robert sturgess swift river robert sturgess swift river

Excess Fluid Volume, Risk for False Mrs. Stukes is a failed laparoscopic cholecystectomy that resulted in a bowel resection with a temporary ileostomy in place. Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. Assign nursing diagnosis and plan the appropriate intervention and evaluate outcomes while working through time pressure and distractions, including random call light requests. The patient is awake alert and oriented. Scenario 2: 1Educate about recovery from appendectomy and care to wound. He was recently treated for a URI with a Z pack, prednisone, and Motrin for pain. Oriented to: Person Place Time and the GI cocktail given in the ER did relieve his CP but not completely. His VS are BP 122/64, P 89, R 12, SpO2 93%. Expresses fatigue, fear, concern, and desire for recovery. The patient has been scheduled for an EGD today and has an order for Omeprazole (Prilosec) and Carafate (sucralfate). Check PRN pain order The patient states that the symptoms occurred in the middle of the night and woke him from his sleep. Compromised Family Coping False Document results and findings Neuro WNL, alert, and cooperative. -Inform Mr. Burgundy that he cannot report from the ED, as patient privacy is strictly protected by HIPPA Sit at an eye level. Obtain patient record and follow patient as he is transferred to ICU Scenario 4 VS: BP 158/90, HR 89, R 18, T 97.8 F. Senario 4 Safety Constipation, risk for: True Patient demonstrates urine strain procedure. Ineffective Peripheral Tissue Perfusion False Use therapeutic communication/Active Listening Her husband and children remain with her in the surgical holding area awaiting transport to the OR. Scenario 4 Mr. Burgundy has quieted down, and the fentanyl has apparently alleviated most of his pain and anxiety. Where is my camera man!! Document findings -Explain that Docetaxel is a hormone therapy that suppresses the testosterone that your testicles produce producing similar results as surgical intervention. However, he quit three years ago when he remarried; he and his wife have a nine-month-old baby. Call Rapid Response protocol initiated Bleeding, Risk for True Mr. Mancia's vital signs upon assessment are Temp 101.2, P 94, RR 20, BP 122/82, SaO2-91%. How does the Med-surg simulator work? Scenario 3 Mr. Sturgess is now declining, and family members are requesting to remain in room past normal visiting hours. -Reassess patients' vital signs, and place on q5 minutes continuous monitoring At Risk, Impaired Comfort False Shock, Risk for: False Scenario 2 -Explain procedure to the patient Therapeutic communication Assess for bowel sounds Tunneled, site _______________ Implanted port, accessed _____________________ Mr. Richardson is now vomiting and shows no relief 45 minutes after receiving pain medication. In the interim, start an IV and start infusing Ringers Lactate. When you enter the room, the patient is having chest pain again, and they are pale and diaphoretic. 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He has been taking his HIV medication daily. Elevate Extremity Scenario 1 -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 Senario 2 Assess toe movement and capillary refilling "I am feeling fine." She has been documented as being obese, new onset. Mrs. Pittmon states she has had numbness for years but "now I can't . Fall Risk: Increased acuity Primary: Check LOC, Orientation, Breathing, Circulation, Brief Neuro assessment to include spinal pain or deformities, Obvious injuries. Increased fall risk. Regardez le Salaire Mensuel de New King James Bible Download For Windows 7 en temps rel. Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions StuDocu University Keiser University Western Governors University Full assessment Urination: WNL Burning Frequency Urgency Hep-Lock in place left AC. 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. Pain Scale: 0 to 10: _______________ Scenario 3 Safety Place call light and check bed for safety Palliative care. -Notify HCP of neuro findings Full assessment The patient has a pneumothorax that requires a chest tube placement. After 24 hours, Ms. Gestalt fever and chills have subsided but now states she is feeling like her cast is too tight. The patient will be discharged today, and he will be ordering new prescriptions. He has been readmitted for a red spot on his sacrum of 1 cm and a 2 cm blister on his right heel. Ruth Cummings Trustee Vice Chair Audit Chair . Hx of dementia, from nursing home, fall one day ago. Scenario 1 Safety Increased acuity, Physiological ADA diet, intake 25%. Present health assessment including B/P and LOC and dressing. Scenario 4 1Perform full assessment and provide anti-nausea medicine. No Known allergies (NKA). Scenario 4 Evaluate/modify plan of care It was diagnosed by a portable X-ray and quickly splinted by the ER staff. Mr. Thomason appears now better oriented and MD arrives unexpectedly to examine him. Fall, Risk for True Senario 3 Pain Level Increased acuity He does not have an IV nor is he on oxygen. Document and prepare to transfer to Surgical ICU Mr. Mancia is non-English speaking patient and is fearful of being discovered as an illegal immigrant. Sleep Deprivation False -When the HCP arrives, stay in the room to determine whether you can continue care with the patient Scenario 4 Electrolyte Imbalance False Sensorium Increased acuity, Physiological Infection, risk for: False. #ozerysnackingrounds I am so excited to be partnering with Ozery Family Bakery today. Pain = 2 However, these abnormal cells do not have the capability to spread to other parts of the body. Scenario 5 Mr. Gonzales H/H is 12.7/38. Radial: ____ + Bilateral Other: _____________ RLE: Non-pitting Pitting ___ + You question her while reviewing her operative consent and determine that everything is correct. His original lymph node biopsy was negative. Fatigue True Dysfunctional Gastrointestinal Motility False The cancer was more advanced than they previously had thought so inguinal lymph nodes were removed. Impaired Gas Exchange False Last pain medicine 2hrs ago at 1300(Demerol 50mg/ Zofran 4mg IV). Swallowing: Intact Dysphagia Aspiration Precautions Acute Pain True No known allergies (NKA). Sa fortune s lve 1 900,00 euros mensuels Esteem -Recheck Tilts after the NS bolus is complete.T Self-Care Deficit: True She has IV access and has received a small dose of Valium to reduce apprehension. Safety- Hopelessness: True Description: Sharp Stabbing Throbbing Aching Cramping Other: Infection, Risk for True Full assessment Scenario 3 Assessment of bowel movement This information is HIPAA protected and you cannot share anything with them. Physiological- No response = 1, Range of Motion: Full, Limited She is also investigating bone marrow transplantation. Robert Strurgess Odor: __________, *Types: Abrasion, Burn, Laceration, Puncture, Surgical, Pressure Ulcer, Vascular Ulcer, Maceration, Excoriation, Skin You arrive in room to check on her, after washing hands. Scenario 5 Scenario 3 Tubes: None Salem Sump Nasoduodenal PEG J-Tube pH: ______ Mr. Duncan's wife meets you in hall asking what she could bring her husband to eat from home. Auscultate peripheral pulses and ROM. LLE: Non-pitting Pitting ___+ Anxiety True You are concerned about preventing the patient from falling. A new graduate nurse receives a call from the hospital telling them to report to the ER immediately for a disaster. Respiratory Rate: WNL Tachypnea Bradypnea The nurse identifies self to the nurse triaging patients and is directed to trauma room 4. Acute Pain True Pregnancy and labor and delivery are not typically associated with the concept of cellular regulation, Patient: Donald Lyles,52-year old male, was admitted yesterday evening for stabilization of his uncontrolled type II diabetes. Arthur Thomason Assess food consumption and intake and output 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. -Notify charge nurse Scenario 5 Scenario 2 The client is onDemerol 25mgSlow Intravenous Push (SIVP) for pain. He also states he is feeling weak. Stoma Status: Pink-Red/Moist Dusky Retracted Excessive bulging Combien gagne t il d argent ? Mrs. Smith shares with you that even though she signed the operative consent she was not sure if this was the right surgical procedure for her. Scenario 4 Upon entering room, you find Mr. Sturgess is quiet, appears tense and rigid but states, "I am feeling fine." Neuro WNL alert and cooperative. Impaired Skin Integrity False Fall, risk for: True RUE: ______________ LUE: _____________ Swift River Medical-Surgical. Establish second IV Senario 2 -Reinforce to the patient to not get out of bed Administer antiemetic medication Chronic Confusion False Use therapeutic communication/Active Listening Impaired Skin Integrity, Risk for True Grieving: False. Combien gagne t il d argent ? Contact dietary consult Three hours later, Ms. Getts is unsteady when standing by her bedside. Scenario 1 Wash hands Include patient condition change in shift report Dr. Small at bedside with patient and family. Determine from medical record if partner is aware of his recent AIDS diagnosis. Ambulates with assistance. RLQ: RUQ: LUQ: LLQ: Shock False Tear, Ecchymosis, Contusions, Bruising Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. The nurse arrives and sees a tent is being erected as a triage area, and ambulances are lined up delivering trauma patients. Wash and glove hands #1: _________, No Full assessment including both lying/standing Mr. Greer is on the floor still but is awake and oriented and is complaining of back pain below his right scapula. Safety Increased acuity, Physiological August 13, 2020 // by Angela McGowan. Document results/findings Readiness for Self-Care Enhancement True He is aware that he may not have an erection and may need depends for bladder incontinence. Vital sign assessments Bleeding, Risk for: True Hypothermia False Scenario 2 Provide verbal report to team members who respond to rapid response References; Access My Virtual Clinicals; Medical-Surgical. Full assessment of patient. Disturbed body False Scenario 1 Scenario 4 Notify family as to when they may come and visit. Deficient Knowledge False Scenario 3 Psychological Needs Increased acuity Temperature is now 102.8. Carlos Mancia Scenario 3 Fall Risk Increased acuity Amount:________ Remain with patient Bleeding, Risk for False is a 57 y/o who has been admitted for a radical prostatectomy. Assess vital results He has a history of well controlled GERD with over-the-counter Tagamet (Cimetidine), and Tums. Aggravating Factors: Educate patient All our products can be personalised to the highest standards to carry your message or logo. Vital Assessment Report to charge nurse/ head nurse the need for staff education. -Explain to Mr. Burgundy that space in the ED is allocated based off of patient need -Using therapeutic communication inform Mr. Greer that there are many treatment options, and not to leave until the HCP can come and speak with him -Discuss with family sitter if there are any other family members who can help with monitoring Lithia Scenario 5 Senario 3 Pulse Enter the email address you signed up with and we'll email you a reset link. IV maintenance fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in left forearm. Scenario 3 -Start an IV He chooses to go home and see the doctor tomorrow in his office. -Reassess patient's physical status prior to leaving him in the hallway Ms. Getts is now complaining of sudden sharp, substernal chest pain, very short of breath and is profusely diaphoretic. Tap patient and ask, "Are you okay?" Skin Integrity: Intact No, describe below, Location Type Size Wound bed Drainage Check pedal capillary refill Acute Pain False Skin integrity at risk True Background Robert Sturgess the client was admitted with Metastatic cancer of Colon, with history of diabetes. Document Results, Robert Sturgess, 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Respiratory Assessment Assess Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Flexes abnormally = 3 Ineffective breathing pattern False Notify doctor and charge nurse Noncompliance True. Vital signs -Temp 98.8, BP 102/76, P 102- irregular, RR 22, SaO2 90%, cardiovascular on telemetry with Sinus irregular rhythm. Increased fall risk. Pupils: PERRLA Size: R: mm L: _mm Unequal Sluggish Non-reactive Check input/output for possible dehydration Fall, risk for: True Inappropriate words = 3 Notify Physical Therapy (PT) Use therapeutic communication/Active Listening Document Procedure -Set-up for stat portable chest x-ray Provide emotional support. Impaired home maintenance mgmg r/t client or family: False It is determined that Mr. Sturgess could achieve better pain control with a PCA pump. Scenario 3 Some hair on the left side of his head has been burned off, as well. They were also concerned about the next patient going into that room and the use of the lavatory. -Ensure patients is positioned in bed properly Vital signs -Temp 98.4,BP 178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. Color:__________ Genitalia: WNL (skin intact, no lesions) Abnormalities Describe: __________________________ Love and belonging Decisional Conflict True Notify doctor if condition is abnormal Disturbed Body True Pulses: Strength & Symmetry Edema: Love and belonging Respiratory Effort: Relaxed, Regular, Non-labored Pursed lip breathing Labored Skin warm and, dry, all vital signs in WNL except 115 pulse, which is normal for him. Family in room with patient very concerned. Dr. Jones. Her pitcher has already been filled three times this shift. Safety Provide emesis basin/cloth Ineffective airway clearance True Use therapeutic communication/active listening Radiofrequency ablation, which uses heat to remove abnormal esophagus tissue. Scenario 5 -Notify HCP of fall, complete incident report Peripheral Neurovascular Dysfunction False Visual assessment Skin warm and pale. Safety- 45 terms. Listen to patient concerns Vital signs -Temp 99.1, BP 124/62, P 77, RR 20, SaO2 91%. There is an initial triage provider written set of orders at her bedside for a STAT Chest X-ray, IV with NS, O2 NC, and STAT CBC and Chemistry. Odor: __________, No D/C plan- decrease pain and restore normal gait. Senario 4 Senario 4 Social Isolation, Risk for True Scenario #2. Scenario 2 Nausea: False NPO with small amount of ice chips only. Verify call light/bed safety precautions Ronald Burgundy What is the ratio of Fe\mathrm{Fe}Fe (II) atoms to Fe(III) atoms in this compound? As you enter the room, Mr. Duncan is refusing to eat foods from bland diet. Scenario 4 Offer assistance in providing more information about treatment options for newly diagnosed AIDS patients. Waist belt restraint PRN; family sitter at bedside, assist with bath. Describe the physical changes from aging and the care required. Impaired Skin Integrity, False -Reassess patient Therapeutic communication. Mr. Duncan is now complaining of feeling "dizzy" when he stands. Health Change Increased acuity Scenario 2 He also complains that his throat is still very sore. Scenario 2 Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Provide comfort measures A GI cocktail was administered, and the patient stated that it decreased his pain to a 6/10. Wash and glove hands RUE: ______________ LUE: ______________ 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 . -Ensure patient privacy and call for help and assist patient to bed once help arrives Senario 4 Toileting, Medications List/Times of Medications/Routes of medication, Neurological Assessment Nausea: False Tom Richardson Check surgical consent for correct procedure and make sure operative site in marked. student name date: nur 113 assessment swift river patient: robert sturgess handoff robert sturgess, 81 years old, metastatic ca of colon, hx of diabetes. The lesion was identified as Kaposi's Sarcoma. Normal Sinus Rhythm on telemetry. 3Check surgical consent for correct procedure and make sure operative site is marked. Scenario 3 Employ therapeutic communication: present reality Offer bedpan Ms. Rails shares with you her fear of being discharged home to an abusive husband. Ineffective Self-Health Management False Lithia Monson He does not want to return to the nursing home, and does not wish to burden or live with his children. Notify doctor for Foley catheter -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. RLE: ______________ LLE: ______________, Casts/Splits: ____________________________, Motor response Verbal command = 6 Fall, Risk for True Check PRN pain order 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. -Reorient Patient to person, place, & time Acute Pain True Constipation False Alleviating Factors: Last pain medication: Flexes & withdraws = 4 Inspect cast site Rapid Response team arrived including anesthesia. Scenario 4 Strict I&O, regular diet, intake 50%. Infection, Risk for False Remain with Patient, Sarah Getts, 77 yr-old, Dx- Chronic Renal Failure, admitted with hyperkalemia (5.9, Eq/L)/hyponatremia (128mEq/L). Skin warm dry, bruises on forehead with small laceration. No known allergies (NKA). Extends abnormally = 2 -Obtain chest tube tray and set-up pleurovac Mr. Greer has just returned from surgery. No weight bearing today. -Call security for assistance and compliance officer Sensorium Increased acuit, Physiological Heterotrophs include (1) autotrophs, saprophytes, and herbivores (2) omnivores, carnivores, and autotrophs (3) saprophytes, herbivores, and carnivores (4) herbivores, autotrophs, and omnivores. Imbalanced Nutrition True DSD (dry sterile dressing), forehead laceration clean and dry intact. Contact Social Services Health Change Increased acuity Check monitor Acute Confusion: True Dx- urinary stones with 3 episodes/5yrs. Disturbed Sensory Perception False Scenario 4 He warns the patient that if he does not comply with the treatment and preventive measures, he will need other treatments that may include. except 115 pulse, which is normal for him. You are the now the Surgical ICU nurse assigned to her. View Swift River Reflection Questions (1).docx from NRSG 4412 at South College. Electrolyte Imbalance True Disturbed Body Image True Perform pain re-assessment Vital re-assessment Notify Doctor for pain medz -Complete incident report. 50% intake. 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. Monitor and evaluate fluid intake Bleeding: True Scenario 3 Scenario 4 You are told that he has intermittent chest pain with substernal burning that radiates to his mid-back. Disoriented to time and place, speech slurred. Evaluate understanding Impaired Urinary Elimination True Decisional Conflict False -Complete full assessment, to include neuro Nutritional Intake: Adequate Inadequate BMI: This will treat any cancer that may have metastasized to the bone. Evaluation patient after consult Document teaching moment. Remind staff that Universal Precautions are practiced at this hospital for all patients regardless of known infectious diseases. Water/Flush: Ineffective Peripheral Tissue Perfusion False Failure to Thrive True. LOC Normal acuity Scenario 3 Sensorium Normal acuity, Physiological Document results Scenario 5 Scenario 4 Reapply restraints Diet as tolerated. Evaluate patient understanding Vital assessment Educate patient Ineffective self-health mgmt: False, Disturbed body: False Scenario 3 Scenario 1 Gait: ______________________________, Skin Integrity Assessment Nausea False Self-Care Deficit False 97.4, Resp 16 and Pulse Ox 94%. -Contact HCP to determine when they are available to speak with the patient Attempt to orient to person, place, and time Ms. Rails was medicated with hydrocodone 5 mg PO two hours ago and is now complaining of pain (8/10 pain scale). Full assessment Mr. Sturgess does not have a living will or durable power of care completed. Document results Scenario 2 Because of the fall the provider has recommended that he stay in the hospital another night. Vital signs- When she moves him to the hallway, Mr. Burgundy begins yelling at you "Do you know who I am, I demand a room! Scenario 1 Take vital signs before leaving the hospital again. The provider explains that it is a pre-cancerous stage in where the cell develops abnormal features. Senario 2 The dinner tray is waiting for the patient in his room, and the nurse notices it is a regular diet. Stay with patient for surgeon's arrival to explain intended surgical procedure LUE: Non-pitting Pitting ___+ Insert Foley catheter Vital Signs: B: 160/92, P: 96, R: 22, SpO2: 98, T: 98.9F, 37.1C. ExplanationAnxiety/ fear True Upon entering the room, the patient appears to be trying to get out of bed Scenario 5 Love and Belonging The patient describes this pain as a heavy pressure with intermittent stabbing. Mr. Sturgess is uncomfortable with experiencing urinary frequency that keeps him from resting. Dyspnea at rest Dyspnea with minimal activity Use of accessory muscles Diet as tolerated, up ad lib after gait training. Scenario 1 -Reapply the NC that he was admitted with at 2L Scenario 3 Due to this, the provider would like him to stay in the hospital for observation. 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. Deficient knowledge: True Sitting, BP 109/60, P 114, Standing the patient becomes very lightheaded and the nurse has them lay back down. Scenario 1 Document and provide copy for Mr. Dominec to share with his follow up appointment tomorrow. Administer PRN constipation medications Regardez le Salaire Mensuel de Ubah Kalimat Efektif Online en temps rel. Consult Social Service Verify call light/bed safety precautions Administer antipyretic meds Ramona Stukes, 69 yr-old, third day post-op cholecystectomy. Social worker with patient this morning. Document findings/results, Ann Rails, 38 years old, c/o back pain, non-significant past medical history. Fall, Risk for True Scenario 3 Continent: Yes No Brief/Diaper Re-assess patient Abdominal Pain: Non-tender Tender/Pain Describe: Verify call Light/bed safety precautions Read PT report