NursingSprint

✔️ Blood pressure: is critically low at 80/46 mm Hg, indicating hypotension. This could result from severe dehydration secondary to profuse diarrhea and possible sepsis from C. difficile infection. Addressing hypotension is the priority because it directly affects organ perfusion and can lead to shock if not promptly treated.

✔️ Nurse's clinical responsibility: is to stabilize circulation first by fluid resuscitation and prompt provider notification. Hypotension is a life-threatening issue and requires immediate intervention to restore adequate perfusion to vital organs.

✔️ Potassium level: is 3.1 mEq/L, indicating hypokalemia, likely due to gastrointestinal losses from diarrhea. Hypokalemia can cause cardiac dysrhythmias and muscle weakness, making it the next critical concern after stabilizing blood pressure.

✔️ According to the ABCs (Airway, Breathing, Circulation) prioritization framework, circulatory stability (blood pressure) takes precedence, followed by addressing electrolyte imbalances that can compromise cardiac function.

Educational Insight:

In emergency and clinical prioritization guidelines, hypotension is treated as a medical emergency because of its potential to cause multi-organ failure. After circulation is addressed, correcting electrolyte abnormalities like hypokalemia prevents secondary complications.

Incorrect Options Explained Briefly:

1. Temperature: Elevated temperature (38.9°C) indicates infection but is not more urgent than hypotension.
2. Hgb level: Although slightly elevated at 17 g/dL (likely due to dehydration), it is not immediately life-threatening.
3. Hct level: Elevated (48%), also reflects hemoconcentration due to fluid loss, but secondary to addressing circulation and potassium.
4. Abdominal findings: Important for ongoing assessment but not priority over hypotension or hypokalemia.