Contact Social Services Awaiting diagnostic labs. -Notify charge nurse of patient's deteriorating condition Full assessment Seznam uivatel, kte vlastn, prodvaj nebo shnj film. Sit at an eye level. Students also viewed Culture Concept notebook Development concept notebook Elimination concept notebook Gas Exchange concept notebook The patient has a Foley catheter in place and is reporting 8/10 incisional pain and he is asking why his throat is sore. Neuro WNL. Skin warm and, dry, all vital signs in WNL except 115 pulse, which is normal for him. The patient has a pneumothorax that requires a chest tube placement. Mr. Dominec decides he does not want to see Infectious Disease doctor about his new cough. Blood Glucose 185, 4 units of insulin sliding scale for coverage. : an American History (Eric Foner), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. How does the Med-surg simulator work? Scenario 1 Impaired Urinary Elimination True Infection, risk for: False. She has been admitted to the floor with complaints of numbness in her right foot and ankle. Sleep Deprivation False Check physician orders Skin warm and pale. Color:__________ Remain with patient Other: _______________________________ I need to be reporting!" Airborne Isolation. Provide emesis basin/cloth -Remind patient to call for help is he need to get up and provide patient with a urinal. You correctly diagnosed 11 out of 16 options. The provider explains that it is a pre-cancerous stage in where the cell develops abnormal features. -Explain that Docetaxel is a hormone therapy that suppresses the testosterone that your testicles produce producing similar results as surgical intervention. Neuro WNL alert and cooperative. Scenario 4 She has arrived in pre-op and about to have surgery this morning. Document teaching moment. Document findings You now arrive in the recovery unit one hour post-surgery and you are told that the surgery went well. -Ensure patient privacy and call for help and assist patient to bed once help arrives Ronald Burgundy Senario 2 -Discuss and determine sitter availability IV fluids of D5 1/2 NS are infusing at 100 mL/hour to his right forearm. Isolative, appears fearful, crying, and refusing to see her husband. Acute Confusion True Impaired Skin Integrity, Risk for False Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. Dr. Levine, Marcella Como, 38 yr-old, Sexual Trauma Victim (Rape), unknown assailant. Vital signs -Temp 98.4, BP 116/76, P 96, RR 20, SaO2 99%. Full assessment You enter room and find Ms. Gestalt crying because she has just learned her medical insurance has lapsed and she is already two months behind on her car payments. Yes Productive Non-productive Describe Sputum: _______________________ Contact charge nurse. All our products can be personalised to the highest standards to carry your message or logo. Perform neuro assess You are the now the Surgical ICU nurse assigned to her. Provide a few chairs if possible for her family to also be comfortable -Ensure IV is patent, Lithia Monson Allergic to sulfa drugs. Scenario 1 Cough: Disoriented, confused = 4 Explain that he will probably not be going home at least until his doctor sees him. Begin post op education for day one Senario 2 Report this activity immediately to the hospital privacy officer Skin integrity, impaired True Carlos Mancia His children are visiting, and they are very supportive. Palliative care. Scenario 5 except 115 pulse, which is normal for him. Sensorium Increased acuity, Physiological Chronic Pain False Disturbed Body Image True LOC Normal acuity Document results He told the nurse that he has had some changes in his bowel habits and his stools have been very dark. Neuro WNL alert and cooperative. The cells are allowed to warm up and then are frozen again. 20ga. Impaired Gas Exchange False Esteem Communication/Speech: Clear Non-verbal Slurred Aphasia Other and the GI cocktail given in the ER did relieve his CP but not completely. Love and belonging He tells the nurse he has called his wife and wants to be discharged now. The oncologist is insistent that the treatment begin immediately. Kathy Gestalt He asks to speak to a clergy member. Scenario 3 Senario 5 Two hours later, Mr. Duncan is asked how frequent his stools have been today. BP 154/89, P 94 F, R 22, T 98.3F, SaO2 95% on room air. Respiratory Rate: WNL Tachypnea Bradypnea Scenario 5 jasmine . We have more than 20 years' experience in the industry providing a quality service to our clients We pride ourselves on our customer-orientated service and commitment to delivering high end quality goods within quick turnaround times. 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Read PT report However, these abnormal cells do not have the capability to spread to other parts of the body. Scenario 5 Scenario 1 She receives the pre-op medication. Vital Signs: B: 160/92, P: 96, R: 22, SpO2: 98, T: 98.9F, 37.1C. Her husband who is present states, "I thought it was just a lumpectomy she was having this morning." Perform pain re-assessment Scenario 2 Scenario 5 Upon entering room, you find Mr. Sturgess is quiet, appears tense and rigid but states, "I am feeling fine." . Regardez le Salaire Mensuel de Tthuchicago Org en temps rel. Scenario 2 Deficient Diversional Activity False Physiological- Diet as tolerated. Glasgow Coma Scale 0-15 Musculoskeletal Remain with patient Educational Needs Increased acuity -Using therapeutic communication inform Mr. Greer that there are many treatment options, and not to leave until the HCP can come and speak with him Patients vital signs are BP: 100/58, P: 106, R: 28, PaO2: 92%, T: 97.1 F, 36.2 C. Grieving False Swallowing: Intact Dysphagia Aspiration Precautions Palliative care. Re-assess patient Offer masks to visitors Recent blood gases demonstrate falling PaO2 (hypoxemia) and increasing CO2 (Hypercapnia). Cardiovascular Assessment Safety Senario 4 Scenario 1 -Tell the patient that they are being admitted to r/o any cardiac issues Esteem Sensorium Normal acuity, Physiological No known allergies (NKA). Tube Feeding: Type:_________________________ Amount/Rate: ________________________ Bolus/Infusion Robert Sturgess Robert Sturgess 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Educate patient regarding changes to POC Robert Strurgess Educational Needs Increased acuity Include patient condition change in shift report Deficient knowledge: True When you enter the room, the patient is having chest pain again, and they are pale and diaphoretic. Skin cool to touch and appears pale. Noncompliance True Scenario 3 Scenario 5 Eye opening Spontaneous = 4 He insists that he is not hungry and refuses assistance with his meal. Attain fluids/fiber diet and assisted ambulation He has been taking his HIV medication daily. Release restraints/full range of motion Evaluate patient learning Provide emotional support. Senario 2 They would also like to start Radium-223. -Continue to observe urine for hematuria and document findings -Complete neuro checks as ordered Diet as tolerated. To access your Swift River Virtual Clinicals login to ATI's Student Portal and access the Virtual Clinical card in My ATI. IV maintenance fluids with D5 1/4 NS @ 150 ml/hr X 3 then reduce rate to 75 ml/hr. Request time she can arrive and staff to help with transfer Re-assess patient PT to educate patient -Discuss with family sitter if there are any other family members who can help with monitoring Lithia Physiological- You are told that he has intermittent chest pain with substernal burning that radiates to his mid-back. Alert and cooperative. Mr. Mancia is holding Catholic Rosary in hand and is crying as you enter the room. Scenario 2 Scenario 2 Chronic Pain False Background Robert Sturgess the client was admitted with Metastatic cancer of Colon, with history of diabetes. Scenario 5 "I am feeling fine." Bowel sounds: Active, Hyperactive, Hypoactive, Absent (listen for full 5 minutes) Blood Glucose 185, 4 units of insulin sliding scale for coverage. Where is my camera man!! Vital signs -Temp 97.2, BP 96/74, P 82, RR 20, SaO2 97%. Impaired Skin Integrity False Sa fortune s lve 2 000,00 euros mensuels Ineffective Peripheral Tissue Perfusion False Reassure patient and help explain any new orders from physician to patient Neuro- confusion to time and place, but oriented to self, speech clear, poor historian, did not recognize son today which is new for her; Neuro assessment and vital signs q1 hr. Reasses temp in 1 hour. Obtain and provide the infectious disease doctor's contact information for him. 1Perform full assessment and provide anti-nausea medicine. It is now third day post-op, the order is for Ms. Cumble to stand by bedside on both legs for 5 minutes, three times a day. ADA diet, intake 25%. The patient was placed on 2 L O2 NC, EKG monitoring to include a 12 lead, Pulse Oximeter. Imbalanced Nutrition False Safety Evaluate understanding DSD (dry sterile dressing), forehead laceration clean and dry intact. Pain, Acute True Impaired Home Maintenance Management r/t Client or Family False Safety Increased acuity, Physiological Assess for fall risk Pain Level Increased acuity Viola Cumble Stoma: N/A Colostomy Ileostomy Effluent Consistency: Gown and mask Acute Pain True Upon entering room, you find Mr. Sturgess is quiet, appears tense and rigid but states, "I am feeling fine." Robert Sturgess, 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. NURS 320 Med_Surg_Swift_River **New Patients from 2020, Post- Covid-19 Update:** **Charlie Raymond , John Duncan, Carlos Mancia, kenny barrett, Tim Jones, Julia Monroe, Donald Lyles, John Wiggins, Richard Dominec, Preston Wright, Tom Richardson, Joyce Workman, Karen Cole, Jose Martinez, Mary Barkley Charlie Raymond Document results Regardez le Salaire Mensuel de Ticketmaster Beyonce Koln en temps rel. Patient and family upset regarding dx. Dyspnea at rest Dyspnea with minimal activity Use of accessory muscles Safety- Need frequent reminder to stay in room and maintain mask precautions. Peripheral Neurovascular Dysfunction: False Sleep deprivation: False Mr. Gonzalez has returned from his EGD and is still sleeping from the sedation. Decreased Cardiac/perfusion: False Deficient Knowledge True -Complete full assessment, to include neuro Administer new pain medz His partner is not with him at this time but will arrive soon to facilitate his discharge home. When you arrive to room 4, you are told to assume the care for the patient and get ready to transport them to the floor ASAP. Nutritional Intake: Adequate Inadequate BMI: Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. You determine to apply the restraint now. He was recently treated for a URI with a Z pack, prednisone, and Motrin for pain. Assist patient out of bed You enter his room and recognize that Mr. Thomason appears to be talking to himself and appears confused. Administer antipyretic meds -Assess patient's understanding of the teaching and discuss home support, os de la main et de la ceinture pelvienne, Julie S Snyder, Linda Lilley, Shelly Collins. Scenario 4 Ms. Rails shares with you her fear of being discharged home to an abusive husband. -Medicate for pain ADA diet, intake 25%. Neuro WNL alert and cooperative. Assess intake and output and possible reasoning Deficient Knowledge False Escort patient to vehicle It is determined that Mr. Sturgess could achieve better pain control with a PCA pump. Acute Pain: True Cryotherapy, which uses an endoscope to apply a cold liquid or gas to abnormal cells in the esophagus. Senario 5 He is emotionally distraught, and is insisting that he be allowed to report what is going on from the ED. Deficient Knowledge False She has just been transported from recovery. List the nursing care order. Hopelessness False. Toggle navigation Swift River. Skin Color: Consistent with ethnicity pinkish-tan light-tan dark-tan light-brown dark-brown -Verify that discharge orders have been written, provide discharge instructions, and in inform provider about the chest pain. Consult Social Service Educate patient/family Pain Level Normal acuity His VS are BP 122/64, P 89, R 12, SpO2 93%. Wound clean dry and intact. Call rapid response Scenario 2 -Elevate head of bed and place the patient on Pulse oximetry. Place patient on PCA pump Mr. Thomason appears now better oriented and MD arrives unexpectedly to examine him. Fall Risk Increased acuity Bleeding: True Document and provide copy for Mr. Dominec to share with his follow up appointment tomorrow. Scenario 1 Psychological Needs Normal acuity Robert Sturgess Scenario 1 Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. -Check patency of Foley catheter, urine color, and ensure it is secure to the patient's leg Leave to break room and not continue in conversation. Tubes: None Salem Sump Nasoduodenal PEG J-Tube pH: ______ Scenario 5 Pulse Ox: ___________ % on ____________FiO2; Room Air; Delivery Device Sa fortune s lve 10 000,00 euros mensuels Regardez le Salaire Mensuel de Nba 2k23 Pc Review en temps rel. Ineffective Coping False Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions StuDocu University Keiser University Western Governors University Scenario 4 Impaired mobility: False Safety Senario 3 The patient states that the symptoms occurred in the middle of the night and woke him from his sleep. Stay with patient for surgeon's arrival to explain intended surgical procedure Needs frequent reminding due to determination to do things herself without assistance. Carotid:____ + Bilateral Other: _____________ RUE: Non-pitting Pitting ___+ Mr. Thomason is anxious and is obviously worsened from the shift before in overall condition. Adjust crutches Assess pain He warns the patient that if he does not comply with the treatment and preventive measures, he will need other treatments that may include. Scenario 4 Outline an experimental approach to demonstrate the average RNA chain growth rate during transcription of a cloned gene in vitro. Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. The sister of Mr. Mancia calls from home to speak with you. Upon assessment, you determined that she is confused to person, time, and place but is easily directable. Date of insertion: _________________________ Date of dressing: _________________________________ The charge nurse tells you she will send someone to assist you, and to get out 2mg of Versed to have ready to sedate the patient at time of procedure. Oral Care Alleviating Factors: Last pain medication: A special lowbed has been ordered that will lower to the ground. Assess for bowel sounds Electrolyte Imbalance False Vital signs are: B/P 112/78, temp. Expresses fatigue, fear, concern, and desire for recovery. He is aware that he may not have an erection and may need depends for bladder incontinence. His CP is 7/10 and his BP is 165/96, P 92, R 18, SaO2 98 on 2L NC. Report current urinary output quantify per hour and color of urine Skin moist, respiratory bilateral wheezes and rhonchi. Scenario 2 Decreased Cardio Tissue Perfusion False Educate caller regarding HIPAA Assist patient The charge nurse asks you to assume the patient's nursing care. Dr. Small at bedside with patient and family. Bleeding, Risk for True Report to charge nurse/ head nurse the need for staff education. Health Change Increased acuity Palliative care. Report and document results -Explain to the patient that he is now considered stable, you are taking him to the hallway, and he will be admitted to an impatient room within a few hours Deficient knowledge: True Call Rapid Response protocol initiated He does not want to return to the nursing home, and does not wish to burden or live with his children. 45 terms. -Assess if the contents of lunch tray are intact. Scenario 5 Fall Risk Increased acuity No known allergies (NKA). His orthostasis is normalized after a second liter of NS was administered. student name date: nur 113 assessment swift river patient: robert sturgess handoff robert sturgess, 81 years old, metastatic ca of colon, hx of diabetes. Dysfunctional Gastrointestinal Motility False
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