The nurse has rounded on all the assigned clients. While rounding, several health care providers have written orders on the nurse’s clients. Which order would be the priority for the nurse to address?

  • furosemide (Lasix) 80 mg IV push STAT for a client with fluid overload
  • a new insulin sliding scale for a client with a glucose level of 242
  • perform a dressing change on a client with a stage 2 diabetic foot ulcer
  • discharge a client who was admitted for removal of an abdominal abscess
Number 1 is correct.
STAT orders should always be performed first, unless there is another eminently life-threatening event in progress. The priority is to administer the Lasix for the client in fluid overload. Untreated fluid overload can lead to crackles and other adventitious lung sounds, making breathing more laborious. Additional fluid also places strain on the heart, which must pump more effectively against the extra fluid. Edema develops, and the extra fluid to be excreted places a burden upon the kidneys. Blood pressure also increases. The next task would be to administer insulin to the client with an elevated blood sugar. It is important to get the blood sugar under control to prevent damage to the body’s cells. The client should then be discharged to avoid any delay in allowing her to return home. The dressing change will be time consuming and should be performed last, after the more time-sensitive tasks have been completed.