Which is the priority nursing diagnosis for a patient who has been diagnosed with Meniere’s disease?

Choice A reason: This is an incorrect choice because the hospice RN works closely with the patient’s daughter to ensure that the patient’s dying requests are met is not a patient assignment that demonstrates the concept of team nursing. Team nursing is a model of care in which a team of healthcare providers, including RNs, licensed practical nurses (LPNs), nursing assistants, and other support staff, work together to provide care for a group of patients¹. Working closely with the patient’s daughter is an example of family-centered care, not team nursing.

Choice B reason: This is an incorrect choice because the RN cares for the same five patients every day during their stay following joint replacement surgery is not a patient assignment that demonstrates the concept of team nursing. Team nursing is a model of care in which a team of healthcare providers, including RNs, licensed practical nurses (LPNs), nursing assistants, and other support staff, work together to provide care for a group of patients¹. Caring for the same five patients every day is an example of primary nursing, not team nursing.

Choice C reason: This is the correct choice because the RN, the LPN, and the nursing assistant work together to provide all the care needed by eight patients for the shift is a patient assignment that demonstrates the concept of team nursing. Team nursing is a model of care in which a team of healthcare providers, including RNs, licensed practical nurses (LPNs), nursing assistants, and other support staff, work together to provide care for a group of patients¹. Each member of the team performs specific duties appropriate to their role to provide total patient care. Teams may include licensed practical nurses (LPNs) and unlicensed assistive personnel (UAP) that are supervised by a registered nurse (RN). Less experienced, or non-critical care RNs, may be assigned to a team in a critical care unit led by an experienced critical care RN. Each team member plays a vital role.

Choice D reason: This is an incorrect choice because the RN coordinates care of the patient with the physician assistant to ensure that the clinical pathway is followed is not a patient assignment that demonstrates the concept of team nursing. Team nursing is a model of care in which a team of healthcare providers, including RNs, licensed practical nurses (LPNs), nursing assistants, and other support staff, work together to provide care for a group of patients¹. Coordinating care of the patient with the physician assistant is an example of interprofessional collaboration, not team nursing.

Choice A reason: This is incorrect. The PCA will not give additional pain medication whenever the button is pushed. The PCA is programmed to deliver a specific dose of pain medication at a specific interval. If the button is pushed before the interval is over, the PCA will not release any medication. This is to prevent overdose and side effects.

Choice B reason: This is incorrect. The PCA will not deliver medication through the IV until the pain is all gone. The PCA is designed to provide pain relief, not pain elimination. The PCA has a limit on how much medication it can deliver in a certain period of time. The patient may still have some pain even after using the PCA.

Choice C reason: This is correct. You or a designated family member are the only one who gets to push the PCA button-nobody else may do so. The PCA is intended to give the patient control over their pain management. The patient should push the button when they feel pain, not when someone else thinks they need it. Allowing others to push the button can lead to under- or over-medication, which can be harmful.

Choice D reason: This is incorrect. Wait until the pain becomes severe before pushing the PCA button is not a good instruction. The PCA is more effective when the patient pushes the button before the pain becomes too intense. Waiting too long can make the pain harder to control and require more medication. The patient should use the PCA as needed to keep the pain at a tolerable level.