-Explain to Mr. Burgundy that space in the ED is allocated based off of patient need Tibial: _____ + Bilateral Other: ______________ Generalized: Pedal: ______ + Bilateral Other: ____________ Sacrum: Non-pitting Pitting ___ +. Electrolyte Imbalance False Chronic Pain False Scenario 2 Imbalanced Fluid Volume, Risk for True Skin warm dry, bruises on forehead with small laceration. Evaluate medication effectiveness His partner is at the bedside asking, "how much longer will he have to wait until taken to surgery?" Recently he manifested an unusual black lesion on his thigh and developed an opportunistic fungal mouth infection which was treated successfully. Mr. Gonzalez has been admitted to the floor to determine that his chest pain is not related to a cardiac event. Upon entering the room, you find Ms. Rails sleeping. Acute Pain True Scenario 3 Full assessment IV D5 1/2 NS @150ml/hr. Wash and glove hands Upon assessment, you determined that she is confused to person, time, and place but is easily directable. Students will prioritize medical surgical . Shock False Mr. Mancia is holding Catholic Rosary in hand and is crying as you enter the room. Scenario 1 Bleeding, Risk for False 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. Educational Needs Increased acuity Neptune is an average distance of 4.5109km4.5 \times 10^{9} \mathrm{km}4.5109km from the Sun. Safety- Provide comfort and pain measures Deficient Diversional Activity False Bleeding False Wash and glove hands Scenario 4 -Reassess patient q 5 minutes until awake, then 15 minutes until they are fully awake (not Drowsy). LLE: Non-pitting Pitting ___+ Scenario 2 Vital signs -Temp 98.2, BP 94/60, P72, RR 22, SaO2 99%. -Complete neuro checks as ordered Upon entering the room, you find Mr. Sturgess is quiet, appears tense and rigid but states, Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Neuro WNL's, alert and cooperative. 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. Acute Confusion True Stoma status: Pink-Red/Moist Dusky Retracted Excessive bulging Mr. Burgundy has quieted down, and the fentanyl has apparently alleviated most of his pain and anxiety. Swift River Clinical Practice Chamberlain University - Homework Score Electrolyte Imbalance True It is now the second day post op and he is given discharge information. Family at beside. Verify call light/bed safety precautions 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. The pain makes him short of breath. Evaluate learning Robert Strurgess Pain Level Increased acuity Senario 2 He is complaining of pain in his left arm, and pain in his left chest when he tries to take a deep breath. Patient, and family upset regarding dx. Encourage fluids Senario 3 Document results Nutrition True Employ therapeutic communication: present reality The patient is awake alert and oriented. -Medicate for pain Senario 1 Document results/findings Bleeding Risk for: False 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. Mr. Dominec had his surgical procedure and is doing great. Odor: __________, No Provide verbal report to team members who respond to rapid response Reassure patient of options John Duncan, 56yr-old male, Dx- Gastroenteritis, returned yesterday from Cancun, c/o intractable diarrhea, weak, pale, and refusing to eat. Verbal command = 3 Scenario 5 Adjust crutches Awaiting diagnostic labs. 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. Purposive Communication Module 2, Chapter 1 - Summary Give Me Liberty! Use therapeutic communication/Active Listening Assess for bowel sounds Psychological Needs: Increased acuity However, these abnormal cells do not have the capability to spread to other parts of the body. Evaluate/Modify Mobility Plan, Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical Hx. Physiological- Linen Change Disoriented, confused = 4 jasmine . Senario 5 She receives the pre-op medication. Describe the physical changes from aging and the care required. When she moves him to the hallway, Mr. Burgundy begins yelling at you "Do you know who I am, I demand a room! 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. Pulse Discharge instructions -Complete initial post-op assessment Scenario 4 Skin warm and dry, all vital signs in WNL It was diagnosed by a portable X-ray and quickly splinted by the ER staff. Educational Needs Increased acuity Acute pain: True Refer call to contact health department Constipation False Scenario 4 Begin post op education for day one Contact head nurse or supervisor in the OR to evaluate new situation Allow for non-compliance of request Cryotherapy, which uses an endoscope to apply a cold liquid or gas to abnormal cells in the esophagus. **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 . Scenario 2 Assessment of bowel movement 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. The oncologist is recommending Docetaxel as opposed to an orchiectomy. Ambulates with assistance. Educate patient No response = 1, Range of Motion: Full, Limited Decreased Cardiac/perfusion: False Offer masks to visitors Peripheral Neurovascular Dysfunction: False Acute Pain: True Scenario 2 You explain that his condition has worsened and now he has been taken to ICU. He is having some difficulty hearing and complains of ringing in his ears. Obtain translator Contact charge nurse. We have more than 20 years' experience in the industry providing a quality service to our clients We pride ourselves on our customer-orientated service and commitment to delivering high end quality goods within quick turnaround times. Encourage Mr. Dominec to discuss with his partner his best treatment options. Urination: WNL Burning Frequency Urgency Vital signs -Temp 98.4,BP 178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. Deficient Fluid Volume True Swift River Med Surg Scenarios Answers - Homework Score Intermittent/Continuous Other: -Check patency of Foley catheter, urine color, and ensure it is secure to the patient's leg Assist patient out of bed Pain: No Yes: Location: ______________________ Acute Chronic Constant Intermittent -When the HCP arrives, stay in the room to determine whether you can continue care with the patient Failure to Thrive True. Dr. Anderson, Educational Needs Increased acuity Assess food consumption and intake and output 3. Radiofrequency ablation, which uses heat to remove abnormal esophagus tissue. 20ga. LOC Normal acuity NG tube to low suction possibly D/C'd today after Dr. Levine rounds. Provide information for MD to call family at home and explain what has just happened Pain affecting: N/A Sleep Activity Exercise Relationships Appetite Concentration Tube Feeding: Type:_________________________ Amount/Rate: ________________________ Bolus/Infusion Hopelessness: True Disoriented to time and place, speech slurred. He has not had his BP medication today. Inform and educate spouse of dietary orders Scenario 4 Mr. Sturgess is recently dx w/ metastatic cancer of colon and he and his family have chosen only Scenario 5 Ineffective breathing pattern False Educational needs: Increased acuity Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Remain with patient No known allergies (NKA). 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. Vital signs -Temp 97.2, BP 96/74, P 82, RR 20, SaO2 97%. Consult Social Service 20ga. Ms. Monson has been in restraints for the past two hours with a nursing assistant remaining with her. -Perform neuro assess The lesion was identified as Kaposi's Sarcoma. 45 terms. Call rapid response Mr. Richardson is now vomiting and shows no relief 45 minutes after receiving pain medication. Waist belt restraint PRN; family sitter at bedside, assist with bath. Students also viewed Culture Concept notebook Development concept notebook Elimination concept notebook Gas Exchange concept notebook Carotid:____ + Bilateral Other: _____________ RUE: Non-pitting Pitting ___+ Dr. Altace, Physiological- Identify patient Sensorium Normal acuity, Physiological Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Perform neuro assess Acquire daily weight and food intake Wash and glove hands Present health assessment including B/P and LOC and dressing. Inappropriate words = 3
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