IV Assessment/ N/A Regardez le Salaire Mensuel de Nba 2k23 Pc Review en temps rel. Scenario 2 Wash and glove hands Noncompliance: False Chronic Pain False Tom Richardson Radiofrequency ablation, which uses heat to remove abnormal esophagus tissue. The nest morning the gastroenterologist informs Mr. Gonzalez that his EGD confirmed a diagnosis of Barrett's esophagus with Dysplasia. The patient is awake alert and oriented. Love and Belonging Imbalanced Nutrition True Offer assistance in providing more information about treatment options for newly diagnosed AIDS patients. -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 Deficient knowledge: True The client is onDemerol 25mgSlow Intravenous Push (SIVP) for pain. Family in room with patient very concerned. Increased fall risk. Vital signs taken by automatic B/P Cuff q 15 minutes 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 . Evaluate understanding No response = 1, Mobility: You enter patient's room. Senario 2 GI WNL. Skin warm and dry, may sit up on edge of bed today. Scenario 2 Administer pain medications Perform pain re-assessment -Inform patient to not get out of bed without assistance and place call light in reach Odor: __________, No Pain Level Increased acuity Ms. Cumble is in bed and appears comfortable and requests assistance from you to get out of bed to go to the bathroom. Monitor and evaluate fluid intake A GI cocktail was administered, and the patient stated that it decreased his pain to a 6/10. -When the HCP arrives, stay in the room to determine whether you can continue care with the patient 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. Urination: WNL Burning Frequency Urgency Perform full assessment and provide anti-nausea medicine. Upon assessment, you determined that she is confused to person, time, and place but is easily directable. Deficient Knowledge False He has a history of hypertension and is not compliant with medication. Self-Care Deficit False Reassure patient of options -Reassess patient q 5 minutes until awake, then 15 minutes until they are fully awake (not Drowsy). Document results and findings Social Isolation, Risk for True Combien gagne t il d argent ? -Restart the IV and draw CBC Mr. Dominec has a male partner and has been married for the past ten years and share their three children to the marriage. Chronic pain: True Senario 2 Assess food consumption and intake and output Acute Pain: True Verify call light/bed safety precautions Ineffective Peripheral Tissue Perfusion False Diet as tolerated. -Remind patient to call for help is he need to get up and provide patient with a urinal. Document results Aggravating Factors: Mr. Wright is pleasant and cooperative, but needs to be reminded to avoid pressure on his heel and sacrum. Educate patient -Ensure there is suction in the room, and check Apical/Radial Pulse Deficit: No Yes Murmur Valve Click -Assess if the contents of lunch tray are intact. Physiological- Mr. Richardson is now pain free and questioning why he is plagued with recurring urinary stones. Regardez le Salaire Mensuel de New King James Bible Download For Windows 7 en temps rel. -Use therapeutic communication/active listening Educational needs: Increased acuity Nathaniel Gonzalez She shares concern about patient's wife who is now coughing and having night sweats. Isolative, appears fearful, crying, and refusing to see her husband. Psychological Needs Increased acuity Perform circulatory evaluation The 'Strandperle' (lit. Powerlessness True. She has IV access and has received a small dose of Valium to reduce apprehension. The provider explains that it is a pre-cancerous stage in where the cell develops abnormal features. Remain with patient and reassure Disturbed Body Image True Head/Face: Symmetric Asymmetric Drooping Place pt on PCA pump The Swift River is one of the most unique and popular trout fishing destinations in Massachusetts, yet the dynamics of this exceptional fishery have not been well understood. -Remove the lunch tray and ensure pre-operative consent has been signed. Scenario 4 Remain with patient Impaired Urinary Elimination True Expresses fatigue, fear, concern, and desire for recovery. Determine clinical decisions based on listening to an audible client report. Iron forms a sulfide with the approximate formula Fe7S8\mathrm{Fe}_7 \mathrm{~S}_8Fe7S8. -Give NS liter bolus Stat lithotripsy treatment ordered. This shop has been compensated by Inmar Intelligence and its advertiser. Safety Sleep deprivation False If patient statement differs from the surgical consent she has signed, notify surgeon immediately Scenario 3 Allow family to remain Robert Strurgess Impaired Home Maintenance Management False Upon entering the room with a translator to admit him to the hospital, he is asked for address and phone number but refuses to comply. Neck: ______________ Obtain translator Robert Sturgess Scenario 1 Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. Hx of dementia, from nursing home, fall one day ago. Scenario 2 Tibial: _____ + Bilateral Other: ______________ Generalized: Pedal: ______ + Bilateral Other: ____________ Sacrum: Non-pitting Pitting ___ +. Fatigue True The oncologist is recommending Docetaxel as opposed to an orchiectomy. An abc-phase-sequence three-phase balanced wye-connected source supplies power to a balanced wye-connected load. Impaired Comfort True Senario 1 Scenario 3 You discuss this cough with Mr. Dominec to determine how long he has had it. Breath Sounds: Clear bilaterally. Insertion Site: Dry/Intact Redness/Erythema Drainage Tenderness Maceration Apply restraint Raspberry and Cream Cheese Stuffed Blueberry French Toast with Ozery. Escort patient to vehicle Inappropriate words = 3 Fall, Risk for True 3Check surgical consent for correct procedure and make sure operative site is marked. Neuro WNL alert and cooperative. Mr. Sturgess is now declining, and family members are requesting to remain in room past normal visiting hours. Scenario 1 August 13, 2020 // by Angela McGowan. Mr. Dominec leaves the room and you discharge him and escort him and his partner to the car. Recent blood gases demonstrate falling PaO2 (hypoxemia) and increasing CO2 (Hypercapnia). Escort patient He was initially sedated with versed 2mg, and Fentanyl 100 mg by the EGD nurse, but the patient was not tolerating the procedure, so anesthesia was called to administer propofol. He told the nurse that he has had some changes in his bowel habits and his stools have been very dark. Upon entering the room, you find Ms. Rails sleeping. Teach Cameron. Assess Refer call to contact health department Deficient Fluid Volume True Notify doctor for Foley catheter Fall Risk Increased acuity Self-Care Deficit: True Neuro WNL alert and cooperative. Shock False Love and Belonging Combien gagne t il d argent ? Scenario 3 Vital signs -BP 124/82, Temp 98.2, P 84, RR 22, SaO2 96%. Connect telemetry Ramona Stukes, 69 yr-old, third day post-op cholecystectomy. Ineffective Airway Clearance True Document teaching moment. Remain with Patient, Sarah Getts, 77 yr-old, Dx- Chronic Renal Failure, admitted with hyperkalemia (5.9, Eq/L)/hyponatremia (128mEq/L). Impaired Home Maintenance management r/t client or family False Anxiety True He is emotionally distraught and is insisting that he be allowed to report what is going on from the ER. Health Change Increased acuity Dr. Donofrio, Physiological Fall Risk Increased acuity They wanted to know and pressure you for the information. -Notify HCP of fall, complete incident report He also states he is feeling weak. When she moves him to the hallway, Mr. Burgundy begins yelling at you "Do you know who I am, I demand a room! Deficient Knowledge True 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. Stools are decreasing but patient remains very weak. Family Health III-Pediatrics (NSG 6435) Emergency Medical Technician (EMS 1150) Applied Research In Business (MIS 781) Anatomy & Physiology I With Lab (BIOS-251) Molecular Biology (BP 723) Newest Marketing Management (D174) Professional Application in Service Learning I (LDR-461) Professional Capstone Project (PSY-495) Theology (104) He was recently treated for a URI with a Z pack, prednisone, and Motrin for pain. He is questioning the nurse as to why he has been admitted for heartburn. Oriented to: Person Place Time Hep-Lock in place left AC. Normal Sinus Rhythm on telemetry. You escort them with you to the ICU. Regular diet. Nausea False When the nurse retunes to the room the patient tells the nurse that when he went to the bathroom he became very lightheaded. The patient is asking you where her son is, the last place she saw him was right before the explosion. His wife tells the nurse that he seemed very distant and did not want to talk much. Scenario 1 Where is my camera man!! After washing and gloving hands, you then identify yourself and the patient, Ann Rails. Robert Sturgess - Swift River Swift River University Nightingale College Course Concepts of Nursing I (BSN 246) Academic year2022/2023 Helpful? Airborne Isolation. Scenario 2 Type of Line: Peripheral, location ______________ CVL, location _____________ PICC, location _______________ Scenario 1 No response = 1, Muscle Strength: WNL, Flaccid, Contracted Scenario 4 Insert Foley catheter -Draw a repeat CBC per HCP order to determine current Hemoglobin status Temperature is 98.3, HR is 87, RR is16, BP is 121/74, PaO2 is 98%. Document results -Ask Mr. Burgundy to lower his tone as it can be disturbing to other patients LOC Increased acuity Tubes: None Salem Sump Nasoduodenal PEG J-Tube pH: ______ Administer antipyretic meds Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. Decreased Cardiac/perfusion: False Imbalanced Nutrition: True View Swift River Reflection Questions (1).docx from NRSG 4412 at South College. Scenario 5 Risk for Infection True The tour started nicely through the new area Hafencity but then continued to the area under development and a very desolate district of Hamburg. List the nursing care order. Read PT report You explain that his condition has worsened and now he has been taken to ICU. Ms. Gestalt is now complaining of fever and chills. Contact head nurse or supervisor in the OR to evaluate new situation Arthur Thomason Stoma Status: Pink-Red/Moist Dusky Retracted Excessive bulging Then the bus splashed into the river for a cruise. Fatigue True Perform neuro assess The cells are allowed to warm up and then are frozen again. Pain: No Yes: Location: ______________________ Acute Chronic Constant Intermittent Vital sign Temp 98.4, BP 136/78, P 72, RR 20, SaO2 97%. Scenario 5 Scenario 3 Neuro WNL alert and cooperative. ASA is held but morphine 4 mg was given after his GI cocktail. Pain and numbness in legs for one week. Non-significant past medical history. Safety Mr. Gonzales H/H is 12.7/38. IV fluids of D5 1/2 NS are infusing at 100 mL/hour to his right forearm. He is emotionally distraught, and is insisting that he be allowed to report what is going on from the ED. You also notice the patient is more difficult to orient. Genitourinary Assessment Kathy Gestalt, 33yr-old, Dx- second day post-op open right Tibia/Fibula fracture, plaster cast in place on right lower leg. Deficient knowledge: True Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. No known allergies (NKA). Deficient Knowledge False Scenario 5 Sleep Deprivation False Psychological Needs Increased acuity Scenario 4 Vital re-assessment -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 Inform his partner that everything is being done to keep him comfortable. Evaluate understanding Constipation, Risk for True Scenario 2 Provide for physical and thermal comfort. Fear True Scenario 2 -Explain procedure to the patient Document results Bleeding, Risk for True -Complete initial post-op assessment Family at beside. Enter the email address you signed up with and we'll email you a reset link. Evaluate understanding. Check PRN pain order Noncompliance True Senario 4 Allergic to sulfa drugs. Nursing questions and answers. Tom Richardson, 46yr-old. The ER nurse reports that his cardiac enzymes were borderline, (Troponin?, CK/CKMB?) Physical Mobility, Impaired True Evaluate outcome of dietary plan You are concerned about preventing the patient from falling. Mr. Mancia is non-English speaking patient and is fearful of being discovered as an illegal immigrant. Scenario 4 Our Swift River Simulations are designed to help students and practicing nurses master their skills of Prioritization, Delegation, and Sequential thinkingwithout the requirement of being onsiteor even having to download software. Anxiety False Scenario 3 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. Scenario 3 Obtain Spanish signs & brochure -Recheck Tilts after the NS bolus is complete.T Urinary Catheter: N/A Indwelling Short-term Indwelling Long-term Date of Insertion:________ Size: _____F
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