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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.
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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.
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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.