His, Joyce Workman Room 303 Joyce Workman Joyce Workman, 42- year old female who presents to the Diabetes Clinic with a new diagnosis of type II diabetes. Skin warm and dry, may sit up on edge of bed today. Viola Cumble Vital signs -Temp 98.6, BP, Erma Willis, a 65-year-old woman with a history of adenocarcinoma and multiple past episodes of related secondary infections, was admitted to the medical-surgical unit this morning with a diagnosis, Reflective Journal VCBC Post work Cellular Regulation VCBC Post Work Start Assignment Due No Due Date Points 10 Submitting a file upload Please submit your post work to Canvas within 48 hours of, Typically the concept of cellular regulation Involves the study of cancer and related diagnoses. Neuro WNL alert and cooperative. Scenario 1 Course Hero is not sponsored or endorsed by any college or university. IV maintenance fluids with D5 1/4 NS @ 150 ml/hr X 3 then reduce rate to 75 ml/hr. Emergency intubation and assisted breathing is provided for Mr. Thomason Document and provide copy for Mr. Dominec to share with his follow up appointment tomorrow. Temp 98, BP 114/67, P 115, RR 20, SaO2 98%. Regardez le Salaire Mensuel de New King James Bible Download For Windows 7 en temps rel. Anxiety True It is determined that Mr. Sturgess could achieve better pain control with a PCA pump. Cough: Wash and glove hands Scenario 4 Use therapeutic communication/Active Listening Ask patient to explain to you what procedure she was expecting to have this morning. Swallowing: Intact Dysphagia Aspiration Precautions Sleep Deprivation False Procedure is canceled for the day and rescheduled later allowing for new consent. Document results/findings Love and belonging VS: BP 158/90, HR 89, R 18, T 97.8 F. Notify family as to when they may come and visit. Safety Impaired Gas Exchange True Scenario 4 Excess Fluid Volume, Risk for False Combien gagne t il d argent ? Scenario 4 Ms. Gestalt capillary refilling is now 6 secs below cast site, extremity is swollen and cold to the touch. Mr. Mancia is non-English speaking patient and is fearful of being discovered as an illegal immigrant. Lithia Monson Therapeutic communication. The patient is awake, alert, and oriented. Swift River Clinical Practice Chamberlain University Expert James Moore Category: Nursing Description Full Document Jose Martinez Room 301 Jose Martinez, Jose Martinez, 43- year old male experiencing chest pain while watching a state rival football game earlier in the evening. Sa fortune s lve 2 216,00 euros mensuels Psychological Needs Increased acuity Peripheral Neurovascular Dysfunction: False Safety The Swift River is one of the most unique and popular trout fishing destinations in Massachusetts, yet the dynamics of this exceptional fishery have not been well understood. He does not have an IV nor is he on oxygen. Acute pain: False Document results Disturbed Body True D/C plan- decrease pain and restore normal gait. However, he quit three years ago when he remarried; he and his wife have a nine-month-old baby. Impaired Skin Integrity, Risk for True Record intake and output Our Swift River Simulations are designed to help students and practicing nurses master their skills of Prioritization, Delegation, and Sequential thinkingwithout the requirement of being onsiteor even having to download software. Hep-Lock in place left AC. Tubes: None Salem Sump Nasoduodenal PEG J-Tube pH: ______ Psychological Needs Normal acuity After 24 hours, Ms. Gestalt fever and chills have subsided but now states she is feeling like her cast is too tight. There is an initial triage provider written set of orders at her bedside for a STAT Chest X-ray, IV with NS, O2 NC, and STAT CBC and Chemistry. She is with her physician. Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. jessdevan. Three hours later, Ms. Getts is unsteady when standing by her bedside. Seznam uivatel, kte vlastn, prodvaj nebo shnj film. Place pt on PCA pump Listen to patient concerns Skin moist, respiratory bilateral wheezes and rhonchi. Contact head nurse or supervisor in the OR to evaluate new situation Failure to Thrive False. Nutrition True , a 58-year-old male patient presents to the ER CO CP 10/10. Your response to all of them would be: Scenario 1 It is unclear if he lost consciousness. Fall Risk Increased acuity Scenario 5 Inform and educate spouse of dietary orders Scenario 4 The nurse arrives and sees a tent is being erected as a triage area, and ambulances are lined up delivering trauma patients. You escort them with you to the ICU. Verify call light/bed safety precautions Scenario 3 Nausea/Vomiting: Yes No Ms. Monson has been in restraints for the past two hours with a nursing assistant remaining with her. Radiofrequency ablation may be recommended after endoscopic resection. Assess for bowel sounds Mr. Richardson is now pain free and questioning why he is plagued with recurring urinary stones. There is an order to apply a waist belt restraint if needed. Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Scenario 4 Offer assistance -Assess for fall risk Perform circulatory evaluation Wash and glove hands Nausea: False Scenario 3 Notify doctor and charge nurse -Set-up for stat portable chest x-ray Dr. Altace, Educational Needs Increased acuity Failure to Thrive True. Seek clarification Gait: ______________________________, Skin Integrity Assessment Use therapeutic communication/Active Listening He is restless with slight confusion but is easily orientated with attempts from nurse. Sensorium Increased acuit, Physiological Ineffective Coping False Scenario 5 Read PT report Spiritual Distress False. Spanish interpreter available at extension 61178. Auscultate peripheral pulses and ROM. Mr. Sturgess is now declining, and family members are requesting to remain in room past normal visiting hours. Report current urinary output quantify per hour and color of urine Administer antipyretic meds Fall Risk Increased acuity Family in room with patient very concerned. Educate patient Scenario 3 Physiological- Explain to physician what interventions you have recently initiated Scenario 3 -Take initial vital signs (room air Pulse Ox) -If cardiac is suspected call the provider and the rapid response team. While assessing the patient, Mr. Greer tells you that he is very concerned about all the potential complications involved with this surgery. No known allergies. He has been readmitted for a red spot on his sacrum of 1 cm and a 2 cm blister on his right heel. Scenario 5 The patient is awake alert and oriented. RLQ: RUQ: LUQ: LLQ: Construct dietary consult (plan) He warns the patient that if he does not comply with the treatment and preventive measures, he will need other treatments that may include. Document results and findings Self-Care Deficit False -Explain procedure to the patient Scenario 2 You observe Ms. Getts being assisted by another nurse who is being blatantly rude and disrespectful to her. He has been taking his HIV medication daily. Observe closely first hour Opening Title Production company Cast and crew Genre J A N U A R Y 2: The Killing of John Lennon: IFC First Take: Andrew Piddington (director/screenplay); Jonas Ball, Krisha Fairchild, Gunter Stern, Gail Kay Bell, Mie Omori, Robert C. Kirk: Crime, Drama: 4: One Missed Call: Warner Bros. Pictures / Alcon Entertainment / Kadokawa Pictures: Eric Valette (director); Andrew Klavan (screenplay . Ms. Rails shares with you her fear of being discharged home to an abusive husband. Students will form a preliminary assessment based on reported assessment data for medical surgical patients in a virtual clinical environment. Evaluate learning Infection, Risk for False Senario 3 The charge nurse tells you to get the Mr. Burgundy to the hallway because six more patients are inbound, and we need to clear out our trauma-bays. 0800 1200 The patient got dizzy when he stood up from the commode. Temp -Elevate head of bed and place the patient on Pulse oximetry. Vital signs -Temp 98.8, BP 102/76, P 102- irregular, RR 22, SaO2 90%, cardiovascular on telemetry with Sinus irregular rhythm. He also has metal fragments on his left side on his leg arm and torso. Scenario 4 Imbalanced Nutrition True Also worth mentioning is the 'Alter Schwede' - a 217t . Validate NPO Status -Assess patients' pain and rule out cardiac pain. Re-assess patient Obtain recent chest X-ray reports and recent ABG's for physician to review palliative care. Dr. Anderson, Educational Needs Increased acuity Nausea: False Remain with Patient, Sarah Getts, 77 yr-old, Dx- Chronic Renal Failure, admitted with hyperkalemia (5.9, Eq/L)/hyponatremia (128mEq/L). You enter room one hour after the physician has left the patient. Carlos Mancia Type of Line: Peripheral, location ______________ CVL, location _____________ PICC, location _______________ Notify doctor if condition is abnormal Do not probe further Senario 1 Stoma: N/A Colostomy Ileostomy Effluent Consistency: Safety Increased acuity, Physiological Hx of dementia, from nursing home, fall one day ago. -Have patient remain in bed, head elevated 30 degrees -Tell the patient to call immediately if the chest pain gets worse or they become short of breath Pain, Acute True sounds= 2 Respiratory Assessment Yes Productive Non-productive Describe Sputum: _______________________ He was recently diagnosed with stage III prostate cancer. Vital assessment Microeconomics And Behavior Robert Frank 9th Edition Author: old.bubbies.com-2022-05-03T00:00:00+00:01 Subject: Microeconomics And Behavior Robert Frank 9th Edition Keywords: microeconomics, and, behavior, robert, frank, 9th, edition Created Date: 5/3/2022 7:02:15 AM Scenario 3 -Reinforce the risk if patient has not been NPO and ask the patient when the last time they ate. Noncompliance True. NPO with small amount of ice chips only. Scenario 5 Stat lithotripsy treatment ordered. Senario 5 Sleep deprivation False Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Scenario 2 Hx of dementia, from nursing home, fall one day ago. Scenario 1 His CP is 7/10 and his BP is 165/96, P 92, R 18, SaO2 98 on 2L NC. Acute Pain: True Evaluate/Modify Mobility Plan, Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical Hx. 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. He also states he is feeling weak. Obtain translator Safety- Assess toe movement and capillary refilling Respiratory Rhythm: Regular Rhythmic Irregular Periods of Apnea Cheyne-Stokes When the nurse retunes to the room the patient tells the nurse that when he went to the bathroom he became very lightheaded. Cardiovascular has pacer with rate of 82bpm on demand. When the HCP realizes who he is, he tells the nurse to move the patient in the treatment room down the hall and put Mr. Burgundy in there. The pathology report shows no cancerous lesions. Full assessment Apply restraint Refer call to contact health department Offer nutrition/toilet Abdominal Pain: Non-tender Tender/Pain Describe: Scenario 1 Sensorium: Normal acuity, Bleeding, risk for: False -Evaluate patient's understanding of teaching 20ga. Decreased cardio tissue perfusion: False Leave to break room and not continue in conversation. Mr. Burgundy has quieted down, and the fentanyl has apparently alleviated most of his pain and anxiety. Activity as tolerated with assistance. Document results and findings Her husband and children remain with her in the surgical holding area awaiting transport to the OR. Scenario 3 Check input/output for possible dehydration He insists that he is not hungry and refuses assistance with his meal. At Risk, Impaired Comfort False You are about to call the Surgical ICU and give report. They would also like to start Radium-223. Safety Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Respiratory Effort: Relaxed, Regular, Non-labored Pursed lip breathing Labored Safety Scenario 5 Knowledge Deficit True Notify lead nurse/doctor Hep-Lock in place left AC. LOC Normal acuity Fall Risk Increased acuity Health Change: Increased acuity He is having some difficulty hearing and complains of ringing in his ears. Document results and findings Diet as tolerated. Apply oxygen -Remove the dinner tray and make sure the diet is soft food. Reassure patient and help explain any new orders from physician to patient Wash and glove hands He is married, and his wife is requesting to stay at his side. Mr. Thomason appears now better oriented and MD arrives unexpectedly to examine him. Impaired Mobility True Palliative care. Palliative care. Assess vital results Scenario 5 High fall risk. Administer antipyretic medication The surgeon believes that the surgery was successful but recommends the patient have chemotherapy and radiation postoperatively. You correctly diagnosed 11 out of 16 options. Esteem Genitalia: WNL (skin intact, no lesions) Abnormalities Describe: __________________________ Apply fall risk bracelet You now arrive in the recovery unit one hour post-surgery and you are told that the surgery went well. Upon entering room, you wash/glove hands. Senario 5 Secondary: Assess vital signs, auscultate heart, lungs, and bowl sounds. Senario 5 Document findings/results, Ann Rails, 38 years old, c/o back pain, non-significant past medical history. Impaired Home Maintenance management r/t client or family False Document results Increased fall risk. -Inform Mr. Burgundy that he cannot report from the ED, as patient privacy is strictly protected by HIPPA He also complains that his throat is still very sore. Deficient Knowledge False Scenario 2 Patient and family upset regarding dx. Gastrointestinal Assessment The patient is being prepared for discharge and his IV has been removed. Ineffective breathing pattern False Explain reason for assessment and procedure No Decreased Cardiac/perfusion False Color:__________ Needs frequent reminding due to determination to do things herself without assistance. -Document and contact nursing supervisor/Charge nurse
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