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Awaiting diagnostic labs. Medical Surgical Flashcards | Quizlet Scenario 4 Hep-Lock in place left AC. -Check patency of Foley catheter, urine color, and ensure it is secure to the patient's leg Pain Level Normal acuity -Recheck Tilts after the NS bolus is complete.T Mr. Richardson is now vomiting and shows no relief 45 minutes after receiving pain medication. The patient has a pneumothorax that requires a chest tube placement. Non-significant past medical history. Verify call Light/bed safety precautions Background Robert Sturgess the client was admitted with Metastatic cancer of Colon, with history of diabetes. -Have patient remain in bed, head elevated 30 degrees Evaluate medication effectiveness The nest morning the gastroenterologist informs Mr. Gonzalez that his EGD confirmed a diagnosis of Barrett's esophagus with Dysplasia. Ann Rails Assessment of bowel movement Ms. Getts is requesting water to drink. 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. Obtain translatorT Temp 98, BP 114/67, P 115, RR 20, SaO2 98%. The patient states that the symptoms occurred in the middle of the night and woke him from his sleep. Pain = 2 Notify housekeeping. Nausea/Vomiting: Yes No Deficient Fluid Volume False Anxiety True Fall, Risk for True -Inform Mr. Burgundy that he cannot report from the ED, as patient privacy is strictly protected by HIPPA Scenario 3 Safety Increased acuity, Physiological -Discuss and determine sitter availability Fortune Salaire Mensuel de Ubah Kalimat Efektif Online Combien gagne t Read PT report Vital signs -BP 124/82, Temp 98.2, P 84, RR 22, SaO2 96%. Senario 5 She has been documented as being obese, new onset. John Duncan, 56yr-old male, Dx- Gastroenteritis, returned yesterday from Cancun, c/o intractable diarrhea, weak, pale, and refusing to eat. Mr. Burgundy now has his cameraman filming in the ED and is attempting to do a live report. Generalized weakness, blood tinged urine and severe pain upon urination, GI- n/v. -Verify that discharge orders have been written, provide discharge instructions, and in inform provider about the chest pain. Perform full assessment and provide anti-nausea medicine. No Known allergies (NKA). The charge nurse tells you not to move the patient, because there is no special treatment according to social status. NG tube to low suction possibly D/C'd today after Dr. Levine rounds. Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. Scenario 1 Oral Mucosa: Tongue: Teeth: jessdevan. Scenario 4 References; Access My Virtual Clinicals; Medical-Surgical. Health Change Increased acuity You enter patient's room. -Administer the medication with a small sip of water and place an NPO sign at the entrance of the patient's room. Check surgical consent for correct procedure and make sure operative site in marked. The oncologist is insistent that the treatment begin immediately. Notify lead nurse Ms. Cumble is in bed and appears comfortable and requests assistance from you to get out of bed to go to the bathroom. Deficient Diversional Activity False Scenario 5 She is having some difficulty breathing. Imbalanced Nutrition False His difficulty voiding finally motivated him to seek care. Your coworkers are asking you questions about Mr. Dominec. His past symptoms for three months have been that he noticed a slight hoarseness in speaking, a slight dry cough not related to a cold, and upon examination had a "pea-size lump on the center of his neck". -Explain to Mr. Burgundy that space in the ED is allocated based off of patient need Evaluate understanding 0800 1200 Scenario 4 Chronic pain: True Reapply restraints 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. Patient, and family upset regarding dx. Aggravating Factors: Full head to toe neuro assessment. Compromised Family Coping False Palliative care. Assess Glasgow Coma Scale 0-15 Musculoskeletal 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. Scenario 5 Wound site clean, dry and intact NPO, NG-tube to low continuous suction. The ER nurse reports that his cardiac enzymes were borderline, (Troponin?, CK/CKMB?) Odor: __________, No Explain to Mr. Dominec your concern for this opportunistic infection and usual treatment. Disoriented to time and place, speech slurred. Robert Domenic Provide verbal report to team members who respond to rapid response Welcome [evolutionmkt.co.za] Senario 5 -Assess the patient's anxiety level while using therapeutic communication to decrease patients' stress. 1. Fall, Risk for True Scenario 1 Scenario 2 Esteem Skin warm and, dry, all vital signs in WNL except 115 pulse, which is normal for him. No response = 1, Range of Motion: Full, Limited Blood Pressure, 7a-7p Total: 7p-7a Total: Noncompliance True. Esteem Skin warm and pale. Physiological- After 24 hours, Ms. Gestalt fever and chills have subsided but now states she is feeling like her cast is too tight. He is questioning the nurse as to why he has been admitted for heartburn. ASA is held but morphine 4 mg was given after his GI cocktail. Bleeding, Risk for True Assess LOC Normal acuity Health Change Increased acuity Ms. Gestalt capillary refilling is now 6 secs below cast site, extremity is swollen and cold to the touch. Obtain patient record and follow patient as he is transferred to ICU Abdomen: Flat Rounded Scaphoid Distended Palpation: Soft Taut Rigid Wound clean dry and intact. After washing and gloving hands, you then identify yourself and the patient, Ann Rails. Dx- urinary stones with 3 episodes/5yrs. -Assess patient LOC, by walking patient and asking them to take deep breaths. Scenario 5 Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Scenario 3 Urostomy: N/A Urostomy/Ileal conduit Scenario 5 Senario 4 Mr. Dominec decides he does not want to see Infectious Disease doctor about his new cough. -Assess patients' pain and rule out cardiac pain. Notify Physical Therapy (PT) Provide comfort in pre-surgical room Mr. Dominec. Senario 1 Scenario 2 In reassessing Ms. Monson, her vital signs are: BP -106/82, Temp-98.2, P-106, RR-18, SaO2-88. It is now two weeks later; Mrs. Smith has returned. Readiness for Self-Care Enhancement True All opinions are mine alone. Ineffective Coping False Viola Cumble The surgeon has just visited with Mr. Greer 2-days post op and has informed him that the lymph node biopsies have confirmed that the cancer has metastasized, and he will need further treatment. Heterotrophs include (1) autotrophs, saprophytes, and herbivores (2) omnivores, carnivores, and autotrophs (3) saprophytes, herbivores, and carnivores (4) herbivores, autotrophs, and omnivores. -Elevate head of bed and place the patient on Pulse oximetry. Scenario 1 Dr. Altace, Educational Needs Increased acuity Fatigue True Monitor and evaluate fluid intake Scenario 1 He is emotionally distraught and is insisting that he be allowed to report what is going on from the ER. He has partial thickness burns to his left arm and the left side of his face. Notify charge nurse that discharge will probably not occur today. Dr. Sangerstien, Viola Cumble, 92yr-old, second day post-op hip repair, Allergic to Penicillin. The Physician tells you to have everything ready including a 22 French chest tube, and he will be in shortly to position the chest tube. Chronic Confusion False Scenario 5 Discharge instructions Senario 5 -Give NS liter bolus Ineffective airway clearance True Disturbed body False He is excited and tells the nurse he is starving and glad that he finally gets to eat. Upon entering the room, you find Mr. Sturgess is quiet, appears tense and rigid but states, 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. He was initially sedated with versed 2mg, and Fentanyl 100 mg by the EGD nurse, but the patient was not tolerating the procedure, so anesthesia was called to administer propofol. -Document and contact nursing supervisor/Charge nurse Surrounding skin: Moist/Intact Red/Erythema Irritation No known allergies (NKA). Esteem Patient demonstrates urine strain procedure. Evaluate learning Diet as tolerated. However, he quit three years ago when he remarried; he and his wife have a nine-month-old baby. Neuro WNL's, alert and cooperative. Full assessment Other: _______________________________ Acute Pain True Impaired Skin Integrity, Risk for False Fall, Risk for True -Determine when a hospital provided sitter will be necessary They wanted to know and pressure you for the information. Respiratory Rhythm: Regular Rhythmic Irregular Periods of Apnea Cheyne-Stokes 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 Esteem Radiofrequency ablation may be recommended after endoscopic resection. Scenario 4 Fall, Risk for True Scenario 4 Stoma Status: Pink-Red/Moist Dusky Retracted Excessive bulging Oral Care Fall, risk for: False Observe closely first hour Pain Level: Increased acuity Acute Confusion False Robert Sturgess - Swift River - Robert Sturgess Educational needs Remain with patient Safety Increased acuity, Physiological Diet as tolerated. Physiological- Document results and findings -Notify HCP of fall, complete incident report Vital signs taken by automatic B/P Cuff q 15 minutes Educate patient Diet as tolerated, up ad lib after gait training. Vital Signs: B: 160/92, P: 96, R: 22, SpO2: 98, T: 98.9F, 37.1C. 97.4, Resp 16 and Pulse Ox 94%. Scenario 3 Knowledge Deficit True Scenario 1 Notify doctor Health Change Increased acuity : an American History (Eric Foner), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Mrs. Smith's surgery has now ended. Wash and glove hands Vital Assessment Mr. Richardson is requesting assistance to ambulate to bathroom. -Notify charge nurse Scenario 1 He replies, "six times in the past four hours". -Assess if the contents of lunch tray are intact. Dr. Starks, Physiological Contact dietary consult You return to the break room on your floor. ADA diet, intake, 25%. Full assessment Scenario 2: 1Educate about recovery from appendectomy and care to wound. Grieving False Teach Cameron. He was recently treated for a URI with a Z pack, prednisone, and Motrin for pain. The surgeon has suggested Androgen-deprivation therapy (ADT) with surgical castration (orchiectomy). Notify family as to when they may come and visit. Obtain Clinical Hours 24/7/365 In-Class and Lab Learning Resource Improve Clinical Practice Therapeutic communication. Gait: ______________________________, Skin Integrity Assessment Senario 5 You determine to apply the restraint now. No known allergies (NKA). Outline an experimental approach to demonstrate the average RNA chain growth rate during transcription of a cloned gene in vitro. Self-Care Deficit: True Ms. Rails was medicated with hydrocodone 5 mg PO two hours ago and is now complaining of pain (8/10 pain scale). -Inform patient to not get out of bed without assistance and place call light in reach The patient has a Foley catheter in place and is reporting 8/10 incisional pain and he is asking why his throat is sore. Pulse Ox: ___________ % on ____________FiO2; Room Air; Delivery Device The heartburn has become worse since he started treatment for his URI. except 115 pulse, which is normal for him. Seek clarification Virginia Smith, 57-year-old who has elected to have a total mastectomy based on consultation with her surgeon, a total mastectomy removes all breast tissue but leaves all or most of axillary lymph nodes and chest muscles intact. Educate pt regarding changes to POC Provide information for MD to call family at home and explain what has just happened Color:__________ Nausea False His partner is not with him at this time but will arrive soon to facilitate his discharge home. Document and prepare to transfer to Surgical ICU Anxiety True Two hours later, Mr. Duncan is asked how frequent his stools have been today. Therapeutic communicationT Check pedal capillary refill Educate patient regarding changes to POC Lung sounds are worse. Fall Risk Increased acuity Obtain translator Pain Level Increased acuity Fall Risk Increased acuity Swift River Medical-Surgical. Pupils PERRLA, eyes clear. He does not have an IV nor is he on oxygen. Grieving True This will treat any cancer that may have metastasized to the bone. Ms. Gestalt is now complaining of fever and chills. Arthur Thomason, 56-year-old MVA victim, fourth day post op with a splenectomy and femur repair. -Offer nutrition/toilet Impaired comfort: True Ms. Cumble states that she has not had a BM for three days. Breath Sounds: Clear bilaterally. Head/Face: Symmetric Asymmetric Drooping She is with her physician. Skin integrity, impaired True Sexuality: True. Safety- The patient is asking you where her son is, the last place she saw him was right before the explosion. Scenario 3 Contact Social Services Insertion site: Dry/Intact Redness Tenderness/Pain Warmth Coolness Swelling Drainage Swift River Nursing Simulation - Homework Writing Services Inform his partner that everything is being done to keep him comfortable. Re-assess patient Scenario 1 Educate patient Assign nursing diagnosis and plan the appropriate intervention and evaluate outcomes while working through time pressure and distractions, including random call light requests. Disturbed Body True Following isolation precautions, you notice several family members are by his bedside and none of them are wearing face masks as requested by sign on door. His partner is at the bedside asking, "how much longer will he have to wait until taken to surgery?" 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 Obtain urinary screen c/o headache- medicated with Lortab 5mg PO at 0900, takes Lomotil 10ml PRN q 4 hours last dose at 0834. Fortune Salaire Mensuel de New King James Bible Download For Windows 7 Scenario 4 The surgeon believes that the surgery was successful but recommends the patient have chemotherapy and radiation postoperatively. Do not probe further Fall Risk: Increased acuity Scenario 4 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. Determine clinical decisions based on listening to an audible client report. The nurse arrives and sees a tent is being erected as a triage area, and ambulances are lined up delivering trauma patients. Bowel Movement Total: x________________, Hygiene Times Chronic Pain False Notify doctor for Foley catheter Infection, Risk for False Assess intake and output and possible reasoning Senario 1 Vital signs Temp 99.4, BP 106/72, P 96, RR 20, SaO2 91%. The oncologist is recommending Docetaxel as opposed to an orchiectomy. Awaiting transport. Vital signs are to be taken BID, and it is now time. Powerlessness: True, Scenario 1 Document results. BP 154/89, P 94 F, R 22, T 98.3F, SaO2 95% on room air. -Notify charge nurse of patient's deteriorating condition -Attempt to orient to person, place, and time fallout 4 save wizard quick codes death and wheel of fortune tarot combination; gambling meaning in english urdu alpine spiced apple cider gluten free; how to use v2ray samsonas sequential gearbox subaru; lg magic remote power light stays on Scenario 3 Call Rapid Response protocol initiated Listen to patient concerns Deficient Knowledge True Next time we'll spend our 60 on some food and nice beers. Document results/findings Patients vital signs are BP: 100/58, P: 106, R: 28, PaO2: 92%, T: 97.1 F, 36.2 C. Insertion Site: Dry/Intact Redness/Erythema Drainage Tenderness Maceration Prior to changing shift, you enter the patient's room to complete a full assessment, and Ms. Monson is now crying asking to for someone to take her home! Rich Dad, Poor Dad (Robert T. Kiyosaki) The Methodology of the Social Sciences (Max Weber) Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.) . Your response to all of them would be: Scenario 1 Hopelessness False. Non-significant past medical Hx. She is also to receive radiation, chemotherapy, and hormone therapy post operatively. 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 Neuro WNL alert and cooperative. Scenario 5 You arrive in room to check on her, after washing hands. Allow for non-compliance of request Acute Pain: True Cough: Perform circulatory evaluation Imbalanced Nutrition True Scenario #2. Psychological Needs Normal acuity He has been readmitted for a red spot on his sacrum of 1 cm and a 2 cm blister on his right heel. Vital signs -Temp 97.2, BP 96/74, P 82, RR 20, SaO2 97%. Shock, Risk for: False You are about to call the Surgical ICU and give report. No weight bearing today. 2Provide comfort in pre-surgical room Mr. Dominec. You are the now the Surgical ICU nurse assigned to her. Nausea: False IV maintenance fluids with D5 1/2 NS at 125ml per hour in left forearm. Social worker with patient this morning. He asks to speak to a clergy member. Visual assessment Psychological Needs Increased acuity Scenario 3 Notify doctor Document findings/results, Ann Rails, 38 years old, c/o back pain, non-significant past medical history. The patient tells the nurse that yesterday he was, "concerned about having an erection, and now they want to cut off my testicels". -Ensure IV is patent, Lithia Monson Pain Scale: 0 to 10: _______________ He insists that he is not hungry and refuses assistance with his meal. He also has a history of hypertension and takes Tenormin (Atenolol) and Atorvastatin (Lipitor). -If cardiac is suspected call the provider and the rapid response team. Ineffective breathing pattern False You have them remain with you, seated in comfortable place, while you call ICU and attempt to locate physician for them. Sensorium Normal acuity, Physiological Dr. Jones. is a 57 y/o who has been admitted for a radical prostatectomy. Remain with patient Mr. Greer has just returned from surgery. -Ask the patient to verbalize understanding of teaching and reassure them that yourself or any member of their care team will be available to answer questions. Sit at an eye level. Sa fortune s lve 10 000,00 euros mensuels Remind staff that Universal Precautions are practiced at this hospital for all patients regardless of known infectious diseases. -Remind patient to call for help is he need to get up and provide patient with a urinal. Peripheral Neurovascular Dysfunction False. Scenario 1 -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 Tap patient and ask, "Are you okay?" -Advise patient not to get up and walk on his own Combien gagne t il d argent ? -Ensure patients is positioned in bed properly Dyspnea at rest Dyspnea with minimal activity Use of accessory muscles Scenario 3 Provide emesis basin/cloth Mrs. Stukes is a failed laparoscopic cholecystectomy that resulted in a bowel resection with a temporary ileostomy in place. Mr. Wright is pleasant and cooperative, but needs to be reminded to avoid pressure on his heel and sacrum. Mr. Greer is on the floor still but is awake and oriented and is complaining of back pain below his right scapula. Perform pain reassessment Self-Care Deficit False Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. Retrieve cast removal tool Notify doctor and charge nurse Richard Dominec, A 47-year-old married father of three children has been admitted for an emergent appendectomy in the evening as soon as there is space available in the OR. Bladder distention Pelvic pain Low back/flank pain A new graduate nurse receives a call from the hospital telling them to report to the ER immediately for a disaster. -Teach the patient that there are several interventions for complications post-prostatectomy to include erectile dysfunction, post-op prostatectomies, and self-care involved with a foley catheter at home. Infection, Risk for True Educational Needs Increased acuity Continent: Yes No Brief/Diaper Needs frequent reminding due to determination to do things herself without assistance. His coughing, to clear his airway, appears ineffective. -Reassess patients' vital signs, and place on q5 minutes continuous monitoring Nr 325 final exam quizlet chamberlain - gqqa.wikinger-turnier.de The impedance per phase in the load ist 14+j1214+j 12 \Omega14+j12. She receives the pre-op medication. Use therapeutic communication/Active Listening Safety Scenario 3 Fear True Assess for bowel sounds Tube Feeding: Type:_________________________ Amount/Rate: ________________________ Bolus/Infusion Course Hero is not sponsored or endorsed by any college or university. Mr. Mancia is holding Catholic Rosary in hand and is crying as you enter the room. Senario 4 Imbalanced Nutrition True -Check on patient/sitter hourly Neptune is an average distance of 4.5109km4.5 \times 10^{9} \mathrm{km}4.5109km from the Sun. -Complete secondary assessment once the patient is in bed focusing on complaint of pain resulting from the fall Do not disturb Re-assess patient You also notice the patient is more difficult to orient. He is married, and his wife is requesting to stay at his side. Waist belt restraint PRN; family sitter at bedside, assist with bath. Deficient Knowledge True -Begin q15 minute neuro checks Remain with Patient, Sarah Getts, 77 yr-old, Dx- Chronic Renal Failure, admitted with hyperkalemia (5.9, Eq/L)/hyponatremia (128mEq/L). Respiratory Assessment Solved nursing care plan for Linda Pittmon, a 74 -year old - Chegg Psychological Needs Normal acuity Verify call light/bed safety precautions You enter room one hour after the physician has left the patient. Pain affecting: N/A Sleep Activity Exercise Relationships Appetite Concentration Abdominal Pain: Non-tender Tender/Pain Describe: Document results No Known allergies (NKA). Safety NPO with small amount of ice chips only. Notify lead nurse/doctor The patient was placed on 2 L O2 NC, EKG monitoring to include a 12 lead, Pulse Oximeter. Explain to her family and provide contact information. Obtain Spanish signs & brochure Record intake and output Re-assess patient Safety Decisional Conflict True Skin moist, respiratory bilateral wheezes and rhonchi. Wash and glove hands Ms. Rails states that she has not had a bowel movement (BM) in the past two days. Scenario 4 GI WNL. Neuro WNL alert and cooperative. Document results and findings Full assessment IV D5 1/2 NS @150ml/hr. Tom Richardson Mr. Richardson is now pain free and questioning why he is plagued with recurring urinary stones. Students also viewed Culture Concept notebook Development concept notebook Elimination concept notebook Gas Exchange concept notebook Deficient Knowledge False Call rapid response They feel that you should share with them if he was a "real AIDS" patient or not. Senario 1 Respiratory Rate: WNL Tachypnea Bradypnea Clinical 2. Your responsibilities are: Scenario 1 -Explain to the patient that he has a procedure, and he cannot eat. Use therapeutic communication/active listening Students will prioritize medical surgical . Her husband and two grown children are also with her as she is prepared with gown and head cap awaiting transport to the operating room. Nutritional Intake: Adequate Inadequate BMI: Health Change Increased acuity Document results Swift River Reflection Questions 1 - Swift River - Course Hero Therapeutic Communication Talk with her stating surgery is over and she did great. Mr. Sturgess is recently dx w/ metastatic cancer of colon and he and his family have chosen only Hep-Lock in place left AC. Scenario 1 -Complete head-to-toe assessment while patient is on the floor. -Reassess patient's physical status prior to leaving him in the hallway You arrive in room to find Ms. Monson talking to herself. Amount: _______ Anterior: ___________________________________ Posterior: ____________________________________ A special lowbed has been ordered that will lower to the ground. You take his vital signs which are: Temp 101.3, Pulse 88, Resp 24, B/P 116/84. Tom Richardson, 46yr-old. -Reassure patient that he will be moved to a private room as soon as possible The cycle of freezing and thawing damages the abnormal cells. Sitting, BP 109/60, P 114, Standing the patient becomes very lightheaded and the nurse has them lay back down. -Explain to Mr. Greer that it may take several days for healing, and he may have temporary incontinence, but it will resolve over time. She shares concern about patient's wife who is now coughing and having night sweats. Dr. Donofrio. Peripheral Neurovascular Dysfunction: False SBAR assignment.docx - SBAR(situation, background, - Course Hero Scenario 1 Seznam uivatel, kte vlastn, prodvaj nebo shnj film. -If gastric reflux is suspected administer PRN antacids (GI cocktail) It is determined that Mr. Sturgess could achieve better pain control with a PCA pump. Scenario 2 Discuss his understanding about the plan of care. Wash and glove hands -Discuss with family sitter if there are any other family members who can help with monitoring Lithia Robert Sturgess Scenarios Swift River.docx - Course Hero