Then, pause the video while you're doing that work then come back and we'll walk through the question together. Shoosh, how did that go for you? Whoah, one thing to be getting tired and maybe you've been doing questions for a while now then you get a question like this and you're like "Ahh, they all look the same." But they're really not, there's always a difference. So, for fun, I'm going to start with number 4. I've got a client, type 2 diabetes, and a gangrenous foot. Okay, that's not good. Right? That things aren't going well, we know they're not getting good circulation to their feet, they might have to have it amputated. So, number 4, that's my baseline. Now, I'm going to start at the very top and work my way down. So, compared to number 4, what about number 1? A client with type 2 diabetes, they're the same, and a blood glucose level of 450. Okay, that's pretty high. I'm going to see number 1 before I'd see number 4 so I'm going to cross off number 4. Now, I'm going to compare number 2 to number 1. A client with type 1 diabetes and a blood glucose level of 400. Okay, listen. Type 1, type 2 at this point, one is 450, one is 400. I don't see that much of a difference with them so I'm going to pause and keep both of those in, I'm going to look at number 3. A client with type 2 diabetes and a blood glucose of 49. Okay, so what's the difference? 1 and 2 have high blood sugar, right, and 3 has low, dangerously low blood sugar. So, who's at more danger? Oh, yeah it's number 3. Low blood sugar is going to be a much bigger problem. Now, we'll treat the high blood sugar. Right? I know that can be a problem. If you're type 1, you can end up in DKA and then a coma and yeah it goes very very bad. But right now what we're looking at that blood sugar is critically low and it could be life threatening. Remember, this client may end up with some really unfortunate side effects, affects your brain, seizures, coma, could even lead to death. This requires immediate intervention. Remember, the other people will be seen. Those high blood glucose levels? Yup, they're high, we need to treat them and we'll do something but these patients are in better shape than somebody who has a blood sugar that low. That's why they take the top priority.

03:35 And the poor guy, number 4 with the foot, yeah he's going to need some intense therapy like antibiotics and wound debridement and all kinds of stuff and maybe surgery that they can fix it or to amputate the limb but they're not our top priority there. So, good job. They learn in this question that when the answer choices look really similar, know that there are differences there, you just have to slow down and look for them. And if you do the work of comparing one to another and eliminating one of those choices, you really going to do much better on those patient priority questions. Who should you see first? So good luck, keep going with this, we've got lots more questions to go over together.