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Educate patient -Tell the wife that you will speak to the husband, and this is apprehension is expected with this surgery/diagnosis. Students will assign correct nursing diagnosis for patients in a medical surgical virtual clinical environment. Evaluate outcome of dietary plan Awaiting diagnostic labs. He has not had his BP medication today. Refer call to contact health department The nurse identifies self to the nurse triaging patients and is directed to trauma room 4. Noncompliance True. -Give NS liter bolus Obtain Spanish signs & brochure Document results Consult Social Service Scenario 1 He replies, "six times in the past four hours". Vital assessment Ask patient to explain to you what procedure she was expecting to have this morning. After washing and gloving hands, you then identify yourself and the patient, Ann Rails. Microeconomics And Behavior Robert Frank 9th Edition The cycle of freezing and thawing damages the abnormal cells. When the nurse retunes to the room the patient tells the nurse that when he went to the bathroom he became very lightheaded. Surrounding skin: Moist/Intact Red/Erythema Irritation -Complete head-to-toe assessment while patient is on the floor. After two hours, Mr. Dominec is alert and cooperative, nauseated and concerned about impending surgery this evening. Teach patient about safety when getting out of bed Senario 2 Safety Mr. Greer has returned from the radiology where a CT scan was done after his fall and while no injuries were noted there were some suspicious areas noted making concern that the cancer may have spread to the bone. Decreased Cardio Tissue Perfusion False Senario 5 Scenario 3 Scenario 5 Compromised Family Coping False She is also investigating bone marrow transplantation. 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. Ronald Burgundy Explain to physician what interventions you have recently initiated His children are visiting, and they are very supportive. Neuro WNL alert and cooperative. Scenario 3 Scenario 3 Ms. Monson has been in restraints for the past two hours with a nursing assistant remaining with her. Psychological Needs Increased acuity Senario 5 Connect telemetry Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. DSD (dry sterile dressing), forehead laceration clean and dry intact. -Begin q15 minute neuro checks Scenario 4 Excess Fluid Volume, Risk for False You return to the break room on your floor. His wife tells the nurse that he seemed very distant and did not want to talk much. Psychological Needs Increased acuity Safety- 1. : an American History (Eric Foner), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Notify doctor of change in condition in particular: unproductive cough and low-grade fever. Present health assessment including B/P and LOC and dressing. -Assess if the contents of lunch tray are intact. Students will prioritize medical surgical . Anxiety False Nausea/Vomiting: Yes No Hep-Lock in place left AC. -Ask Mr. Burgundy to lower his tone as it can be disturbing to other patients Neuro WNL. Scenario 3 -Reinforce to the patient to not get out of bed Abnormal left leg weakness, gait unsteady, 5/10 on numeric pain scale. Readiness for Self-Care Enhancement True Psychological Needs: Increased acuity Scenario 5 Scenario 5 Robert Sturgess Scenario 1 Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. Encourage fluids Skin warm and dry, may sit up on edge of bed today. Palliative care. **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 . Ineffective Self-Health Management True Perineal Care Scenario 4 -Assess for fall risk Safety His left humerus is fractured and splinted. Check input/output for possible dehydration -Contact HCP to determine when they are available to speak with the patient Swift River fisheries research | Mass.gov Strict I&O, regular diet, intake 50%. Therapeutic communicationT Read PT report -Elevate head of bed and place the patient on Pulse oximetry. Contact dietary consult -Explain to patient why his throat may be sore Scenario 4 Nutritional Intake: Adequate Inadequate BMI: Apply fall risk bracelet Where is my camera man!! No known allergies (NKA). Disturbed Sensory Perception False Scenario 3 Provide verbal report to team members who respond to rapid response IV NS is started, and lab work is sent. Wash and glove hands Bleeding: True It was diagnosed by a portable X-ray and quickly splinted by the ER staff. Deficient knowledge: True Vital re-assessment Hopelessness: True Fear: True His difficulty voiding finally motivated him to seek care. Increased fall risk. Senario 3 Document results RUE: ______________ LUE: ______________ 00 Comments Please sign inor registerto post comments. Home; Our Focus; Our Legacy; Our Partners; Our People; Our Fellows; Our Investments -Explain to the patient that he has a procedure, and he cannot eat. Teach Cameron. You observe Ms. Getts being assisted by another nurse who is being blatantly rude and disrespectful to her. She is with her physician. His partner is at the bedside asking, "how much longer will he have to wait until taken to surgery?" 0800 1200 Fall, risk for: False You are the now the Surgical ICU nurse assigned to her. Powerlessness: True, Scenario 1 Full assessment -Ensure bed is in lowest position, and rails are in place He is emotionally distraught and is insisting that he be allowed to report what is going on from the ER. Linen Change Health Change Increased acuity RUE: ______________ LUE: _____________ Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. -Explain procedure to the patient No known allergies (NKA). Use therapeutic communication/Active Listening Senario 3 Evaluate/modify plan of care Safety No known allergies (NKA). Encourage fluids/fiber/ambulation Dr. Donofrio, Chronic Pain, Risk for constipation, impaired nutrition, anxiety, fear, grieving, hopelessness, powerlessness, Daily Flowsheet & Physical Assessment, Vital Signs Intake & Output Vital signs are: B/P 112/78, temp. 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. Dr. Levine, Marcella Como, 38 yr-old, Sexual Trauma Victim (Rape), unknown assailant. Senario 2 -Notify charge nurse of patient's deteriorating condition Scenario 2 Do not disturb Peripheral Neurovascular Dysfunction: False Neck: ______________ Mr. Greer is on the floor still but is awake and oriented and is complaining of back pain below his right scapula. Procedure is canceled for the day and rescheduled later allowing for new consent. SBAR assignment.docx - SBAR(situation, background, - Course Hero Intermittent/Continuous Other: Esteem Normal Sinus Rhythm on telemetry. Airborne Isolation. -If gastric reflux is suspected administer PRN antacids (GI cocktail) student name date: nur 113 assessment swift river patient: robert sturgess handoff robert sturgess, 81 years old, metastatic ca of colon, hx of diabetes. -Explain to Mr. Greer that it may take several days for healing, and he may have temporary incontinence, but it will resolve over time. -Ensure the bed is in lowest position, the side rails are up, the call light is in reach, and ask the patient if they need anything before you leave the room Compromised Family Coping False Wash and glove hands He told the nurse that he has had some changes in his bowel habits and his stools have been very dark. 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. Scenario 1 Radial: ____ + Bilateral Other: _____________ RLE: Non-pitting Pitting ___ + Your response to all of them would be: Scenario 1 Fortune Salaire Mensuel de Nba 2k23 Pc Review Combien gagne t il d Evaluate understanding Full assessment Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. Scenario 5 Mr. Gonzalez has returned from his EGD and is still sleeping from the sedation. Oriented to: Person Place Time Vital sign Temp 98.4, BP 136/78, P 72, RR 20, SaO2 97%. Check PRN pain order Scenario 4 Noncompliance True Course Hero is not sponsored or endorsed by any college or university. Ronald Burgundy Education of Foley Cath Procedure r/o Tuberculosis. Ineffective Renal Perfusion, Risk for True The nest morning the gastroenterologist informs Mr. Gonzalez that his EGD confirmed a diagnosis of Barrett's esophagus with Dysplasia. Bleeding, Risk for True Esteem Insertion Site: Dry/Intact Redness/Erythema Drainage Tenderness Maceration Temperature is now 102.8. Mr. Sturgess does not have a living will or durable power of care completed. Stoma: N/A Colostomy Ileostomy Effluent Consistency: Psychological Needs Normal acuity Mr. Duncan's wife meets you in hall asking what she could bring her husband to eat from home. Head/Face: Symmetric Asymmetric Drooping 2. Scenario 4 Visual assess Psychological Needs Increased acuity : an American History (Eric Foner), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Day 2 admission, Thomas Richardson is complaining of severe pain and is now begging you for some relief; states pain scale 10/10. LOC Increased acuity Mr. Richardson is requesting assistance to ambulate to bathroom. The patient asks the nurse to explain about these medications and why they are in such a hurry. Flexes abnormally = 3 In reassessing Ms. Monson, her vital signs are: BP -106/82, Temp-98.2, P-106, RR-18, SaO2-88. Disturbed Body Image True -Explain that Radium-223 mimics calcium and is absorbed during new bone growth. Patient and family upset regarding dx. Scenario 5 Senario 4 IV D5 1/2 NS with 20 KCL @ 125 ml/hr in left forearm. -Notify HCP of fall, complete incident report Scenario 2 Mrs. Stukes is feeling nauseated. Needs frequent reminding due to determination to do things herself without assistance. Perform circulatory evaluation Document results He also complains that his throat is still very sore. Scenario 5 You correctly diagnosed 11 out of 16 options. Bleeding Risk for: False Perform circulatory evaluation Severe pain (10/10) medicated q 30 minutes x4 with IV Morphine 2mg with little relief. Nathaniel Gonzalez Nausea False Impaired Skin Integrity False Scenario 2 Educate patient It is now two weeks later; Mrs. Smith has returned. 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. Administer antipyretic medication Mr. Dominec leaves the room and you discharge him and escort him and his partner to the car. Anxiety True Therapeutic communication. 2Provide comfort in pre-surgical room Mr. Dominec. Document conversation Last pain medicine 2hrs ago at 1300(Demerol 50mg/ Zofran 4mg IV). Document teaching moment. Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. -Check patency of Foley catheter, urine color, and ensure it is secure to the patient's leg -Document and contact nursing supervisor/Charge nurse Iron forms a sulfide with the approximate formula Fe7S8\mathrm{Fe}_7 \mathrm{~S}_8Fe7S8. Combien gagne t il d argent ? Request time she can arrive and staff to help with transfer Use therapeutic communication/Active Listening Scenario 4 They feel that you should share with them if he was a "real AIDS" patient or not. Full assessment Acute Confusion True Don Personal Protective Equipment Crutches at bedside adjusted for height. References; Access My Virtual Clinicals; Medical-Surgical. Assess Mr. Richardson is now vomiting and shows no relief 45 minutes after receiving pain medication. Scenario 4 Health Change Increased acuity Impaired comfort: True Administer PRN constipation medications Sleep Deprivation False. Scenario 3 Obtain recent chest X-ray reports and recent ABG's for physician to review Call rapid response Health Change Increased acuity Remind the nursing staff that the patient is NPO. Mrs. Pittmon states she has had numbness for years but "now I can't . Self-Care Deficit: True He is a local TV news reporter that was filming an event at the county fair when there was an explosion. Love and Belonging Neuro WNL's, alert and cooperative. Check surgical consent for correct procedure and make sure operative site in marked. Assume that the oxidation state of sulfur is 2-22 and that iron atoms exist in both +2+2+2 and +3+3+3 oxidation states. Skin warm and dry, all vital signs in WNL -Draw a repeat CBC per HCP order to determine current Hemoglobin status Combien gagne t il d argent ? -Assess patients' pain and rule out cardiac pain. Perform pain reassessment Ineffective Coping False Full assessment Skin Integrity: Intact No, describe below, Location Type Size Wound bed Drainage Knowledge Deficit True Disturbed Body True Rapid Response team arrived including anesthesia. Scenario 1 : beach pearl), in walking distance of the velgnne ferry stop, is considered the mother of all urban beach clubs. Decisional Conflict True All our products can be personalised to the highest standards to carry your message or logo. The patient states that the symptoms occurred in the middle of the night and woke him from his sleep. Diet as tolerated. Provide emotional support. Provide a few chairs if possible for her family to also be comfortable Pain affecting: N/A Sleep Activity Exercise Relationships Appetite Concentration Vital signs -Temp 97.2, BP 96/74, P 82, RR 20, SaO2 97%. Scenario 5 Educate patient regarding changes to POC To access your Swift River Virtual Clinicals login to ATI's Student Portal and access the Virtual Clinical card in My ATI. Upon entering the room, you find Mr. Sturgess is quiet, appears tense and rigid but states, -If cardiac is suspected call the provider and the rapid response team. Robert Sturgess Scenarios Swift River.docx - Course Hero Swift River Reflection Questions 1 - Swift River - Course Hero Hx of dementia, from nursing home, fall one day ago. Document results and findings Ms. Getts is now complaining of sudden sharp, substernal chest pain, very short of breath and is profusely diaphoretic. Offer masks to visitors You call his doctor to inform him the family has arrived. His VS are BP 122/64, P 89, R 12, SpO2 93%. -Explain that Docetaxel is a hormone therapy that suppresses the testosterone that your testicles produce producing similar results as surgical intervention. She has arrived in pre-op and about to have surgery this morning. The dinner tray is waiting for the patient in his room, and the nurse notices it is a regular diet. Put the patient on O2 NC and Fentanyl 25mcg IVP for pain. Regular diet. Use therapeutic communication/Active Listening Ms. Gestalt is second day post-op and has requested to get out of bed and to ambulate to bathroom. Scenario 3 They were also concerned about the next patient going into that room and the use of the lavatory.