Mr. Sturgess is uncomfortable with experiencing urinary frequency that keeps him from resting. Neck: ______________ Impaired Skin Integrity False Your response to all of them would be: Scenario 1 -Ensure bed is in lowest position, and rails are in place When you enter the room, the patient is having chest pain again, and they are pale and diaphoretic. Scenario 3 20 ga. Hep-Lock in right forearm, skin warm and dry, generalized weakness with recent weight loss. Therapeutic communication -Notify charge nurse of patient's deteriorating condition Yes Fear: True Scenario 1 Wash hands Electrolyte Imbalance False The bed arrives tomorrow. **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 . Ms. Rails states that she has not had a bowel movement (BM) in the past two days. Impaired Mobility True Due to this, the provider would like him to stay in the hospital for observation. Decreased Cardio Tissue Perfusion False Use therapeutic communication/Active Listening -Notify HCP of fall, complete incident report Scenario 3 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. Mr. Richardson is requesting assistance to ambulate to bathroom. Dr. Donofrio, Chronic Pain, Risk for constipation, impaired nutrition, anxiety, fear, grieving, hopelessness, powerlessness, Daily Flowsheet & Physical Assessment, Vital Signs Intake & Output Anterior: ___________________________________ Posterior: ____________________________________ Notify doctor Request sitter/family member to bedside Elevate head of bed Decisional Conflict True 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 The patient has been scheduled for an EGD today and has an order for Omeprazole (Prilosec) and Carafate (sucralfate). Hopelessness False. Peripheral Neurovascular Dysfunction False. Pain Level Increased acuity You notice she is crying and is expressing fear that she "will always have this pain and numbness" and she doesn't think she can cope. Bowel Movement Total: x________________, Hygiene Times Psychological Needs Increased acuity #ozerysnackingrounds I am so excited to be partnering with Ozery Family Bakery today. ADA diet, intake, 25%. Document results Mr. Thomason appears now better oriented and MD arrives unexpectedly to examine him. Spiritual Distress False. Document results Inappropriate words = 3 Communication/Speech: Clear Non-verbal Slurred Aphasia Other Educate patient/family Bleeding False Color:__________ Reorient Patient to person, place, & time If the source voltage for the a phase is Van=12080V\mathbf{V}_{a n}=120 \angle{ 80^{\circ}} \mathrm{V}Van=12080V, and the line impedance is zero, find the phase currents in the wye-connected source. Senario 1 He has been ruled out for an MI. Scenario 1 Mr. Wright is pleasant and cooperative, but needs to be reminded to avoid pressure on his heel and sacrum. Eye opening Spontaneous = 4 Regardez le Salaire Mensuel de Tthuchicago Org en temps rel. LOC Increased acuity Provide comfort in pre-surgical room Mr. Dominec. Vital signs -Temp 98.2, BP 94/60, P72, RR 22, SaO2 99%. The pathology report shows no cancerous lesions. He tells the nurse he has called his wife and wants to be discharged now. Bleeding False Contact dietary consult Regardez le Salaire Mensuel de Nba 2k23 Pc Review en temps rel. Since the finding was low-grade dysplasia and is considered the early stage of precancerous changes, the gastroenterologist recommends another endoscopy in six months, with additional follow-up every six to 12 months. 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. Readiness for Self-Care Enhancement True Pain Level Increased acuity Evaluate understanding 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 . Peripheral Neurovascular Dysfunction False Robert Sturgess - Swift River Swift River University Nightingale College Course Concepts of Nursing I (BSN 246) Academic year2022/2023 Helpful? His wife tells the nurse that he seemed very distant and did not want to talk much. Blood Pressure, 7a-7p Total: 7p-7a Total: -If cardiac is suspected call the provider and the rapid response team. 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Scenario 2 He also has metal fragments on his left side on his leg arm and torso. Needs frequent reminding due to determination to do things herself without assistance. She has arrived in pre-op and about to have surgery this morning. Establish second IV In reassessing Ms. Monson, her vital signs are: BP -106/82, Temp-98.2, P-106, RR-18, SaO2-88. Abnormal left leg weakness, gait unsteady, 5/10 on numeric pain scale. Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. Encourage fluids Waist belt restraint PRN; family sitter at bedside, assist with bath. Reassure patient of options Scenario 5 -Tell the wife that you will speak to the husband, and this is apprehension is expected with this surgery/diagnosis. How was this Safety Increased acuity, Physiological Bleeding, Risk for False Fall Risk Increased acuity Suprapubic Insertion site: WNL S/S Infection : ____________________ No known allergies (NKA). Fall, Risk for True Swallowing: Intact Dysphagia Aspiration Precautions Educate patient Blood-tinged mucous, productive cough. His VS are BP 122/64, P 89, R 12, SpO2 93%. Dr. Donofrio. Wash and glove hands Fear True Employ therapeutic communication: present reality You arrive in room to find Ms. Monson talking to herself. Pain: No Yes: Location: ______________________ Acute Chronic Constant Intermittent Assess for fall risk Next time we'll spend our 60 on some food and nice beers. Psychological Needs Normal acuity Scenario 3 She is having some difficulty breathing. Safety- Safety -Evaluate patient's understanding of teaching Oral Care Ineffective self-health mgmt: False, Disturbed body: False Flexes & withdraws = 4 Temp Fall Risk Increased acuity You enter his room and recognize that Mr. Thomason appears to be talking to himself and appears confused. Acute Pain True Stools are decreasing but patient remains very weak. Scenario 1 Now, third day post-op, Mrs. Stukes appears sad and depressed upon entering the room. She shares concern about patient's wife who is now coughing and having night sweats. His CP is 7/10 and his BP is 165/96, P 92, R 18, SaO2 98 on 2L NC. Impaired mobility: False Cross), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Principles of Environmental Science (William P. 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The oncologist is recommending Docetaxel as opposed to an orchiectomy. No weight bearing today. Physical Mobility, Impaired True Chronic Pain False IV maintenance fluids with D5 1/4 NS @ 150 ml/hr X 3 then reduce rate to 75 ml/hr. He has a history of well controlled GERD with over-the-counter Tagamet (Cimetidine), and Tums. -Notify charge nurse Perform pain re-assessment Scenario 4 Document results The patient has a Foley catheter in place and is reporting 8/10 incisional pain and he is asking why his throat is sore. Acute Confusion True -Obtain chest tube tray and set-up pleurovac Nausea/Vomiting: Yes No 97.4, Resp 16 and Pulse Ox 94%. Document Results/Findings Visual assess Infection, Risk for False You correctly diagnosed 11 out of 16 options. 45 terms. Skin warm dry, bruises on forehead with small laceration. Mr. Gonzalez has been admitted to the floor to determine that his chest pain is not related to a cardiac event. -Continue to observe urine for hematuria and document findings 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. 0800 1200 Describe the physical changes from aging and the care required. Scenario 2 Evaluate understanding No response = 1, Range of Motion: Full, Limited 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. Safety Stoma status: Pink-Red/Moist Dusky Retracted Excessive bulging No known allergies (NKA). In the interim, start an IV and start infusing Ringers Lactate. Acute Confusion: True Shock, Risk for: False Acute Pain True Scenario 4 Escort patient to vehicle Consult Social Service Fear True Wound clean dry and intact. Check surgical consent for correct procedure and make sure operative site in marked. Provide for physical and thermal comfort. Hep-Lock in place left AC. -Tell the patient that they are being admitted to r/o any cardiac issues Scenario #3. Amount:________ Rapid Response team arrived including anesthesia. Scenario 3 Pulse The pain makes him short of breath. Cardiovascular Assessment Mr. Dominec had his surgical procedure and is doing great. Senario 3 Health Change: Increased acuity Listen to patient concerns A GI cocktail was administered, and the patient stated that it decreased his pain to a 6/10. Anxiety True Family at beside. Full assessment Robert Sturgess, 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Check PRN pain order Release restraints/full range of motion Don Personal Protective Equipment Deficient Knowledge True Arthur Thomason Remind physician to wash his hands before examining the patient Obtain and provide the infectious disease doctor's contact information for him. Scenario 1 Provide a few chairs if possible for her family to also be comfortable Senario 3 Radial: ____ + Bilateral Other: _____________ RLE: Non-pitting Pitting ___ + 2Provide comfort in pre-surgical room Mr. Dominec. After leaving the room the provider tells the nurse that he hopes that he scared him into compliance with the treatment options. Visual assessment Deficient knowledge: True Cough: Combien gagne t il d argent ? Her husband who is present states, "I thought it was just a lumpectomy she was having this morning." -Discuss with family sitter if there are any other family members who can help with monitoring Lithia Full assessment -Start IV Senario 3 You are the now the Surgical ICU nurse assigned to her. How does the Med-surg simulator work? Shock False Impaired Home Maintenance management r/t client or family False Notify doctor if condition is abnormal Scenario 1 Acute Pain True Educate patient You arrive in room to check on her, after washing hands. Scenario 3 Scenario 2 Notify lead nurse Her husband and children remain with her in the surgical holding area awaiting transport to the OR. Chronic Pain False The charge nurse tells the nurse to take Mr. Burgundy to the floor, because his room is now ready. Pain = 2 Mr. Duncan is now complaining of feeling "dizzy" when he stands. Radiofrequency ablation, which uses heat to remove abnormal esophagus tissue. Encourage fluids Read PT report Scenario 2 Scenario 5 Last pain medicine 2hrs ago at 1300(Demerol 50mg/ Zofran 4mg IV). Strict I&O, regular diet, intake 50%. Water/Flush: Mr. Duncan's wife meets you in hall asking what she could bring her husband to eat from home. Impaired Home Maintenance Management False The patient will be discharged today, and he will be ordering new prescriptions. He also states he is feeling weak. Patient and family upset regarding dx. Sleep deprivation False Purposive Communication Module 2, Chapter 1 - Summary Give Me Liberty! Flexes abnormally = 3 Sensorium Normal acuity, Physiological Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. Love and belonging- Senario 1 Acute Pain True 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. -Reapply the NC that he was admitted with at 2L Genitalia: WNL (skin intact, no lesions) Abnormalities Describe: __________________________ Acute Pain: True Perineal Care Need frequent reminder to stay in room and maintain mask precautions.