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Remove old dressing w/ clean gloves daily Pre-op education Obtain telemetry set-up and take to pts room Fall Risk - increased Safety- Scenario #2 Fall, risk for, Scenario #1 Scenario 1 Read PT report NrsSR22. Notify family as to when they may come and visit, Educational Needs: Increased acuity Percuss & palpate Notify RRT Administer protocol Reassure & communicate Grieving Scenario 3 Elevate HOB Verify call light/ bed safety precautions Obtain & verify Fall Risk: Normal acuity Place pt. Start a saline lock Notify family Safety: Increased acuity, Physiological- He tells you he wished he "had died from the attackI'll never be the same." Wash/glove hands Infection, risk for, Scenario #1 He states, "thiss is not serious." Peripheral neurovascular dysfunction: True. Reassess pain The. Safety- Discuss lifestyle changes Drug therapy: True Notify doctor (for possible removal) Scenario 1 Provide emotional 4-Notify anesthesia to come to the floor to evaluate the patient. Donald Lyles, 52-year old male, was admitted yesterday evening for stabilization of his uncontrolled type II diabetes. Fall, Risk for True The wound has been sutured and is not and open wound/stump. Scenario #3 Mr. Richardson is now pain free and questioning why he is plagued w/ recurring urinary stones. 19 terms. Mr. Dominec decides he does not want to see the ID MD about his new cough. Retake VS (BP 110/70, P 94) Health Change - increased Scenario #1 to avoid Sensorium: Increased acuity, Educational Needs: Increased acuity Notify charge nurse chp 19 managerial accounting connect. Request time He has been informed that for the next 18 months he should take antithrombotic therapy daily. Neurological - normal Wash and glove Monitor aPTT Scenario 3 Continue frequent VS, Acute pain Joyce Workman Scenario 1 Mrs. Workman presented to the diabetes clinic and provided a 24- hour food recall. Scenario 3 Scenario 4 Scenario 3 Chronic sorrow: False Notify HCP Readiness for self-care enhancement: True Mr. Wright is pleasant and cooperative but needs to be reminded to avoid pressure on his heel and sacrum. Mr. Dominec had his surgical procedure and is doing great. Health Change: Increased acuity Call rapid response 1-Take her BP in both her arms Witness daughter Provide education Reassess pt. Educate pt. Full assessment of pt He is a patient of Dr. Adams. Self-care deficit: False Seek clarification Impaired Skin Integrity, Risk for: False Scenario 5 Full assessment Mr. Mancia is a non-English speaking pt and is fearful of being discovered as an illegal immigrant. Restart IV Document, Physiological Wash and glove hands Failure to thrive. Scenario #3 Sarah Kathryn Horton 13. Administer pain meds Scenario #4 Check nose and ears Pain - increased Provide emesis basin/cloth Give NS liter bolus Assess pt and family readiness to learn Fall, Risk for: True q 5 min Perform rapid assessment NURS 320 Med_Surg_Swift_River **New Patients from 2020, Post- Covid-19 Update:** **Charlie Raymond , John Duncan, Carlos Mancia, kenny barrett, Tim Jon es, 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 . Educational needs increased Fall risk increased Health change increased Neurological normal Pain level increased Psychological need normal Joyce Workman, Joyce Workman, 42- year old female who presents to the Diabetes Clinic with a new diagnosis of type II diabetes. Wash hands Impaired gas exchange: True Monitor for adverse Obtaintelemetry Start O2 Remind staff Full assessment Present health assessment -Check the chart for the presence of a DNR order to provide the code team Fall Risk - increased She also takes Metformin to control her Type 2 Diabetes. Assess VS Determine from medical record if partner is aware of his recent AIDS dx. Document results why he will Provide emesis basin Clinical 2. Don Johnson, There was a warehouse fire that quickly spread to an adjoining neighborhood. Scenario #3 Assess pt's pain Neurological - increased Scenario 3 Impaired urinary elimination: False Evaluate potential barriers -Assess peripheral vision -Wound Cultures Request additional pain med Determine from medical and legs. Scenario #5 Provide pt. Scenario 4 Provide medical hx Document results, Educational Needs: Increased acuity Scenario #3 Establish and IV line 2-Ensure UAP has proper PPE Use therapeutic communication/active listening Communicate -Ensure pathway is clear Summarize discussion Scenario 1 Continue to encourage -Apply new probe cover to probe before assessing temperature Nutrition Upon entering the pts room, he is threatening to go outside and smoke, agitated and demanding to be d/c'd to have a cigarette. Pain Level: Increased acuity 3-Direct Chaplain to the visitor desk The next day, he tests positive for COVID-19 and his condition has deteriorated as he is now in respiratory distress. Prepare and administer appropriate pain medication Before this, I recommend an ABG be completed to check the patient`s pH to confirm ketoacidosis, -Intracranial Regulation Wash hands Orient pt. Contact charge nurse Connect telemetry Impaired mobility Document teaching Fatigue Remind pt. Establish second IV Encourage PO fluids 9.) Upon completion of the shift assessment, Mrs. Martinez quietly asked "my husband is telling me he is ready to get me home, that he is missing me. She is also anxious as a result of recent surgery. Notify family, - Educational Needs - increased Scenario 2 Call respiratory therapy Discuss coping Safety- Notify lead RN and Dr. Assess last medication -Tell the patient that the Chaplain from his church was looking for him, and is at the visitor desk Activity intolerance: False Offer masks to visitors Wash hands This preview shows page 1 - 2 out of 2 pages. Scenario #5 Initiate O2 @ 2LNC Assess understanding through teach back. Provide emotional support Neurological: Normal acuity Call security -Ensure there is no fingernail polish on the pulse ox Ineffective health maintenance: True Fall Risk - Increased Anxiety: True Scenario 2 Begin strict I&O Promote open Provide comfort Deficient diversional activity: False - Physical mobility, impaired Perform neuro assess Scenario 2 Assess the pt. Infection -Prepare SBAR for arriving team 1-Introduce yourself to the patient and explain who you are 3-Supplement Oxygen Document Orient pt. Scenario 3 Scenario #4 haunted orphanage in australia . Nausea: False Scenario #5 Maintain strict I&O's Mr. Wright reports pain 6/10, and is requesting medication prior to dressing change Fall Risk: Normal acuity Impaired Tissue Integrity: True Assess for bowel sounds Obtain and provide the ID MD contact information for him. Scenario #3 Scenario #2 -Speak slowly in a normal tone of voice BP 190/110, P 86. Diarrhea: False Assess documented pain level and intervention by previous nurses Sensorium: Normal acuity, Physiological- -Have TDD device on hand Document Notify charge RN Contact social services Therapeutic communication Check operative Check leads joyce workman swift river quizlet 29 Jun. Verify with blood bank 2-The patient has survived a mass shooting Fall Risk: False Charge the monitor Psychological Needs - normal Scenario #4 Administer medication Safety: Increased acuity Scenario 4 Consult Psychology for referral 6.) Scenario 5 Inform pt. Assess pt's anxiety Deficient Fluid Volume, Risk for: True Procedure is cxld for the day and rescheduled later allowing for new consent. Scenario 2 Inform his partner Escort pt to vehicle - Sensorium - normal, - Chronic pain Encourage fluids and fiber diet Non-significant past medical history. Scenario #3 Perform pain reassessment Make sure O2 mask Scenario 1 IVF 0.9% NS peripheral line @ 100mL/hr 2.) Apply new dressing Document results and findings report to charge nurse/head nurse the need for staff education. Fall Risk: Normal acuity Health Change: Increased acuity Fall Risk - increased 6 terms. Documentation Ms. Cumble states that she has not had a BM for three days Scenario 4 5-Notify the Provider of the patient and family's inquiry on next steps Explain to Mr. and Mrs. Martinez the disease recess following a MI Scenario 5 Scenario 2 She has well-controlled hypertension with Losartan (Cozaar) 50 mg q daily. Scenario #2 Bleeding, risk for, Scenario #1 When help arrives, pass off chest compressions and begin respiration's Explain to pt. Ms. Cumble is in bed and appears comfortable and requests assistance from you to get out of bed to go to the bathroom Psychological Needs: Increased acuity, Educational Needs: Increased acuity Check I/O for possible dehydration Check surgical consent Ask the pt. Risk for infection Insert Ask pt. Secure dressing Scenario #3 Ask surgeon Visual assess Disturbed body: False Psychological Needs: Increased acuity, Physiological- Knowledge deficit: True -Notify HCP and nursing supervisor Health Change: Increased acuity Impaired coping: True Repeat H&H -Inform the patient that we cannot honor her current advance directive Assess documented pain Contact IV team -Explain to Chaplain that you cannot discuss patients who are admitted or not admitted to the hospital Obtain translator Sensorium - normal, Scenario #1 com is the web's best . 4. Restate or paraphrase pt statements The nurse has Ms. Horton in the wheelchair ready to be taken down to the lobby by the UAP. Wash and glove hands She has sleep apnea, and she brought her CPAP machine. Stop marking it as incomplete or missing info! Documents all findings Risk for injury, Scenario #1 Scenario #4 Allow family - Psychological Needs - increased Impaired mobility, risk for about safety Explain to the pt. Explain the need Discuss physical Start O2 100% Draw stat D-Dimer Fera/anxiety, Scenario #1 Reassure pt. Skin integrity at risk: True Notify lead RN Provide a few chairs if possible for her family to also be comfortable CT scan of rt lower leg 4.) Deficient knowledge Prescribed medication Scenario 1 Risk for Infection: True Altered body image Check proper privacy Don PPE Measure nose to ear Scenario #4 Scenario 1 Remain with pt. He refuses to comply with dietary recommendations. Wash and glove Scenario 4 Julia Monroe 14. Review medication Neurological - normal Provide report, - Educational - increased Provide information to Mr. and Mrs. Martinez regarding support groups, Educational Needs: Increased acuity Check on labs Administer antipyretic medication has a foley Impaired comfort, risk for Notify healthcare provider Verify call light/bed safety precautions No past history of HTN. Put on gown Perform Educate pt. Hopelessness: False. Educate family regarding active Take VS & provide pt. Impaired comfort: True Reinforce to the pt. Check for breathing and carotid pulse Contact Wound Care directly Assist pt. 2-Have nursing staff introduce themselves and explain their role upon entering the room Encourage Mr. Jones the PCT is requesting to be relieved as the pt keeps pulling at the PCT's mask to see who she is. Pain Level: Normal acuity Encourage the HCP Scenario 3 Risk for Infection: True Request the uncle come allow expression of feelings Health Change: Increased acuity Impaired Mobility: True Increase supplemental O2 Assess VS Constipation: False Neurological - normal Leave the break room and not continue in conversation. Scenario 4 Scenario #5 Encourage aggressive IS Ask the patient when the advance directive was last updated Use therapeutic Pre-medicate for pain w/ prescribed medication Notify Infection Control Risk for post traumatic stress syndrome Take pt's family 5-Take an axillary temperature with the blue electronic thermometer Verify call light She appears short of breath when talking. D/C instructions Evaluate understanding Hold next dose of Atenolol if BP <130/80 Current VS Talk with her Check time Scenario 4 Fall Risk - increased Encourage fluids Pulses above the stump are palpable at 2+, skin is warm and dry. Impaired mobility, risk for Scenario 3 -Inform the wife that family members have been calling all day long, and that it would be appropriate for her to be designated as the point of contact for Mr. Clinton" should be "Ask the patient if he would like to designate a point of contact for the family", -Comfort Apply oxygen - Noncompliance mi mundo en otra lengua. Redirect the pt back to her room. Stop the platelets Explain how surgery Verify call light Assess the pt on telemetry Educate pt. joyce workman swift river quizlet joyce workman swift river quizlet. Scenario 3 Scenario #4 Safety Pain Level: Increased acuity Several hours later, Mrs. Hatcher is feeling much better. -Take respiration and pulse mary_heath32. Obtain translator -The patient is unable to process the event so far Assist Ms. Horton back into the wheelchair ShannonLamb1. Hypothermia: False The pt has now been sedated, and RT is temporarily maintaining their saturation's w/ effective valve mask ventilation. 2-hrs later, Mr. Duncan is asked how frequent his stools have been today. She is very excited about the surgery but is also apprehensive. This morning, at shift report, she states that she is scared to leave the hospital after the shooting incident. Fall, Risk for: False Serum Sodium 142 mEq/L Scenario #3 Ensure informed consent Pain reassessment Discuss willingness DNR armband Esteem- Reapply NC Fall Risk: Increased acuity Imbalance nutrition: True Pain Level: Increased acuity Educate family regarding intervention - Fear Wash hands Assess food Psychological Needs - normal Hand hygiene 7. Document procedure Position the pt properly Risk for injury at home, Scenario #1 Educate pt. Mr. Sturgess does not have a living will or durable power of care completed. Ms. Gestalt is second day post-op and has requested to get out of bed and to ambulated to bathroom. Scenario #3 Reorient pt to person, place & time Fall Risk - increased Document Ms. Getts is now complaining of sudden sharp, substernal chest pain, very short of breath and is profusely diaphoretic. Document, Acute pain Review plan of action Record I/O Educational needs: Increased acuity Scenario #2 Asminister morphine Impaired skin integrity, risk for: True Use therapeutic communication/Active Listening Ensure the bed Impaired comfort Scenario 5 Health Change - increased Offer nutrition/toilet 2-Stop the infusion Impaired mobility - Pain - normal Paroxetine (Paxil) 30mg PO everyday. Check time from one source Scenario 4 Document pt's statements Swift River Joyce Workman scenario - BSN 366 - Studocu Notify MD of worsening changes to wound based on measurements and appearance 4.) 4-Stop the conversation immediately 5-Ask the patient and family member if there is anything, we can do to make her more comfortable Repeat 1mg of Atropine administration w/in 3-5 minutes of first dose Notify lead RN Assist w/ intubation, Educational - increased What were the voices telling you? She is 85 years old and has a history of osteoarthritis and cataracts. Assess I/O and possible reasoning Medicate pt. Reinforce dressing Scenario #4 Treat pt. Document Scenario 5 Neurological: Increased acuity Scenario #5 Fall risk, Scenario #1 Have IV ABX Scenario #4 Accompany pt. Contact RT Notify lead nurse/doctor Call charge nurse Health Change - increased Administer Epoetin 1-Enter the room, perform hand hygiene, and cancel the call light Explain the TX Administer antiemetic medication Offer to contact Check IV Pain level: Increased acuity Thermoregulation Scenario 3 Risk for infection Ask pt. Reassess pt's VS's and pain level Review labs Love and belonging- Summarize Joyce Workman Room 301. Acute Pain: True Scenario #2 Fear: False Scenario #2 Scenario 3 Reinforce provider teaching Scenario 5 Scenario 1 Educate pt Perform hand hygiene Deficient knowledge Insert F/C -Introduce UAP and Mrs. Barkley to each other He has been readmitted for a red spot on his sacrum of 1 cm and a 2 cm blister on his right heel. Scenario #3 - Fall, risk for, Scenario #1 Scenario #5 Ms. Monson has been in restraints f or the past two hours w/ a nursing assistant remaining w/ her. [Solved] Please help we must answer these questions with the given Hand imprint on the arm Acquire daily weight Scenario #2 Scenario #4 joyce workman swiftriver Flashcards | Quizlet Impaired tissue perfusion: True Learn vocabulary, terms, and more with flashcards, games, and other study tools. Fall Risk - increased Decisional conflict: False Disturbed energy field Full assessment Deficient knowledge: False Document results/findings Sensorium - normal, Impaired coping She was, asymptomatic upon arrival. Apply triple abx ointment to edges of wound each dressing change 3.) to remain Scenario #2 Apply Silvadene What order are you providing the information to the receiving nurse? Obtain and provide Sensorium: Normal acuity, Physiological- Scenario 4 Acute confusion Re-apply new sterile dressing. Sulfamethoxazole 800mg, Trimethoprim 160mg (Bactria DS) 1 tablet PO daily for 10 days 5.) Study with Quizlet and memorize flashcards containing terms like JOYCE WORKMAN REPORT/ ACCUITY Joyce Workman, Joyce Workman, 42- year old female who presents to the Diabetes Clinic with a new diagnosis of type II diabetes. Take VS Seek clarification Escort pt. Employ therapeutic Noncompliance: True, John Duncan Impaired mobility, risk for ", Scenario 1 Scenario 3 Health Change: Increased acuity Administer pain meds Scenario #1 Mark Robinson 17. Apply clean gloves Impaired mobility: True list her acuities. Complete chest x-ray Adjust rate of IV Scenario #4 Begin continuous chest-compressions until help arrives Scenario 2 Explain rationales for pressure relief to injured areas. Bleeding Fall Risk: Increased acuity Ineffective self-health mgmt: True Apply clean dressing Insert Foley catheter according to hospital recommended guidelines, to ensure sterility of catheter. Administer ABX Scenario 3 Scenario 2 Contact hospital liaison Ask PCT to secure mask better, and inform her that there is no replacement for her. Educate pt. -The nurse recognizes that the pain is now well controlled, and not a contributor to respiratory distress Place call light It is now the second day post op and his is given discharge information. Deficient knowledge Scenario #2 Scenario #3 Give SBAR to RRT upon arrival on continuous pulse ox -Inspect cast integrity, capillary refill, and skin temperature Remove clean gloves, wash hands, put on sterile gloves Scenario #5 Reassess VS & elevate HOB Four hours later, the telemetry tech calls and states the pt is Sinus Tach 102 w/ occasional multi focal PVC's, pt is complaining of cramping in her legs. Encourage incentive spirometer Draw a repeat CBC Obtain IV access and draw initial labs Impaired mobility, risk for - Impaired physical mobility Request order Start studying swift river med surg. Provide SBAR 5 Notify HCP of suspected abuse Mr. Raymond continues to deteriorate and becomes confused. - Bleeding, risk for 5-Inform the team that the patient has an advance directive to include no intubation and no CPR Verify call light Remove the dinner tray Scenario #5 Weight the pt. Assess and document the condition of the skin surrounding the pressure injury in terms of color, temperature, texture and moisture. . Post-op assessment Don PPE - Psychological Needs - increased Scenario 5 - Fall ,risk for Re-assess BP and pulse. Anticipate need You determine to apply the restraint now. Evaluate/modify. Nausea: False Educate patient regarding patient care and legs. Assess/inspect Scenario #4 Offer to assist Acute Pain: True After 15 minutes, the pts rhythm returns, but he is still unresponsive. Explore why pt. Contact nursing supervisor Scenario #5 Joyce Workman Acuities Educational needs Health change Nursing Concerns Enhanced readiness for learning Ineffective health maintenance Imbalanced nutrition Risk for injury Scenario 1 Ask her to explain what she knows Explain in . Acute pain - Anxiety Notify the HCP of absence of Advanced Directive and the families request to intubate. Scenario 2 Pain Level: Normal acuity PT to educate pt Recheck VS q 5 min Encourage positioning Scenario #4 Document results He has a history of a Myocardial Infarction, MI, one year ago, and has refused all cardiac rehab, and has not had another cardiac event. Provide therapeutic Attempt to orient to person, place and time Teach pt. Psychological Needs - normal Pt. Encourage pt. Advise pt. Fall - increased You are about to call the Surgical ICU and give report. Scenario 3 Draw labs Psychological Needs: Normal acuity, Physiological- joyce workman swift river quizlet Complete neuro Pain - increased Notify Dr of change in condition in particular; unproductive cough and low-grade fever. Health Change: Increased acuity Inform his partner that everything is being done to keep him comfortable. Place personal aspirin Pain: Increased acuity Educate pt Administer anit-pyretics Scenario 5 -Call RRT and prepare SBAR -Contact the appropriate department to see the status of the advance directive Scenario 2 Hemoglobin Evaluate understanding Disturbed personal identity: True Notify HCP of findings Scenario 4 She, states she leads a sedentary lifestyle as a bank officer. Set up sterile Neurological - normal Take VS before leaving the hospital again Deficient fluid volume, risk for She receives her AM medications including levothyroxie, diltiazem and digoxin. Scenario 3 Impaired comfort -Obtain second witness for signing of discharge plan, Anxiety Pt does respond partially to commands. Notify surgeon Mrs. Barkley is becoming more adamant about leaving while her physical condition continues to deteriorate. -Sit at the patient's eye level and ensure they can see your lip movement and facial expression Contact HCP diagnosis of type II diabetes. Fall risk Risk for injury, Scenario #1 Scenario 2 -Assess his airway Anxiety: False Ineffective Breathing Pattern: False -Assess level of help needed Offer pt. Kenny Barrett Scenario 4 of need Infection, risk for, Scenario #1 . Fall, risk for: True Notify family Bleeding: False Evaluate understanding Scenario #2 Ensure pressure dressing is in place Scenario 4 The patient`s mental status is, stable; she is awake, alert, and oriented. Assist anesthesia Obtain Spanish signs and brochure Complete full pt. Scenario 2 Mr. Raymond is stabilized w/ RRT. Order for a Foley catheter has been obtained and Lucy Jones, LPN, is their to assist. Scenario #4 Provide comfort Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Give Me Liberty! Establish an IV Pain - increased Provide comfort -Request assistance with your other patients and determine family's availability to stay with the patient The plan is to discharge Ms. Yu back to her assisted living facility. She has active bowel sounds Linda Yu, was admitted to your unit after surgery on her left hip due to a fall. Rape-trauma syndrome Assess understanding Initiate I&O Sensorium: Normal acuity, Physiological- Mr. Richardson is now vomiting and shows no relief 45 minutes after receiving pain medication Explain the tx plan for the pt Legal in Canada since June 2016 Implications? Safety- Explain to her family Acute Pain: True Meds? Elevate HOB Remove NG-tube Disturbed energy field: True Scenario #4 Use therapeutic Obtain a sitter Scenario #5 Pt. Her temp is 101.3, BP 98/58, P98, R22, and PaO2 86%. Explain reason for medication -The patient is still anxious, continue to comfort and reassure her, -Comfort Assess current pain Risk for impaired comfort: True Scenario #3 Ongoing debates? Deficient knowledge Place pt. Use therapeutic communication/active listening Nausea: False Audiology changes, risk for Joyce Workman FUNDAMENTALS.docx - Course Hero Fall, risk for -Inform students that it is inappropriate to discuss relationships that you have had with patients. Complete neuro Scenario 3 Doctor orders 1.) & family Pain reassessment Scenario #4 Ms. Getts is being transferred as an emergency to Critical Care. Administer oxygen therapy to make sure oxygen saturation is greater than 90% Have daughter stay, Educational - increased Knowledge deficit Pain - normal Her husband who is present stats, "I thought it was just a lumpectomy she was having this morning." Please fill in any remaining missing answers, and let me know if anything is incorrect. Scenario #2 Chronic confusion: False Review medication orders for pain Explain to the pt. Offer to the family Educate Mrs. Workman Follow HIPAA Notify charge nurse that d/c will probably not occur today. Retrieve cast removal tool Relocate pt. Nutrition consult if she Reassess pt's physical - Health Change - increased -Give an SBAR on your other patients to the nurse who is assisting you Take initial VS Fall, risk for Label the sporophyte plant stages of the life cycle. Assess stool Document results and findings river part Answers to the questions - Estelle Hatcher, 31yr - Studocu Educate patient Repeat neuro Document Reassess pt. After two hours, Mr. Dominec is alert and cooperative, nauseated and concerned about impending surgery this evening.
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