robert sturgess swift river

nursing care plan for Linda Pittmon, a 74 -year old female patient who is a noncompliant diabetic, and frequently stays at the local homeless shelter. Escort patient August 13, 2020 // by Angela McGowan. Educate patient regarding condition She is also to receive radiation, chemotherapy, and hormone therapy post operatively. Respiratory Rhythm: Regular Rhythmic Irregular Periods of Apnea Cheyne-Stokes Chronic Pain False He has not had his BP medication today. Combien gagne t il d argent ? Assess Impaired Gas Exchange False Robert Domenic Imbalanced Nutrition: True Check physician orders Pain Level Increased acuity Non-significant past medical Hx. Carlos Mancia Scenario 1 You explain that his condition has worsened and now he has been taken to ICU. Blood Glucose 185, 4 units of insulin sliding scale for coverage. Infection, Risk for False Give verbal report Social worker with patient this morning. -Explain that Radium-223 mimics calcium and is absorbed during new bone growth. -Call security for assistance and compliance officer Verbal command = 3 Fear: True Opening Title Production company Cast and crew Genre J A N U A R Y 2: The Killing of John Lennon: IFC First Take: Andrew Piddington (director/screenplay); Jonas Ball, Krisha Fairchild, Gunter Stern, Gail Kay Bell, Mie Omori, Robert C. Kirk: Crime, Drama: 4: One Missed Call: Warner Bros. Pictures / Alcon Entertainment / Kadokawa Pictures: Eric Valette (director); Andrew Klavan (screenplay . Notify doctor Educate pt regarding changes to POC Educate patient Pain Level Increased acuity Scenario 1 Fall, Risk for False Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. -Notify HCP of neuro findings Grieving: True Evaluate caller understanding Decisional Conflict False Robert Sturgess Scenario 1 Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. The nurse identifies self to the nurse triaging patients and is directed to trauma room 4. Electrolyte Imbalance False Impaired Gas Exchange True Combien gagne t il d argent ? He is complaining of pain in his left arm, and pain in his left chest when he tries to take a deep breath. Scenario 3 Mr. Duncan is now complaining of feeling "dizzy" when he stands. Perform full assessment and provide anti-nausea medicine. Observe closely first hour Scenario 3 Scenario 3 Check surgical consent for correct procedure and make sure operative site in marked. Pupils PERRLA, eyes clear. In the interim, start an IV and start infusing Ringers Lactate. Abnormal left leg weakness, gait unsteady, 5/10 on numeric pain scale. Vital signs taken by automatic B/P Cuff q 15 minutes Notify doctor Color:__________ Lung sounds are worse. Diet as tolerated, up ad lib after gait training. Social Isolation, Risk for True Disoriented, confused = 4 She is also investigating bone marrow transplantation. NG tube to low suction possibly D/C'd today after Dr. Levine rounds. Grieving: False. -Explain to Mr. Greer that it may take several days for healing, and he may have temporary incontinence, but it will resolve over time. Pain Level Normal acuity Mr. Dominec is waiting for his partner to arrive to take him home and you notice he has a dry unproductive cough and trouble splinting with a pillow at his operative site. Oral Mucosa: Tongue: Teeth: The patient has been scheduled for an EGD today and has an order for Omeprazole (Prilosec) and Carafate (sucralfate). Inspect cast site Fall, Risk for True No Pulses: Strength & Symmetry Edema: Scenario 5 His partner is not with him at this time but will arrive soon to facilitate his discharge home. Expresses fatigue, fear, concern, and desire for recovery. Scenario 1 Scenario 1 -Draw a repeat CBC per HCP order to determine current Hemoglobin status Ineffective Self-Health Management False Place pt on PCA pump Stools are decreasing but patient remains very weak. Chronic Pain False Stoma status: Pink-Red/Moist Dusky Retracted Excessive bulging He insists that he is not hungry and refuses assistance with his meal. Palliative care. Psychological Needs Normal acuity Robert Sturgess Robert Sturgess 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Wound clean dry and intact. Tubes: None Salem Sump Nasoduodenal PEG J-Tube pH: ______ Document results and findings Scenario 4 Disturbed Body Image True Hopelessness False. 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. Psychological Needs Increased acuity However, he quit three years ago when he remarried; he and his wife have a nine-month-old baby. Senario 4 The cancer was more advanced than they previously had thought so inguinal lymph nodes were removed. Respiratory Rate: WNL Tachypnea Bradypnea Respiratory Effort: Relaxed, Regular, Non-labored Pursed lip breathing Labored Sitting, BP 109/60, P 114, Standing the patient becomes very lightheaded and the nurse has them lay back down. Scenario 3 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 5 He has been readmitted for a red spot on his sacrum of 1 cm and a 2 cm blister on his right heel. Notify lead nurse/doctor Scenario 5 00 Comments Please sign inor registerto post comments. ADA diet, intake, 25%. Neuro WNL alert and cooperative. Multiple abrasions, bruising Head, chest, and inner thigh. Vital signs -Temp 99.1, BP 124/62, P 77, RR 20, SaO2 91%. ExplanationAnxiety/ fear True Grieving False Skin: Warm/dry Clammy/diaphoretic Skin Turgor: Brisk Tenting The client is onDemerol 25mgSlow Intravenous Push (SIVP) for pain. Severe pain (10/10) medicated q 30 minutes x4 with IV Morphine 2mg with little relief. Paul Greer Neuro WNL, alert, and cooperative. Use therapeutic communication/Active Listening Scenario 3 Bleeding, Risk for True His partner is at the bedside asking, "how much longer will he have to wait until taken to surgery?" Document results and findings Deficient Knowledge False There is an order to apply a waist belt restraint if needed. Excess Fluid Volume, Risk for False Sleep deprivation: False is a 57 y/o who has been admitted for a radical prostatectomy. He is aware that he may not have an erection and may need depends for bladder incontinence. Three hours later, Ms. Getts is unsteady when standing by her bedside. -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 Document results Blood-tinged mucous, productive cough. Students will form a preliminary assessment based on reported assessment data for medical surgical patients in a virtual clinical environment. Senario 2 Senario 1 Lithia Monson After washing and gloving hands, you then identify yourself and the patient, Ann Rails. Use therapeutic communication/Active Listening IV D5 1/2 NS with 20 KCL @ 125 ml/hr in left forearm. 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 Explain to her family and provide contact information. Nursing questions and answers. Evaluate outcome of dietary plan He is currently febrile with temperature 100.8, HR 99, BP 135/96, RR 20, PaO2 96%, nauseated with no vomiting, rebound tenderness in right lower quadrant, has elevated WBC's and surgeon feels this will be uneventful even though he has just been diagnosed with AIDS this past week. Mr. Richardson is now pain free and questioning why he is plagued with recurring urinary stones. Several hours later, Mr. Duncan is now complaining of nausea. Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. Vital signs Temp 99.4, BP 106/72, P 96, RR 20, SaO2 91%. The MD on site makes the decision to intubate the patient and start ventilatory assistance and move the patient to Respiratory Intensive Care. Hypothermia False Electrolyte Imbalance False Health Change Increased acuity Impaired Mobility True Next time we'll spend our 60 on some food and nice beers. Scenario 3 Scenario 4 Today's incentive spirometry Tidal Volume is 1250ml, improvement over yesterday's 900ml. Ineffective self-health mgmt: False, Disturbed body: False Document results. Renal diet. Remain with patient Remain with patient Scenario 2 His left humerus is fractured and splinted. Your notice Mr. Thomason is lying supine, appears slightly cyanotic in his lips, is exhibiting more effort to breathe, and is increasingly restless. A few hours after speaking with the sitter about the patient needing complete observation, you notice the sitter outside of the room talking on the phone. Educate patient regarding patient care After two hours, Mr. Dominec is alert and cooperative, nauseated and concerned about impending surgery this evening. Scenario 3 Safety- Love and Belonging She has been documented as being obese, new onset. Impaired Mobility True Health Change Increased acuity Compromised Family Coping: False Self-Actualization Tom Richardson Pulse You now arrive in the recovery unit one hour post-surgery and you are told that the surgery went well. No Known allergies (NKA). Vital assessment Reassure patient and help explain any new orders from physician to patient His difficulty voiding finally motivated him to seek care. Nausea/Vomiting: Yes No Neuro WNL, except leg pain upon movement. Senario 3 Non-significant past medical history. Combien gagne t il d argent ? Consult Social Service Vital re-assessment -Teach the patient that there are several interventions for complications post-prostatectomy to include erectile dysfunction, post-op prostatectomies, and self-care involved with a foley catheter at home. Sarah Getts John Duncan Isolative, appears fearful, crying, and refusing to see her husband. Nausea False Ms. Getts is requesting water to drink. Use therapeutic communication/active listening Genitourinary Assessment Sleep deprivation False Physiological The patient states that the symptoms occurred in the middle of the night and woke him from his sleep. Impaired Home Maintenance management r/t client or family False Safety Increased acuity, Physiological Temperature is 98.3, HR is 87, RR is16, BP is 121/74, PaO2 is 98%. Ineffective Self-Health Management True Evaluate learning Fall, Risk for True The oncologist is insistent that the treatment begin immediately. Cryotherapy, which uses an endoscope to apply a cold liquid or gas to abnormal cells in the esophagus. Continent: Yes No Brief/Diaper Perform neuro assess NPO with small amount of ice chips only. Students will assign correct nursing diagnosis for patients in a medical surgical virtual clinical environment. Mr. Greer has just been visited by his wife. You enter room one hour after the physician has left the patient. 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. Scenario 2 Procedure is canceled for the day and rescheduled later allowing for new consent. 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. Therapeutic communication. Nausea: False Pain = 2 LUE: Non-pitting Pitting ___+ Fear/Anxiety True. Airborne Isolation. Virginia Smith, 57-year-old who has elected to have a total mastectomy based on consultation with her surgeon, a total mastectomy removes all breast tissue but leaves all or most of axillary lymph nodes and chest muscles intact. -Administer the medication with a small sip of water and place an NPO sign at the entrance of the patient's room. Vital Assessment Check pedal capillary refill Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Construct dietary consult (plan) RLE: ______________ LLE: ______________, Casts/Splits: ____________________________, Motor response Verbal command = 6 -Tell the patient to call immediately if the chest pain gets worse or they become short of breath If patient statement differs from the surgical consent she has signed, notify surgeon immediately No known allergies (NKA). Scenario 5 Some hair on the left side of his head has been burned off, as well. Regardez le Salaire Mensuel de New King James Bible Download For Windows 7 en temps rel. Cardiovascular has pacer with rate of 82bpm on demand. Failure to Thrive: True. Hx of dementia, from nursing home, fall one day ago. Obtain recent chest X-ray reports and recent ABG's for physician to review Generalized weakness, blood tinged urine and severe pain upon urination, GI- n/v. -Assess patient's ABC (airway, breathing, circulation) Safety Increased acuity, Physiological She has been admitted to the floor with complaints of numbness in her right foot and ankle. RLE: ______________ LLE: _____________ Ann Rails Pupils: PERRLA Size: R: mm L: _mm Unequal Sluggish Non-reactive Why is cysteine such an important amino acid for defining the tertiary structure of some proteins? Wash and glove hands Needs frequent reminding due to determination to do things herself without assistance. Monitor and evaluate fluid intake Wash and glove hands Fall, risk for: True #1: _________, No Scenario 3 Deficient Knowledge False Two hours later, Mr. Duncan is asked how frequent his stools have been today. Full assessment r/o Tuberculosis. Anxiety True Urinary Catheter: N/A Indwelling Short-term Indwelling Long-term Date of Insertion:________ Size: _____F Re-assess patient Scenario 4 Mr. Richardson is requesting assistance to ambulate to bathroom. Validate NPO Status Description: Sharp Stabbing Throbbing Aching Cramping Other: -Discuss with family sitter if there are any other family members who can help with monitoring Lithia Contact dietary consult Auscultate peripheral pulses and ROM. Psychological Needs Normal acuity You arrive in room to find Ms. Monson talking to herself. Administer antiemetic medication Listen to patient concerns -Ensure IV is patent, Lithia Monson Compromised Family Coping False Notify doctor Skin warm and pale. Toggle navigation Swift River. Patient and family upset regarding dx. Arthur Thomason, 56-year-old MVA victim, fourth day post op with a splenectomy and femur repair. Vital assessment Readiness for Self-Care Enhancement True Pain, Acute True Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Bleeding, Risk for False Scenario 5 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. Dr. Starks, Physiological -Instruct Mr. Burgundy and his cameraman to stop immediately -Discuss effectiveness of sitter The dinner tray is waiting for the patient in his room, and the nurse notices it is a regular diet. Anxiety True -Ensure patients is positioned in bed properly He warns the patient that if he does not comply with the treatment and preventive measures, he will need other treatments that may include. Notify Doctor for pain medz ASA is held but morphine 4 mg was given after his GI cocktail. Document results Acute Pain True Notify housekeeping. No known allergies (NKA).

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