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. Students will prioritize medical surgical . She is also investigating bone marrow transplantation. LLE: Non-pitting Pitting ___+ 3. Acute Pain: True -Ensure there is suction in the room, and check Ms. Rails was medicated with hydrocodone 5 mg PO two hours ago and is now complaining of pain (8/10 pain scale). His original lymph node biopsy was negative. Impaired Home Maintenance Management False Electrolyte Imbalance False 20ga. Document results Scenario 1 **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 (for older swift river patients see other pdf files loaded at the bottom of this file) Preston Wright Room . Document results/findings The patient is awake alert and oriented. Vital assessment Neuro WNL. An abc-phase-sequence three-phase balanced wye-connected source supplies power to a balanced wye-connected load. He requests no visitors at this time, but later asks for his family to be called to discuss a plan of care. Acute Confusion: True Employ therapeutic communication: present reality 45 terms. Safety Explain reason for assessment and procedure -Administer the medication with a small sip of water and place an NPO sign at the entrance of the patient's room. Palliative care. He does not want to return to the nursing home, and does not wish to burden or live with his children. Seek clarification Vital sign assessments He also has a history of hypertension and takes Tenormin (Atenolol) and Atorvastatin (Lipitor). Self-Care Deficit: True Impaired Mobility True Notify Physical Therapy (PT) Scenario 1 Some hair on the left side of his head has been burned off, as well. Apply nasal cannula Health Change Increased acuity Imbalanced Nutrition True Notify family as to when they may come and visit. Notify lead nurse 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. Notify family Secondary: Assess vital signs, auscultate heart, lungs, and bowl sounds. Scenario 3 Pulse Infection, Risk for True Hopelessness: True Scenario 5 Sensorium: Normal acuity, Bleeding, risk for: False Scenario 4 Impaired Home Maintenance Management r/t Client or Family False No response = 1, Range of Motion: Full, Limited It is determined that Mr. Sturgess could achieve better pain control w/ a PCA pump Scenario 2 1. Document and provide copy for Mr. Dominec to share with his follow up appointment tomorrow. Scenario 4 Constipation False John Duncan Why is cysteine such an important amino acid for defining the tertiary structure of some proteins? Educational Needs Increased acuity They feel that you should share with them if he was a "real AIDS" patient or not. The patient will be discharged today, and he will be ordering new prescriptions. Impaired mobility: False -Complete full assessment, to include neuro Abnormal left leg weakness, gait unsteady, 5/10 on numeric pain scale. Document and prepare to transfer to Surgical ICU Scenario 2 Health Change Increased acuity The provider explains that it is a pre-cancerous stage in where the cell develops abnormal features. 97.4, Resp 16 and Pulse Ox 94%. A new graduate nurse receives a call from the hospital telling them to report to the ER immediately for a disaster. Mr. Dominec is waiting for his partner to arrive to take him home and you notice he has a dry unproductive cough and trouble splinting with a pillow at his operative site. Scenario 4 Evaluate medication effectiveness Skin Integrity: Intact No, describe below, Location Type Size Wound bed Drainage Ineffective Renal Perfusion, Risk for True Bleeding, Risk for True The bed arrives tomorrow. Check PRN pain order Safety Dr. Altace, Physiological- How does the Med-surg simulator work? Readiness for Self-Care Enhancement True Ineffective Self-Health Management False Call rapid response Failure to Thrive: True. Deficient Knowledge False Spanish interpreter available at extension 61178. Scenario 5 Fatigue True Upon entering room, you wash/glove hands. Tear, Ecchymosis, Contusions, Bruising -Tell the patient that they are being admitted to r/o any cardiac issues Ramona Stukes, 69 yr-old, third day post-op cholecystectomy. -Document and contact nursing supervisor/Charge nurse r/o Tuberculosis. Imbalanced Fluid Volume, Risk for True Verbal response Oriented converses = 5 Senario 1 Palliative care. Leave to break room and not continue in conversation. Evaluate understanding , a 58-year-old male patient presents to the ER CO CP 10/10. Knowledge Deficit True Vital signs -Temp 98.6, BP 114/62, P 100, RR 20, SaO2 94%. Disoriented to time and place, speech slurred. Nausea/Vomiting: Yes No Rapid Response team arrived including anesthesia. Report to charge nurse/ head nurse the need for staff education. Scenario 2 -Perform admission assessment The charge nurse tells you not to move the patient, because there is no special treatment according to social status. Expresses fatigue, fear, concern, and desire for recovery. Fall, risk for True He tells the nurse he has called his wife and wants to be discharged now. Mr. Sturgess is uncomfortable with experiencing urinary frequency that keeps him from resting. Vital signs -Temp 98.2, BP 94/60, P72, RR 22, SaO2 99%. Notify lead nurse/doctor Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Scenario 1 When she moves him to the hallway, Mr. Burgundy begins yelling at you "Do you know who I am, I demand a room! Stoma: N/A Colostomy Ileostomy Effluent Consistency: Teach patient about safety when getting out of bed Impaired Mobility True The cells are allowed to warm up and then are frozen again. ExplanationAnxiety/ fear True Toggle navigation Swift River. You explain that he is receiving a higher level of care and was he was sedated before leaving the floor to make him more comfortable. Tom Richardson Educate patient Last Bowel Movement: Date: _____________________ Constipation Diarrhea/Loose Other: Temperature spiked during the night to 102.4, BP now 146/94 which is slightly elevated, respirations at 30 bpm and slightly labored, heart rate 102 versus 84 from last night shift. Place call light and check bed for safety Scenario 1 The patient is awake, alert, and oriented. Robert Domenic Re-assess patient 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. Safety Skin warm dry, bruises on forehead with small laceration. Scenario 3 Scenario 2 Provide comfort measures No Known allergies (NKA). She has been documented as being obese, new onset. Dr. Small at bedside with patient and family. Scenario 1 Wound site clean, dry and intact NPO, NG-tube to low continuous suction. 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". -Notify HCP of neuro findings Vital signs -Temp 98.4, BP 116/76, P 96, RR 20, SaO2 99%. Clinical 2. The nurse observes an elderly lady who is crying and has not been taken care of yet. Visual assess He also complains that his throat is still very sore. Escort patient Scenario 1 Estimate the length of the Neptunian year given that the Earth is 1.50108km1.50 \times 10^{8} \mathrm{km}1.50108km from the Sun on the average. Perform pain reassessment The charge nurse tells the nurse to take Mr. Burgundy to the floor, because his room is now ready. Scenario 3 Apical pulse rhythm: Regular Irregular Location: 2021-22, Historia de la literatura (linea del tiempo), Respiratory Completed Shadow Health Tina Jones, CH 02 HW - Chapter 2 physics homework for Mastering, BI THO LUN LUT LAO NG LN TH NHT 1, Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1. Temperature is 98.3, HR is 87, RR is16, BP is 121/74, PaO2 is 98%. Chronic Sorrow False Imbalanced Nutrition: True Scenario 1 Wound clean dry and intact. Administer new pain medz Use therapeutic communication/Active Listening They wanted to know and pressure you for the information. Pain and numbness in legs for one week. Scenario 5 Administer protocol antidiarrheal medication Replace oxygen nasal cannula that had become disconnected They would also like to start Radium-223. Provide emesis basin/cloth Powerlessness: True, Scenario 1 When the nurse enters the room later that day to inform him that the procedure is scheduled for 1430, they see Mr. Gonzalez is sitting in front of a lunch tray. His children are visiting, and they are very supportive. -Elevate head of bed and place the patient on Pulse oximetry. Temperature is now 102.8. 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The nurse performs tilt test, Patient vital signs lying flat, BP 118/62, P 92, R 20, T 98.5, SpO2 97. Dr. Donofrio, Physiological Deficient Fluid Volume True Enter the email address you signed up with and we'll email you a reset link. Your notice Mr. Thomason is lying supine, appears slightly cyanotic in his lips, is exhibiting more effort to breathe, and is increasingly restless. Fall Risk Increased acuity Scenario 2 c/o headache- medicated with Lortab 5mg PO at 0900, takes Lomotil 10ml PRN q 4 hours last dose at 0834. Radiofrequency ablation, which uses heat to remove abnormal esophagus tissue. -Ensure there is a full O2 tank on the gurney, place patient on Nasal Cannula -Discuss with family sitter if there are any other family members who can help with monitoring Lithia Scenario 1 Wash hands Senario 5 Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. The dinner tray is waiting for the patient in his room, and the nurse notices it is a regular diet. 156 terms. Educational Needs Increased acuity Vital assessment His difficulty voiding finally motivated him to seek care. Grieving: True Neptune is an average distance of 4.5109km4.5 \times 10^{9} \mathrm{km}4.5109km from the Sun. IV maintenance fluids with D5 1/2 NS at 125ml per hour in left forearm. Oral Mucosa: Tongue: Teeth: Love and belonging Wash and glove hands Sa fortune s lve 2 216,00 euros mensuels -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 Verify call light/bed safety precautions Reorient Patient to person, place, & time Elevate head of bed After leaving the room the provider tells the nurse that he hopes that he scared him into compliance with the treatment options. Perineal Care Adjust crutches Observe closely first hour -Use therapeutic communication/active listening Knowledge Deficit True Color:__________ D/C plan- decrease pain and restore normal gait. Scenario 1 Full assessment Diet as tolerated. Mr. Gonzalez's repeat troponin was negative and no significant elevation in his other enzymes. Regardez le Salaire Mensuel de Tthuchicago Org en temps rel. Scenario 3 Senario 1 Mrs. Smith's surgery has now ended. Linen Change Safety You correctly diagnosed 11 out of 16 options. Pain Level Increased acuity Your response to all of them would be: Scenario 1 Love and belonging Tibial: _____ + Bilateral Other: ______________ Generalized: Pedal: ______ + Bilateral Other: ____________ Sacrum: Non-pitting Pitting ___ +. The pain makes him short of breath. Assess Today, clubs like Hamburg City Beach Club, Lago Bay, Hamburg del Mar and StrandPauli provide a relaxed summer atmosphere with a view over the Elbe. Document results Reassure patient and help explain any new orders from physician to patient Fear True Vital signs are: B/P 112/78, temp. Verify call Light/bed safety precautions She is also to receive radiation, chemotherapy, and hormone therapy post operatively. Ambulates with minimal assistance. Describe the physical changes from aging and the care required. 3Check surgical consent for correct procedure and make sure operative site is marked. Reapply restraints The cancer was more advanced than they previously had thought so inguinal lymph nodes were removed. -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. Dr. Altace, Educational Needs Increased acuity Sensorium Normal acuity, Physiological Emergency intubation and assisted breathing is provided for Mr. Thomason Bleeding Risk for: False Mr. Sturgess does not have a living will or durable power of care completed. Normal Sinus Rhythm on telemetry. He has partial thickness burns to his left arm and the left side of his face. Give verbal report Pulse Ox: ___________ % on ____________FiO2; Room Air; Delivery Device Request time she can arrive and staff to help with transfer All our products can be personalised to the highest standards to carry your message or logo. Raspberry and Cream Cheese Stuffed Blueberry French Toast with Ozery. -Draw a repeat CBC per HCP order to determine current Hemoglobin status -Complete secondary assessment once the patient is in bed focusing on complaint of pain resulting from the fall While assessing the patient, Mr. Greer tells you that he is very concerned about all the potential complications involved with this surgery. Mr. Greer has just been visited by his wife. Increased fall risk. But that's changing. Mr. Gonzales H/H is 12.7/38. Document pt's statements. Ms. Cumble states that she has not had a BM for three days. He also has metal fragments on his left side on his leg arm and torso. Allow husband to come into recovery for a quick one-minute visit. Hypothermia False She is with her physician. After two hours, Mr. Dominec is alert and cooperative, nauseated and concerned about impending surgery this evening. Listen to patient concerns Next time we'll spend our 60 on some food and nice beers. Scenario 4 His coughing, to clear his airway, appears ineffective. The patient asks the nurse to explain about these medications and why they are in such a hurry. Scenario 2 Impaired Skin Integrity False Educate patient Evaluate outcome of dietary plan Impaired Mobility False Wash and glove hands The impedance per phase in the load ist 14+j1214+j 12 \Omega14+j12. No Encourage to ambulate with assistance to void if needed IV fluids of D5 1/2 NS are infusing at 100 mL/hour to his right forearm. 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.) . 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. Decreased cardio tissue perfusion: False Safety Administer antipyretic meds -Check on patient/sitter hourly Educate caller regarding HIPAA Insert Foley catheter jasmine . Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. -Discuss and determine sitter availability 20ga. Scenario 5 Senario 5 Do not disturb He is experiencing new onset of shortness of breath and has a nasal cannula with 2L of Oxygen in place. You discuss this cough with Mr. Dominec to determine how long he has had it. Multiple abrasions, bruising Head, chest, and inner thigh. Love and Belonging Extends abnormally = 2 Assign nursing diagnosis and plan the appropriate intervention and evaluate outcomes while working through time pressure and distractions, including random call light requests. -Explain to the patient that because of his weakness and unknown cardiac status as well as the IV, he is a fall risk and should not get out of bed without assistance. Senario 4 Senario 2 Suprapubic Insertion site: WNL S/S Infection : ____________________ Scenario 4 Escort patient to vehicle Cardiovascular has pacer with rate of 82bpm on demand. Scenario #3. Arthur Thomason Educate about recovery from appendectomy and care to wound. Recently he manifested an unusual black lesion on his thigh and developed an opportunistic fungal mouth infection which was treated successfully. The nest morning the gastroenterologist informs Mr. Gonzalez that his EGD confirmed a diagnosis of Barrett's esophagus with Dysplasia. Safety Peripheral Neurovascular Dysfunction False Severe pain (10/10) medicated q 30 minutes x4 with IV Morphine 2mg with little relief. He was recently treated for a URI with a Z pack, prednisone, and Motrin for pain. Glasgow Coma Scale 0-15 Musculoskeletal Scenario 3 Ms. Getts is being transferred as an emergency to Critical Care. Procedure is canceled for the day and rescheduled later allowing for new consent. Mr. Mancia's vital signs upon assessment are Temp 101.2, P 94, RR 20, BP 122/82, SaO2-91%. Upon assessment, you determined that she is confused to person, time, and place but is easily directable. Pupils PERRLA, eyes clear. Spiritual Distress False. Review pain medication order Sleep Deprivation False. He states, "This is not serious." Deficient Fluid Volume False Scenario 5 Scenario 5 Pain: No Yes: Location: ______________________ Acute Chronic Constant Intermittent Visual assessment Scenario 5 Respiratory Effort: Relaxed, Regular, Non-labored Pursed lip breathing Labored Recent chest X-ray shows diffuse bilateral interstitial infiltrates in all lobes. Widespread Color Change: N/A pallor cyanosis jaundice erythema This information is HIPAA protected and you cannot share anything with them. 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. 1. : an American History, EMT Basic Final Exam Study Guide - Google Docs, Philippine Politics and Governance W1 _ Grade 11/12 Modules SY. Notify housekeeping. Provide for physical and thermal comfort. Assess Verbal command = 3 Report and document results Full assessment including both lying/standing Notify doctor and charge nurse Impaired Gas Exchange False Document results Tubes: None Salem Sump Nasoduodenal PEG J-Tube pH: ______ school system of the host country and may not know how to choose the programme, Question 34 Correct Mark 100 out of 100 Flag question Question text hr tag, efefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefef, arbitrary parameters a b will be a complete solution of 38 The main problem then, Reduces costs of providing on site office space To individual Makes more time, METHYLXANTHINE DRUGS-Chemistry FinalsExam PrepNotes.docx, 237 Mitzel Corporation has provided its contribution format income statement for, looks like a lack of focus B In short what is stimulating to one person may be, MAN4162 - Verbal and Nonverbal Communication COPY.docx, Recall that in the Black Scholes model the stock price follows the SDE dS t S, make SOAPE and SBAR Ramona Stukes Room301 Ramona Stukes,69 yr-old, third day post-op cholecystectomy. Home; Our Focus; Our Legacy; Our Partners; Our People; Our Fellows; Our Investments However, these abnormal cells do not have the capability to spread to other parts of the body. Document findings Needs frequent reminding due to determination to do things herself without assistance. You question her while reviewing her operative consent and determine that everything is correct. -Medicate for pain He asks to speak to a clergy member. Acute Pain False Senario 5 Cross), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Week #7 Assignment - Incentive Spriometer . Scenario 4 -Continue to observe urine for hematuria and document findings Compromised Family Coping False He also states he is feeling weak. Perform circulatory evaluation Roger Clinton, 57-year-old male construction worker arrives at 0600 to be prepared for a partial thyroidectomy to determine if he has cancer. Then the bus splashed into the river for a cruise. 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. Elevate Extremity -Inform Mr. Burgundy that he cannot report from the ED, as patient privacy is strictly protected by HIPPA The patient has a pneumothorax that requires a chest tube placement. Wash and glove hands Verify call light/ bed safety precautions Scenario 3 Amount:________ -Advise patient not to get up and walk on his own Constipation, Risk for True Carotid:____ + Bilateral Other: _____________ RUE: Non-pitting Pitting ___+ Strict I&O, regular diet, intake 50%. Students also viewed Culture Concept notebook Development concept notebook Elimination concept notebook Gas Exchange concept notebook Mr. Gonzalez has returned from his EGD and is still sleeping from the sedation.