A nurse is prioritizing care for four patients. Which patient should the nurse see first?

A.This statement is incomplete because it lacks a specific time frame and a measurable distance or frequency. A well-written outcome must be SMART: specific, measurable, attainable, realistic, and timed. Without these components, the nursing team cannot objectively evaluate whether the patient has successfully met the goal or if the plan of care needs to be modified.

B.This statement describes a nursing intervention rather than a patient outcome. Outcome statements must focus on the behavior, responses, or status of the patient, not the actions performed by the healthcare provider. Goals are designed to measure the patient's progress toward health, while interventions are the steps the nurse takes to facilitate that progress.

C.Similar to the previous choice, this statement incorrectly focuses on the nurse's behavior. Monitoring is a clinical action performed by staff, not a measurable change in the patient's health status. An appropriate patient-centered goal for this scenario might focus on the patient maintaining a stable sinus rhythm or remaining asymptomatic during the duration of the shift.

D.This statement is written accurately because it is patient-centered, measurable, and includes a clear time frame ("today"). It specifies the criteria for success (feeding self at all mealtimes) and includes a condition for that success (without shortness of breath). This allows the nursing staff to clearly evaluate the patient's functional status and respiratory tolerance at the end of the day.

A.A mask and face shield are required when there is a high risk of splashing or spraying of body fluids into the nurse's mucous membranes. While a draining wound involves fluid, routine entry into the room does not typically present an airborne or droplet risk. These items are more appropriate for procedures like wound irrigation rather than general bedside care.

B.While a gown is appropriate for contact precautions, a face shield is generally unnecessary unless the nurse anticipates an aerosolizing procedure or direct splash. Contact precautions focus on preventing the transfer of pathogens from the wound drainage to the nurse's clothing or skin. The use of a face shield for a foot wound is not standard practice.

C.Non-sterile gloves and a gown are the standard components of contact precautions used for clients with significant wound drainage. The gown protects the nurse's uniform from becoming contaminated with pathogens, while gloves prevent direct skin contact with the drainage. This combination effectively breaks the chain of infection for organisms transmitted through direct or indirect contact.

D.Sterile gloves are used for performing invasive procedures or sterile dressing changes, not for simply entering a client's room. Additionally, a mask is not indicated for a draining wound unless the specific pathogen requires droplet or airborne precautions. Using sterile supplies for routine room entry is an unnecessary use of resources and does not improve safety.