Final answer:
The registered nurse must first address the patient with chest pain after two doses of sublingual nitroglycerin due to the potential life-threatening nature of their condition. Other patients, while requiring care, do not present with immediately critical situations.
Step-by-step explanation:
The patient whose needs must be addressed first by the registered nurse is b. The patient with chest pain after two doses of sublingual nitroglycerin. Chest pain can be a sign of a potentially life-threatening condition such as a heart attack, especially in a patient with a history of heart problems. In such a case, providing immediate care is essential to prevent serious complications or death. In comparison, the other scenarios, while important, are not as immediately life-threatening.
An effective strategy for prioritizing patient care is to use the ABC prioritization framework (Airway, Breathing, Circulation), where conditions threatening these are addressed first. Additionally, the concept of triage is used to determine the urgency of various conditions, favoring those with the potential for rapid deterioration. This approach ensures that nurses provide care based on the severity and urgency of each patient's condition.
For example, a patient awaiting discharge teaching can be educated once more emergent cases have been managed. The constipated patient who requires a bathroom after receiving a laxative should be attended to prevent discomfort, but this need is not urgent. Similarly, the patient who is nauseated and vomiting after receiving narcotic pain medication requires attention to prevent dehydration and provide comfort, but again, this is not immediately life-threatening. Therefore, considering the urgency and potential for serious outcomes, chest pain takes priority.