Offer masks to visitors Scenario 5 Educate patient -Use therapeutic communication/active listening Chronic pain: True Stat lithotripsy treatment ordered. In the interim, start an IV and start infusing Ringers Lactate. Impaired Skin Integrity, False Assist physician in physical exam of patient Document results and findings Remind physician to wash his hands before examining the patient Neuro WNL alert and cooperative. 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. 1Perform full assessment and provide anti-nausea medicine. Vital signs -Temp 98.4, BP 116/76, P 96, RR 20, SaO2 99%. Sensorium Normal acuity, Physiological LLE: Non-pitting Pitting ___+ Scenario 1 Perform pain re-assessment He has been taking his HIV medication daily. Skin integrity, impaired True Educational Needs Increased acuity Perform pain reassessment Scenario 2 Clear liquid diet. Day 2 admission, Thomas Richardson is complaining of severe pain and is now begging you for some relief; states pain scale 10/10. Vital Assessment RS Vclinical Flowsheet - Student Name : Date: NUR 113 Assessment Swift Activity as tolerated with assistance. Bladder distention Pelvic pain Low back/flank pain Color:__________ Verify call light/bed safety precautions Isolative, appears fearful, crying, and refusing to see her husband. How was this Refer call to contact health department Chronic Pain False He requests no visitors at this time, but later asks for his family to be called to discuss a plan of care. You discuss this cough with Mr. Dominec to determine how long he has had it. Noncompliance False He has a history of well controlled GERD with over-the-counter Tagamet (Cimetidine), and Tums. Skin warm and dry, daily dressing changes, T-tube without drainage. Scenario 2 Pain and numbness in legs for one week. Sit at an eye level. NKDA Assessment The client vital signs are: Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%, Neuro WNL alert and cooperative. -Reapply the NC that he was admitted with at 2L -Complete full assessment, to include neuro Vital signs Temp 99.4, BP 106/72, P 96, RR 20, SaO2 91%. Scenario 3 Discharge instructions You determine to apply the restraint now. When you enter the room, the patient is having chest pain again, and they are pale and diaphoretic. You are about to call the Surgical ICU and give report. This will treat any cancer that may have metastasized to the bone. It was diagnosed by a portable X-ray and quickly splinted by the ER staff. You are now preparing for discharge, place steps in order: Senario 1 However, these abnormal cells do not have the capability to spread to other parts of the body. Evaluate patient understanding -Verify that discharge orders have been written, provide discharge instructions, and in inform provider about the chest pain. The nurse arrives and sees a tent is being erected as a triage area, and ambulances are lined up delivering trauma patients. Administer PRN constipation medications Scenario 4 Pain Level Increased acuity 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. Safety- Her chart reports she was extubated upon arrival to the recovery area, received three units (3000 mL) of fluid, receiving O2 @ 4L via nasal cannula, has Foley Catheter in place draining QS clear yellow urine, responds to verbal stimulation, chest dressing in place remains dry and intact, and has just received a small dose of IV morphine for pain. Document Procedure Impaired Comfort True His CP is 7/10 and his BP is 165/96, P 92, R 18, SaO2 98 on 2L NC. Scenario 2 Scenario 3 You also notice the patient is more difficult to orient. Impaired Gas Exchange False -If cardiac is suspected call the provider and the rapid response team. Mr. Richardson is now pain free and questioning why he is plagued with recurring urinary stones. Mr. Burgundy now has his cameraman filming in the ED and is attempting to do a live report. -Complete initial post-op assessment Scenario 1 He is complaining of pain in his left arm, and pain in his left chest when he tries to take a deep breath. Scenario 1 Wash hands Roger Clinton, 57-year-old male construction worker arrives at 0600 to be prepared for a partial thyroidectomy to determine if he has cancer. Apply fall risk bracelet 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. -Check patency of Foley catheter, urine color, and ensure it is secure to the patient's leg Therapeutic communication. Robert Sturgess Scenarios Swift River.docx - Course Hero Swallowing: Intact Dysphagia Aspiration Precautions Evaluate medication effectiveness Rapid Response team arrived including anesthesia. 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. student name date: nur 113 assessment swift river patient: robert sturgess handoff robert sturgess, 81 years old, metastatic ca of colon, hx of diabetes. Regardez le Salaire Mensuel de Ubah Kalimat Efektif Online en temps rel. Scenario 5 Document conversation Obtain urinary screen Robert Sturgess Robert Sturgess 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Educate patient The provider explains that it is a pre-cancerous stage in where the cell develops abnormal features. Impaired comfort: True Verify call light/ bed safety precautions Teach patient about safety when getting out of bed Najvyia ponuka (2013) | Filmotka | SFD.sk Students will assign correct nursing diagnosis for patients in a medical surgical virtual clinical environment. Robert Strurgess Noncompliance True. Take vital signs before leaving the hospital again. NPO with small amount of ice chips only. Notify lead nurse He has a history of hypertension and is not compliant with medication. Combien gagne t il d argent ? Love and Belonging ADA diet, intake 25%. Scenario 1 Ms. Getts is requesting water to drink. Nausea/Vomiting: Yes No Hypothermia False Encourage fluids Fall, Risk for False Allergic to sulfa drugs. Scenario 4 Wash and glove hands Disturbed body False Lithia Monson Bowel sounds: Active, Hyperactive, Hypoactive, Absent (listen for full 5 minutes) Provide comfort measures Scenario 1 Psychological Needs Normal acuity Ineffective airway clearance True Evaluate understanding. Communication/Speech: Clear Non-verbal Slurred Aphasia Other Scenario 1 Determine clinical decisions based on listening to an audible client report. Ms. Rails states that she has not had a bowel movement (BM) in the past two days. Ineffective Airway Clearance True Start secondary large bore IV line Educate patient regarding patient care Acquire daily weight and food intake Deficient Knowledge False -Medicate for pain Educate patient regarding condition Fortune Salaire Mensuel de Tthuchicago Org Combien gagne t il d argent It is determined that Mr. Sturgess could achieve better pain control with a PCA pump. Disturbed Sensory Perception True Scenario 5 Mr. Richardson is requesting assistance to ambulate to bathroom. -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. Neuro WNL's, alert and cooperative. Acute pain: True But that's changing. Teach Cameron. Suprapubic Insertion site: WNL S/S Infection : ____________________ Offer assistance in providing more information about treatment options for newly diagnosed AIDS patients. Safety Anxiety True Scenario 4 -Explain to the patient that he has a procedure, and he cannot eat. Swift River Medical-Surgical. Apical Pulse Rate: Heart Sounds: Normal S 1 S 2 S 3 Fall, Risk for True Notify Doctor for pain medz Scenario 4 Ms. Monson has been in restraints for the past two hours with a nursing assistant remaining with her. Swift River Nursing Simulation - Homework Writing Services Sarah Getts -Reassess patients' vital signs, and place on q5 minutes continuous monitoring Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. The oncologist is insistent that the treatment begin immediately. Deficient Diversional Activity False Deficient Fluid Volume True Provide Operative summary of type of procedure, IV fluid and pain status. The heartburn has become worse since he started treatment for his URI. Evaluate/modify plan of care He has partial thickness burns to his left arm and the left side of his face. Elevate Extremity Inform his partner that everything is being done to keep him comfortable. Blood Glucose 185, 4 units of insulin sliding scale for coverage. Contact Social Services Wash and glove hands Safety Carotid:____ + Bilateral Other: _____________ RUE: Non-pitting Pitting ___+ Because of the fall the provider has recommended that he stay in the hospital another night. -Reassure patient that he will be moved to a private room as soon as possible Hopelessness: True Safety No response = 1, Muscle Strength: WNL, Flaccid, Contracted Sleep deprivation False Cardiovascular has pacer with rate of 82bpm on demand. Scenario 3 Scenario 5 -Have patient remain in bed, head elevated 30 degrees -Ensure there is suction in the room, and check Scenario 2 Re-assess patient Combien gagne t il d argent ? -Offer nutrition and/ or toileting Physiological- Scenario 5 Tear, Ecchymosis, Contusions, Bruising Scenario 1 Knowledge Deficit True He told the nurse that he has had some changes in his bowel habits and his stools have been very dark. Non-significant past medical Hx. She has been admitted to the floor with complaints of numbness in her right foot and ankle. Bleeding, Risk for False Scenario 4 Make-Up Clinic Day 3 MS - Swift River Assignment: Make-up Day 3 Swift Assist patient out of bed Stay with patient for surgeon's arrival to explain intended surgical procedure Scenario 4 When a physician makes an incision into a body cavity just superior to the diaphragm and inferior to the neck, what body cavity will be exposed? Neptune is an average distance of 4.5109km4.5 \times 10^{9} \mathrm{km}4.5109km from the Sun. He is emotionally distraught, and is insisting that he be allowed to report what is going on from the ED. Scenario 1 Decreased cardio tissue perfusion: False Provide for physical and thermal comfort. Fall Risk Increased acuity Sensorium Normal acuity, Physiological Yes Productive Non-productive Describe Sputum: _______________________ Regardez le Salaire Mensuel de New King James Bible Download For Windows 7 en temps rel. Neuro WNL alert and cooperative. He replies, "six times in the past four hours". Purposive Communication Module 2, Chapter 1 - Summary Give Me Liberty! -Explain to Mr. Greer that it may take several days for healing, and he may have temporary incontinence, but it will resolve over time. Scenario 3 Vital Signs: B: 160/92, P: 96, R: 22, SpO2: 98, T: 98.9F, 37.1C. Apply nasal cannula Psychological Needs: Increased acuity -Inform Mr. Burgundy that he cannot report from the ED, as patient privacy is strictly protected by HIPPA Mrs. Stukes is a failed laparoscopic cholecystectomy that resulted in a bowel resection with a temporary ileostomy in place. Outline an experimental approach to demonstrate the average RNA chain growth rate during transcription of a cloned gene in vitro. The patient asks the nurse to explain about these medications and why they are in such a hurry. DOCX Swift River Online Learning - Taxonomy Tom Richardson Tunneled, site _______________ Implanted port, accessed _____________________ Swift River Reflection Questions 1 - Swift River - Course Hero Document results Biopsies were sent to determine the treatment. Allow husband to come into recovery for a quick one-minute visit. Due to this, the provider would like him to stay in the hospital for observation. Therapeutic communicationT The charge nurse asks you to assume the patient's nursing care. Safety Document pt's statements. He is having some difficulty hearing and complains of ringing in his ears. Safety Scenario 5 Allow for non-compliance of request Administer antipyretic medication Deficient Knowledge False Stoma status: Pink-Red/Moist Dusky Retracted Excessive bulging Contact charge nurse. She has received a dose of Hydrocodone for PRN pain 20 minutes ago. The provider advises the Nurse to draw a stat CBC, give a liter bolus of NS, and repeat CBC. LOC Increased acuity Scenario 2 Scenario 2 Remind staff that Universal Precautions are practiced at this hospital for all patients regardless of known infectious diseases. He also complains that his throat is still very sore. The nurse was told by the gastroenterology nurse that they really struggled before they called anesthesia and they may have caused an esophageal abrasion. Palliative care. Perform circulatory evaluation Perform circulatory evaluation Health Change Increased acuity -Explain that Docetaxel is a hormone therapy that suppresses the testosterone that your testicles produce producing similar results as surgical intervention. Scenario 3 Her husband and children remain with her in the surgical holding area awaiting transport to the OR. Some hair on the left side of his head has been burned off, as well. Evaluate outcome of dietary plan No Known allergies (NKA). 45 terms. Notify doctor Check input/output for possible dehydration Scenario 5 No Known allergies (NKA). After two hours, Mr. Dominec is alert and cooperative, nauseated and concerned about impending surgery this evening. Skin integrity at risk True Incomprehensible Notify doctor river part Answers to the questions; Fillable SOC 1 DLA 1; Fillable SOC 1 DLA 2 - Notes on Environmental effects through sociology . List the nursing care order. Secondary: Assess vital signs, auscultate heart, lungs, and bowl sounds. Dysfunctional Gastrointestinal Motility False Decisional Conflict True Health Change Increased acuity LUE: Non-pitting Pitting ___+ There is an order to apply a waist belt restraint if needed. August 13, 2020 // by Angela McGowan. Document results and findings -Provide a diversional activity to pass the time while waiting on the HCP and inform wife that the HCP will be coming soon Love and belonging- 20 ga. Hep-Lock in right forearm, skin warm and dry, generalized weakness with recent weight loss. The patient states that the symptoms occurred in the middle of the night and woke him from his sleep. Health Change Increased acuity -Continue to observe urine for hematuria and document findings Mr. Sturgess does not have a living will or durable power of care completed. Insertion site: Dry/Intact Redness Tenderness/Pain Warmth Coolness Swelling Drainage Color:__________ Escort patient Insertion Site: Dry/Intact Redness/Erythema Drainage Tenderness Maceration You take his vital signs which are: Temp 101.3, Pulse 88, Resp 24, B/P 116/84. It is now two weeks later; Mrs. Smith has returned. Adjust crutches -Call security for assistance and compliance officer -Tell the patient that they are being admitted to r/o any cardiac issues Powerlessness: True, Scenario 1 A new graduate nurse receives a call from the hospital telling them to report to the ER immediately for a disaster. Anterior: ___________________________________ Posterior: ____________________________________ Document and prepare to transfer to Surgical ICU -Start an IV No Known allergies (NKA). Ineffective breathing pattern False Blood-tinged mucous, productive cough. Wash and glove hands NG tube to low suction possibly D/C'd today after Dr. Levine rounds. Bleeding False Acute Confusion False Nathaniel Gonzalez Diet as tolerated. Put the patient on O2 NC and Fentanyl 25mcg IVP for pain. 4Inform his partner that everything is being done to keep him comfortable. Upon assessment, you determined that she is confused to person, time, and place but is easily directable. Fall, Risk for True Allow family to remain Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. Imbalanced Fluid Volume, Risk for True Scenario 4 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. 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. Apical pulse rhythm: Regular Irregular Location: Heterotrophs include (1) autotrophs, saprophytes, and herbivores (2) omnivores, carnivores, and autotrophs (3) saprophytes, herbivores, and carnivores (4) herbivores, autotrophs, and omnivores. Scenario 4 Constipation False Normal Sinus Rhythm on telemetry. You, his prior nurse, notice the family and respond to them. Skin warm dry, bruises on forehead with small laceration. Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. Compromised Family Coping: False Educational Needs Increased acuity You escort them with you to the ICU. Pulses: Strength & Symmetry Edema: 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. Urine Color: Clarity: Odor: Palliative care. Full assessment Neuro WNL alert and cooperative. Scenario 4 Impaired Home Maintenance Management r/t Client or Family False Senario 1 Obtain and provide the infectious disease doctor's contact information for him. Imbalanced Nutrition True Deficient Knowledge True Provide verbal report to team members who respond to rapid response Odor: __________, No Swift River Med Surg Scenarios Answers - Homework Score The MD on site makes the decision to intubate the patient and start ventilatory assistance and move the patient to Respiratory Intensive Care. r/o Tuberculosis. Full assessment Dr. Altace, Physiological- Administer pain medications #ozerysnackingrounds I am so excited to be partnering with Ozery Family Bakery today. Provide emesis basin/cloth No known allergies (NKA). Chronic Confusion False Perform circulatory evaluation Temp Document results Vital signs taken by automatic B/P Cuff q 15 minutes The oncologist is recommending Docetaxel as opposed to an orchiectomy. Grieving False Respirations -Assess patient's understanding of the teaching and discuss home support, os de la main et de la ceinture pelvienne, Julie S Snyder, Linda Lilley, Shelly Collins. The patient has a pneumothorax that requires a chest tube placement. Anxiety False Two hours later, Mr. Duncan is asked how frequent his stools have been today. Remain with patient Visual assessment Scenario 3 Scenario 5 Hx of dementia, from nursing home, fall one day ago. Scenario 5 Assessment of bowel movement Assess for bowel sounds You arrive in room to find Ms. Monson talking to herself. The patient has a Foley catheter in place and is reporting 8/10 incisional pain and he is asking why his throat is sore. Ruth Cummings Trustee Vice Chair Audit Chair . Vital assessment Notify doctor Constipation, risk for: True Course Hero is not sponsored or endorsed by any college or university.

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