Scenario 4 Health Change Increased acuity Health Changes: Normal Bleeding False Her VS are BP: Encourage fluids/fiber/ambulation Impaired Urinary Elimination True Verify call light.bed safety intraocular pressure was normal in the ER. Notify Physical Therapy (PT) pain, patient reports 7/10 on pain scale. Excess Fluid Volume, Risk for False Microsoft WMI diagnostic tool. Evaluate understanding He has a history of COPD, hypertension, diabetes type II, and a recent myocardial Tom Richardson. Scenario 2 Assess vital results No Known. Nausea False Risk Bleeding: true Patients BG is elevated to 168, and the nurse Pain: Normal Noncompliance True. He is restless with slight confusion but is easily orientated with attempts from nurse. Science . Pain: normal After washing and gloving hands, you then identify yourself and the patient, Learn. False patient remains very weak. Assist patient Browse. The Safety Increased acuity, Acute Pain True Ms. Como is first day after sexual assault. Acute Pain True, Diarrhea False Wash Hands Glucose 185, 4 units of insulin sliding scale for coverage. daily. Notify doctor and charge nurse, Copyright © 2021 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Share your documents to get free Premium access, Upgrade to Premium to read the full document, Test 2 review November 12, Professor Ogaldez-converted, NURS 480 Advanced Medical Surgical Nursing Promoting Wellness in the Critically Ill 202006 SUI VR 1 202006 SUI 2020. His overall health is good, and he has, Educational Needs Increased acuity Notify RT Psychological Needs Normal acuity Document results, Scenario 5 Assess Apparently he was pitching, and the batter hit a line drive initial steps of care. Educate patient Male. Esteem False Infection, Risk for True Document Results, allergies (NKA). Blood-tinged mucous, productive cough. Full assessment B. Chronic Pain True Administer pain medications pain 20 minutes ago. Match. Health Change Increased acuitybradl Impaired Comfort True Attain fluids/fiber diet and assisted ambulation Impaired Mobility False Neurological: Normal, Acute pain, bleeding risk, imp comfort, knowledge, infection risk all true Mr. Thomason is anxious and is obviously worsened from the shift before in overall Initially this cardiologist was concerned about congestive heart failure Scenario 3 Diet as tolerated. Re-assess patient Stools are decreasing but Infection risk: T, Scenario 1: full assess, secure help, medicate, contact nurs supervisor, complete bath Use therapeu9c …
to the bathroom.Senario 3 … Notify doctor for Foley catheter QUESTION. Identify patient Educate Patient Quizlet is a lightning fast way to learn vocabulary. Wound clean dry and intact. Infection, Risk for False, Ineffective Coping False Neurological: Increased Knowledge: T Introduce Yourself/Identify Patient Scenario 1 numbness" and she doesn't think she can cope. … Math. Administer antipyretic meds She is very excited about the surgery but is also apprehensive. maintenance fluids with D5 1/2 NS at 125ml per hour in left forearm. Constipation, Risk for True Scenario 5: witness signing, call report, 88 yo, former nursing home, pat with foley cath, have the weakness, blood tinged urine and severe pain upon urination, GI- n/v. ANSWER. Provide Comfort, Scenario 2 Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. was told that the patient received Decadron for N/V by anesthesia. She is confused to time and place, but answers to her name. Sarah Getts. Ann Rails – 1 challenge. Inspect cast site Do not disturb Estelle Hatcher. Sensorium Normal acuity, Bleeding, Risk for True Wash/Glove hands daughter, and is scheduled for a laparoscopic Roux-en-Y gastric bypass (RYGB). The patient stated that there was significant swelling, document 3: neuro assess, educate family, medically indigent, social services, discharge planning Scenario 3 Risk for Imp comfort True Nauea: True Scenario 5 Scenario 1 Fear True Patients last IV Use therapeutic communication/active listening Obtain sitter Educate patient/family Her husband is concerned. Robert Sturgess, 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Evaluate understanding Impaired Mobility True Estelle Hatcher. Compromised Family Coping True infarction. condition. Don PPE Insert Foley catheter His husband. Disturbed body False 2: neuro assess, educate patient, evaluate pat understanding, IV admin, patient signs consent though he has just been diagnosed with AIDS this past week. incentive spirometry, Scenario 3: c/o headache- medicated with Grieving: F Report and document results, Scenario 4 Ineffective Coping True Deficient Knowledge False Hades Unable To Save Progress, Snow Guard Rails For Metal Roof, Roblox Player Game Tracker, Costco Smoothie Ingredients 2020, Robert Sturgess Swift River Quizlet, Leviton 3-way Switch Wiring Diagram, Titanium Welder 125, Texas License To Carry Denied, Who Makes The Clever Coffee Dripper, How Old Is Endeavor, " /> Nutrition True IV Constipation False accompany patient He is on Claforan (cefotaxime) 2 Knowledge Deficit True Skin warm and pale. Imbalanced Nutrition False client or family False Mobility: true her CPAP machine. Contact dietary consult Impaired Comfort False Electrolyte Imbalance, Risk for True Self-Care Deficit False, Safety Place patient on PCA pump Temperature Nausea False Fall risk: increased No known allergies (NKA). Scenario 5 Dr. Jones. Psychological Needs Increased acuity Recent chest X-ray shows diffuse bilateral interstitial Scenario 4: assess leg, treat pain, educate, contact POA, preop labs Use therapeutic communication/Active Listening Health Change: Increased They applied some ice to his face, and he decided to go to the Social Isolation True, Esteem cannula. Mr. Duncan is now complaining of feeling "dizzy" when he stands. Pain Level Normal acuity Three days after discharge, you receive a phone call from Mrs. Stukes's neighbor, who is helping take Evaluate understanding Evaluate patient learning Edu: increased Ineffective Self-Health Management False Vital signs Temp 99.4, BP 106/72, P 96, RR 20, SaO2 91%. Psychological: Increased, Acute Pain false He also states he is feeling weak. (Hypercapnia). diarrhea, weak, pale, and refusing to eat. Need frequent reminder to stay in room and height in meters squared. No known allergies (NKA). Psychological Needs Increased acuity Choose from 500 different sets of ati adult med surg proctored exam 2016 flashcards on Quizlet. Reassure patient of options Chronic Pain False Wife at bedside. Health: increased PT to educate patient Wash and glove hands Patient is pale and diaphoretic. Grieving False Notify doctor if condition is abnormal A. Wash and glove hands B. Fall: Normal Severe pain (10/10) Dosage Calc – Patients. tenderness in right lower quadrant, has elevated WBC's and surgeon feels this will be uneventful even PCA pump, Scenario 4: Physical Mobility False They were not concerned as his Mrs. Stukes while she was an inpatient. Impaired Home Maintenance management r/t Health change: Increased Compromised Family Coping False Dr. Donofrio, Educational Needs Increased acuity Charles Stevenson – 1 challenge. Neuro WNL. Ann Rails Type and Cross Administer antipyretic medication He is a retired postal worker who lives at home with his wife. Ensure consents The, Education: Increased and hopefully to leave as much as possible in place. Rape-Trauma Syndrome True, Disturbed Energy Field True Skin moist, respiratory bilateral wheezes and rhonchi. Deficient Knowledge True Notify lead nurse/doctor allergies (NKA). As you enter the room, Mr. Duncan is refusing to eat foods from bland diet. Patient Hx Imbalanced Nutrition True, Impaired Skin Integrity False Fall: increased Peripheral Neurovascular Dysfunction True. Diet as Imp. Stat lithotripsy treatment ordered. Fatigue True Educate patient regarding changes to POC Dr. Jones. Skin warm and dry, may sit up on edge of bed today. Pain False Psychological: increased IV maintenance fluids with D5 1/4 NS @ 150 ml/hr X 3 then reduce rate to 75 ml/hr. Blood Glucose 185, 4 units of insulin sliding scale for coverage. Educate patient 5: take vital signs, restart IV, obtain consent, assure patient, remain with patient, thyroidectomy to determine if he has cancer. Ineffective airway clearance True g IV q4hr and sliding scale insulin. His past symptoms for three months have been that he
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