Background Robert Sturgess the client was admitted with Metastatic cancer of Colon, with history of diabetes. Determine clinical decisions based on listening to an audible client report. Fear: True Document results 2. Radiofrequency ablation, which uses heat to remove abnormal esophagus tissue. Dr. Suculo, Physiological Vital assessment DSD (dry sterile dressing), forehead laceration clean and dry intact. Psychological Needs Normal acuity Encourage fluids/fiber/ambulation Respiratory Rhythm: Regular Rhythmic Irregular Periods of Apnea Cheyne-Stokes Contact charge nurse. The patient describes this pain as a heavy pressure with intermittent stabbing. Enter the email address you signed up with and we'll email you a reset link. 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 Reassure patient and help explain any new orders from physician to patient 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. You have them remain with you, seated in comfortable place, while you call ICU and attempt to locate physician for them. Explain to physician what interventions you have recently initiated Scenario 2 Chronic Pain True Document results. Pain Level Increased acuity Pulse Ox: ___________ % on ____________FiO2; Room Air; Delivery Device Strict I&O, regular diet, intake 50%. Provide comfort and pain measures Peripheral Neurovascular Dysfunction: False Do not disturb Bladder distention Pelvic pain Low back/flank pain You escort them with you to the ICU. Offer nutrition/toilet jasmine . No known allergies (NKA). Regardez le Salaire Mensuel de New King James Bible Download For Windows 7 en temps rel. Radial: ____ + Bilateral Other: _____________ RLE: Non-pitting Pitting ___ + Now, third day post-op, Mrs. Stukes appears sad and depressed upon entering the room. After washing and gloving hands, you then identify yourself and the patient, Ann Rails. -Explain to Mr. Greer that it may take several days for healing, and he may have temporary incontinence, but it will resolve over time. Document and provide copy for Mr. Dominec to share with his follow up appointment tomorrow. Regular diet. -Document and contact nursing supervisor/Charge nurse The patient is awake, alert, and oriented. Neuro WNL alert and cooperative. Check pedal capillary refill Evaluate/Modify Mobility Plan, Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical Hx. Awaiting diagnostic labs. Scenario 2 Students will assign correct nursing diagnosis for patients in a medical surgical virtual clinical environment. Hep-Lock in place left AC. Robert Sturgess Scenario 1 Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. Acute Pain True Health Change Increased acuity Full assessment Skin warm and, dry, all vital signs in WNL except 115 pulse, which is normal for him. Assess for fall risk Call rapid response Explain reason for assessment and procedure Safety You correctly diagnosed 11 out of 16 options. Scenario 5 Outline an experimental approach to demonstrate the average RNA chain growth rate during transcription of a cloned gene in vitro. He has a history of well controlled GERD with over-the-counter Tagamet (Cimetidine), and Tums. Failure to Thrive False. Grieving: False Apply restraint Scenario 3 Continent: Yes No Occasional Incontinence Frequent Incontinence Brief You question her while reviewing her operative consent and determine that everything is correct. Kathy Gestalt Scenario 5 Adjust crutches Encourage fluids He also complains that his throat is still very sore. Mr. Dominec decides he does not want to see Infectious Disease doctor about his new cough. Mr. Duncan is now complaining of feeling "dizzy" when he stands. His orthostasis is normalized after a second liter of NS was administered. 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) -Medicate for pain Regardez le Salaire Mensuel de Ubah Kalimat Efektif Online en temps rel. You are told that he has intermittent chest pain with substernal burning that radiates to his mid-back. Retrieve cast removal tool A new graduate nurse receives a call from the hospital telling them to report to the ER immediately for a disaster. While assessing the patient, Mr. Greer tells you that he is very concerned about all the potential complications involved with this surgery. His partner is not with him at this time but will arrive soon to facilitate his discharge home. -Reassure patient that he will be moved to a private room as soon as possible Neuro- confusion to time and place, but oriented to self, speech clear, poor historian, did not recognize son today which is new for her; Neuro assessment and vital signs q1 hr. Assist patient Deficient knowledge: False Scenario 4 They would also like to start Radium-223. -Administer the medication with a small sip of water and place an NPO sign at the entrance of the patient's room. SANE nurse to make second visit today. Secondary: Assess vital signs, auscultate heart, lungs, and bowl sounds. Cough: Vital assessment -Medicate for pain Report to charge nurse/ head nurse the need for staff education. Stay with patient for surgeon's arrival to explain intended surgical procedure and the GI cocktail given in the ER did relieve his CP but not completely. Scenario 4 His difficulty voiding finally motivated him to seek care. After 3 hours, Ms. Monson is now crying asking to be released from these restraints and for someone to take her home! Continue.Robert Sturgess Room 305 Robert Sturgess, 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Scenario 5 Put the patient on O2 NC and Fentanyl 25mcg IVP for pain. Pain: No Yes: Location: ______________________ Acute Chronic Constant Intermittent Peripheral Neurovascular Dysfunction False Provide verbal report to team members who respond to rapid response She has been documented as being obese, new onset. Take vital signs before leaving the hospital again. Senario 4 Home; Our Focus; Our Legacy; Our Partners; Our People; Our Fellows; Our Investments He is experiencing new onset of shortness of breath and has a nasal cannula with 2L of Oxygen in place. Flexes abnormally = 3 Ms. Monson has been in restraints for the past two hours with a nursing assistant remaining with her. Scenario 3, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Civilization and its Discontents (Sigmund Freud), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Psychology (David G. Myers; C. Nathan DeWall), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), The Methodology of the Social Sciences (Max Weber), Give Me Liberty! He also has metal fragments on his left side on his leg arm and torso. Color:__________ Inspect cast site Ineffective Airway Clearance True Document results/findings The patient asks the nurse to explain about these medications and why they are in such a hurry. Evaluate learning Shock, Risk for False Inappropriate words = 3 Infection, Risk for False No response = 1, Range of Motion: Full, Limited Scenario 4 Safety Educate patient Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. -Perform neuro assess No known allergies (NKA). Impaired Skin Integrity, Risk for True -Assess for fall risk Decreased Cardio Tissue Perfusion False Deficient Knowledge False 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. Scenario 5 Scenario 3 Knowledge Deficit True -Complete full assessment, to include neuro Request sitter/family member to bedside Vital signs -Temp 98.2, BP 94/60, P72, RR 22, SaO2 99%. Arthur Thomason He is questioning the nurse as to why he has been admitted for heartburn. -Have patient remain in bed, head elevated 30 degrees Obtain translator Psychological Needs Normal acuity Document results No Known allergies (NKA). Educational needs: Increased acuity Breath Sounds: Clear bilaterally. Vital signs Temp 99.4, BP 106/72, P 96, RR 20, SaO2 91%. #ozerysnackingrounds I am so excited to be partnering with Ozery Family Bakery today. Impaired Comfort True You explain that his condition has worsened and now he has been taken to ICU. Wash and glove hands Skin warm and dry, daily dressing changes, T-tube without drainage. Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. palliative care. Estimate the length of the Neptunian year given that the Earth is 1.50108km1.50 \times 10^{8} \mathrm{km}1.50108km from the Sun on the average. -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 She has IV access and has received a small dose of Valium to reduce apprehension. Re-assess patient Impaired Gas Exchange True He insists that he is not hungry and refuses assistance with his meal. Senario 2 Heterotrophs include (1) autotrophs, saprophytes, and herbivores (2) omnivores, carnivores, and autotrophs (3) saprophytes, herbivores, and carnivores (4) herbivores, autotrophs, and omnivores. Scenario 3 Consult Social Service Vital assessment Ineffective self-health mgmt: False, Disturbed body: False Palliative care. He is restless with slight confusion but is easily orientated with attempts from nurse. Teach patient about safety when getting out of bed Scenario 1 Love and belonging- Robert Sturgess, 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Viola Cumble GI WNL. Wash and glove hands Upon entering the room, the patient appears to be trying to get out of bed Mr. Gonzalez has been admitted to the floor to determine that his chest pain is not related to a cardiac event. Chronic Confusion False -Advise patient not to get up and walk on his own Safety Evaluate understanding Dr. Small at bedside with patient and family. Purposive Communication Module 2, Chapter 1 - Summary Give Me Liberty! Fall, Risk for True Esteem Present health assessment including B/P and LOC and dressing. Administer protocol antidiarrheal medication Impaired Skin Integrity False Love and belonging Mr. Dominec had his surgical procedure and is doing great. The nest morning the gastroenterologist informs Mr. Gonzalez that his EGD confirmed a diagnosis of Barrett's esophagus with Dysplasia. In the interim, start an IV and start infusing Ringers Lactate. -Check on patient/sitter hourly If family/visitors come, will need education to airborne precautions. Regardez le Salaire Mensuel de Nba 2k23 Pc Review en temps rel. Verify call Light/bed safety precautions Raspberry and Cream Cheese Stuffed Blueberry French Toast with Ozery. The dinner tray is waiting for the patient in his room, and the nurse notices it is a regular diet. Nausea: False He is married, and his wife is requesting to stay at his side. I need to be reporting!" Stoma Status: Pink-Red/Moist Dusky Retracted Excessive bulging Remind the nursing staff that the patient is NPO. He is having some difficulty hearing and complains of ringing in his ears. Scenario 3 -Use therapeutic communication/active listening Perineal Care Cardiovascular has pacer with rate of 82bpm on demand. 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. You arrive in room to check on her, after washing hands. The cancer was more advanced than they previously had thought so inguinal lymph nodes were removed. Grieving False Fall, risk for: False Alleviating Factors: Last pain medication: Health Change: Increased acuity Safety Deficient knowledge: True Evaluate/modify plan of care 20ga. Disturbed body False Senario 2 Acquire daily weight and food intake Scenario 1 Full assessment Obtain vital signs machine The provider advises the Nurse to draw a stat CBC, give a liter bolus of NS, and repeat CBC. Educational Needs Increased acuity Failure to Thrive True. Perform circulatory evaluation Safety Increased acuity, Physiological Deficient Knowledge False -Check patency of Foley catheter, urine color, and ensure it is secure to the patient's leg Sensorium Increased acuit, Physiological Provide information for MD to call family at home and explain what has just happened Check input/output for possible dehydration Ann Rails Lithia Monson Scenario 2 Infection, Risk for True You arrive in room to find Ms. Monson talking to herself. Oral Care Pain = 2 Bleeding False However, these abnormal cells do not have the capability to spread to other parts of the body. Respiratory Rate: WNL Tachypnea Bradypnea Scenario 5 Her husband and children remain with her in the surgical holding area awaiting transport to the OR. Carlos Mancia Mr. Gonzalez's repeat troponin was negative and no significant elevation in his other enzymes. Acute Confusion True Wash and glove hands Too bad the cruise area was a very unatractive part of the River Elbe. -Tell the patient to call immediately if the chest pain gets worse or they become short of breath Scenario 1 Senario 4 You notice she is crying and is expressing fear that she "will always have this pain and numbness" and she doesn't think she can cope. Isolative, appears fearful, crying, and refusing to see her husband. The patient got dizzy when he stood up from the commode. Scenario 2 Health Change Increased acuity Yes You determine to apply the restraint now. Document results -Remind patient to call for help is he need to get up and provide patient with a urinal. Family arrive one hour after event to his prior room and find Mr. Thomason's room is empty and have no idea of the events that have just occurred. The nurse identifies self to the nurse triaging patients and is directed to trauma room 4. Filmotka filmu Najvyia ponuka (2013). Scenario 5 Use therapeutic communication/Active Listening -Verify that discharge orders have been written, provide discharge instructions, and in inform provider about the chest pain. Several hours later, Mr. Duncan is now complaining of nausea. : an American History (Eric Foner), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Check surgical consent for correct procedure and make sure operative site in marked. 2Provide comfort in pre-surgical room Mr. Dominec. When you enter the room, the patient is having chest pain again, and they are pale and diaphoretic. Use therapeutic communication/active listening Vital signs -BP 124/82, Temp 98.2, P 84, RR 22, SaO2 96%. 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. Wash and glove hands Skin moist, respiratory bilateral wheezes and rhonchi. Bleeding, Risk for False IV NS is started, and lab work is sent. Acute Confusion False Check monitor Chronic Pain False Scenario 1 Seznam uivatel, kte vlastn, prodvaj nebo shnj film. Fall Risk Increased acuity NKDA Assessment The client vital signs are: Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%, Neuro WNL alert and cooperative. Notify lead nurse/doctor No Known allergies (NKA). Powerlessness True. Constipation, risk for: True Explain to Mr. Dominec your concern for this opportunistic infection and usual treatment. Skin Integrity: Intact No, describe below, Location Type Size Wound bed Drainage -Notify HCP of neuro findings Remind staff that Universal Precautions are practiced at this hospital for all patients regardless of known infectious diseases. Senario 5 References; Access My Virtual Clinicals; Medical-Surgical. Vital signs -Temp 97.2, BP 96/74, P 82, RR 20, SaO2 97%. He replies, "six times in the past four hours". Abdominal Pain: Non-tender Tender/Pain Describe: The patient has sustained an injury to her head, that is bandaged, and is bleeding from a wound to her right arm and chest area. Students also viewed Culture Concept notebook Development concept notebook Elimination concept notebook Gas Exchange concept notebook Elevate head of bed Educate patient She is having some difficulty breathing. -Tell the wife that you will speak to the husband, and this is apprehension is expected with this surgery/diagnosis. Also worth mentioning is the 'Alter Schwede' - a 217t . Bowel Movement Total: x________________, Hygiene Times Pain Level: Increased acuity 97.4, Resp 16 and Pulse Ox 94%. Scenario 5 Report current urinary output quantify per hour and color of urine The oncologist is recommending Docetaxel as opposed to an orchiectomy. Notify doctor if condition is abnormal Urinary Catheter: N/A Indwelling Short-term Indwelling Long-term Date of Insertion:________ Size: _____F The patient is awake alert and oriented. Linen Change Encourage fluids Odor: __________, *Types: Abrasion, Burn, Laceration, Puncture, Surgical, Pressure Ulcer, Vascular Ulcer, Maceration, Excoriation, Skin Seek clarification 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. Scenario 2 His children are visiting, and they are very supportive. Ineffective Peripheral Tissue Perfusion False He has been readmitted for a red spot on his sacrum of 1 cm and a 2 cm blister on his right heel. Verify call light/ bed safety precautions Mr. Dominec has a male partner and has been married for the past ten years and share their three children to the marriage. Safety No known allergies (NKA). -Elevate head of bed and place the patient on Pulse oximetry. 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