Chapter 2: Patient Assessment
2.13 Quick Priority Assessment (QPA)
Critical Thinking Exercises: Questions, Answers, and Sources / References
Critical thinking questions are in bold type, and the answers are italicized. Additional resources or references are provided below.
- Your initial assessment of a patient reveals that the patient is having trouble speaking. What would be your next steps?
Assess ABC (airway, breathing, circulation) followed by a neurological nursing assessment including vital signs, Glasgow coma scale, and pupil response. Elevate head of bed in case there is a choking risk. Notify the most responsible physician/prescriber for follow up investigations.
2. Your patient is returning from surgery following an appendectomy. Outline an assessment plan using a systems approach.
Suggested Approach #1: QPA
Steps |
Additional Information |
| A | Airway. Does the patient’s position allow their airway to be patent? For example, if someone has slumped down in the bed or wheelchair, they may require re-positioning. |
| B | Breathing. What is the quality of the breathing? Are there any suggestions that breathing is compromised? Any concerns require further investigation. |
| C | Circulation. What is the patient’s colour. Quickly palpate extremities for warmth. Any concerns require further investigation. |
| I | In. What is going in? Identify every solution going into the patient. Follow all tubes from their source to the patient. Are the volumes adequate? Are the rates accurate? Are the tube insertion sites intact and free of complications? Is the safety equipment (i.e., pumps) plugged in and working? Is there any evidence of complications? |
| O | Out. What is coming out? Are dressings dry and intact? Are any drainage tubes present? If so, what is the nature of the drainage? Follow all tubes from their source to the patient. Are the tubes patent? Are the tubes secured to avoid accidental or unintentional removal? Is there any evidence of complications? |
| P | Pain. Is the patient comfortable? Are analgesics given previously still effective? Does the patient need repositioning? Are they too warm or too cold? Do they need to use the washroom? |
| Safety |
|
Adapted from:
Christensen, B. L., & Kockrow, E. O. (1999). Quick patient assessment using ABC I&0 PS. In, Foundations of nursing (3rd ed.). http://www.cabrillo.edu/~ttaylor/Prep_forms/Quick%20Patient%20Assessment.pdf
Suggested Approach #2: Systems
System |
Details to Assess in Each System |
| Neuro |
|
| Respiratory |
|
| GI |
|
| GU |
|
| CV |
|
| Musculoskeletal |
|
| Integument |
|
| Psychosocial |
|
Note: This exercise can be a valuable discussion. Invite participants to provide rationale for their decisions. This should help students begin to link assessment with potential and actual health issues.