Which patient should be seen first by the nurse?

• A. pt admitted to the floor from ED with COPD exacerbation
• B. arrived back to the floor 5 hrs ago and has been medicated twice for nausea and vomiting
• C. client combative and the UAP is waiting for help to bathe client
• D. pt with a ng feeding tub and is experiencing shortness of breath

Answer: (D)

Prioritize airway and breathing. When a patient with an NG feeding tube has shortness of breath, there is a real risk of airway compromise or aspiration during feeding, which can rapidly become life-threatening. Ensuring adequate oxygenation and a clear airway takes precedence over other issues because breathing problems can deteriorate quickly.

In comparison, a COPD patient who recently arrived from the ED, while serious, is not demonstrating an immediate airway collapse. Nausea/vomiting can cause dehydration or electrolyte disturbances but does not pose the same immediate threat to life as impaired breathing. A combative patient who needs help bathing is a safety and comfort concern, but again, not as urgent as a potential respiratory crisis.

So the patient with shortness of breath from the NG feeding situation is seen first to protect the airway and ensure breathing.