Acute Pain False Safety Scenario 3 Educate patient/family Swift River Med-Surg Flashcards | Quizlet Bleeding, Risk for True Vital signs -Temp 98.6, BP 114/62, P 100, RR 20, SaO2 94%. Assist physician in physical exam of patient Sensorium: Normal acuity, Bleeding, risk for: False Failure to Thrive: True. Educational needs: Increased acuity Document results and findings Sleep deprivation: False Amount:________ Obtain translator Pain Level Increased acuity Reasses temp in 1 hour. He has a history of well controlled GERD with over-the-counter Tagamet (Cimetidine), and Tums. Sensorium Increased acuity, Physiological Seznam uivatel, kte vlastn, prodvaj nebo shnj film. Vital signs taken by automatic B/P Cuff q 15 minutes Vital signs Temp 99.4, BP 106/72, P 96, RR 20, SaO2 91%. Deficient knowledge: True Seek clarification Scenario 3 Connect telemetry Deficient Knowledge False Deficient Knowledge True View Swift River Reflection Questions (1).docx from NRSG 4412 at South College. Scenario 2 Odor: __________, *Types: Abrasion, Burn, Laceration, Puncture, Surgical, Pressure Ulcer, Vascular Ulcer, Maceration, Excoriation, Skin Observe closely first hour There is an order to apply a waist belt restraint if needed. The impedance per phase in the load ist 14+j1214+j 12 \Omega14+j12. Apply oxygen Discharge instructions Safety Increased acuity, Physiological Deficient knowledge: True Notify Doctor for pain medz Obtain Spanish signs & brochure Obtain translator Severe pain (10/10) medicated q 30 minutes x4 with IV Morphine 2mg with little relief. Robert Sturgess Scenarios Swift River.docx - Course Hero Scenario 4 Diet as tolerated. Sarah Getts Neuro WNL's, alert and cooperative. -Complete initial post-op assessment His overall health is good, and he has known he has been HIV positive for the past five years. Hep-Lock in place left AC. Scenario 4 They would also like to start Radium-223. Chronic Pain False Breath Sounds: Clear bilaterally. -Reinforce to the patient to not get out of bed Wash and glove hands Health Change Increased acuity Shock False IV fluids of D5 1/2 NS are infusing at 100 mL/hour to his right forearm. Report this activity immediately to the hospital privacy officer Educate pt regarding changes to POC The provider advises the Nurse to draw a stat CBC, give a liter bolus of NS, and repeat CBC. Esteem Use therapeutic communication/Active Listening Capillary Refill: _________ seconds Educate patient : beach pearl), in walking distance of the velgnne ferry stop, is considered the mother of all urban beach clubs. Sa fortune s lve 2 216,00 euros mensuels Multiple abrasions, bruising Head, chest, and inner thigh. Robert Sturgess - Swift River - Robert Sturgess Educational needs Scenario #2. All opinions are mine alone. Chronic Pain True Take vital signs before leaving the hospital again. Scenario 2 Kathy Gestalt, 33yr-old, Dx- second day post-op open right Tibia/Fibula fracture, plaster cast in place on right lower leg. No known allergies. Senario 5 Educate patient Odor: __________, No Fall, Risk for True Fall, risk for: True Apply restraint Iron forms a sulfide with the approximate formula Fe7S8\mathrm{Fe}_7 \mathrm{~S}_8Fe7S8. Begin post op education for day one Pain Level Increased acuity Procedure is canceled for the day and rescheduled later allowing for new consent. Full assessment of patient. Pupils PERRLA, eyes clear. 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Document results, Care of the Patient with a Cardiovascular or, NCLEX - Care of Patient with an Immune Disord, Quiz: Chapter 54, Care of the Patient with an, Chapter 54: Care of the Patient with an Immun, Chapter 17, Section 5; Providing First Aid fo. Acute Confusion: True Mr. Gonzales H/H is 12.7/38. Tunneled, site _______________ Implanted port, accessed _____________________ 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. Safety Ms. Cumble states that she has not had a BM for three days. Radiofrequency ablation may be recommended after endoscopic resection. Visual assess Day 2 admission, Thomas Richardson is complaining of severe pain and is now begging you for some relief; states pain scale 10/10. Yes Offer masks to visitors Excess Fluid Volume, Risk for False Evaluate caller understanding Skin Integrity: Intact No, describe below, Location Type Size Wound bed Drainage Senario 2 She has been documented as being obese, new onset. IV maintenance fluids with D5 1/2 NS at 125ml per hour in left forearm. He is married, and his wife is requesting to stay at his side. Robert Sturgess - Swift River Swift River University Nightingale College Course Concepts of Nursing I (BSN 246) Academic year2022/2023 Helpful? The charge nurse asks you to assume the patient's nursing care. She has arrived in pre-op and about to have surgery this morning. Scenario 3 He asks to speak to a clergy member. LOC Normal acuity Skin warm and, dry, all vital signs in WNL except 115 pulse, which is normal for him. 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. Disturbed Sensory Perception False Tibial: _____ + Bilateral Other: ______________ Generalized: Pedal: ______ + Bilateral Other: ____________ Sacrum: Non-pitting Pitting ___ +. 20ga. Clinical 2 Flashcards | Quizlet Scenario 5 Check PRN pain order When she moves him to the hallway, Mr. Burgundy begins yelling at you "Do you know who I am, I demand a room! Allow family to remain Comfort/Pain Assessment Discuss follow up with his doctor. Document results Nathaniel Gonzalez Pain Level Increased acuity Perform circulatory evaluation Swallowing: Intact Dysphagia Aspiration Precautions -Provide a diversional activity to pass the time while waiting on the HCP and inform wife that the HCP will be coming soon Temp 98, BP 114/67, P 115, RR 20, SaO2 98%. 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. -Contact HCP to determine when they are available to speak with the patient Pain Level Increased acuity Scenario 1 Scenario 4 -Verify that discharge orders have been written, provide discharge instructions, and in inform provider about the chest pain. Full assessment -Ensure there is a full O2 tank on the gurney, place patient on Nasal Cannula Scenario 5 Reapply restraints Vital assessment Linen Change Education of Foley Cath Procedure Scenario 4 Neuro WNL, alert, and cooperative. Tear, Ecchymosis, Contusions, Bruising Scenario #3. He also states he is feeling weak. Health Change Increased acuity 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. Notify lead nurse/doctor Listen to patient concerns Oral Care You explain that he is receiving a higher level of care and was he was sedated before leaving the floor to make him more comfortable. Assess Gastrointestinal Assessment Regardez le Salaire Mensuel de New King James Bible Download For Windows 7 en temps rel. Robert Sturgess Scenario 1 Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. Pregnancy and labor and delivery are not typically associated with the concept of cellular regulation, Patient: Donald Lyles,52-year old male, was admitted yesterday evening for stabilization of his uncontrolled type II diabetes. Bleeding False Safety- 45 terms. Document results Her husband and two grown children are also with her as she is prepared with gown and head cap awaiting transport to the operating room. When the nurse retunes to the room the patient tells the nurse that when he went to the bathroom he became very lightheaded. Love and belonging No Imbalanced Nutrition True -Elevate head of bed and place the patient on Pulse oximetry. Ambulates with minimal assistance. Patient and family upset regarding dx. GI WNL. Background Robert Sturgess the client was admitted with Metastatic cancer of Colon, with history of diabetes. Wash and glove hands Scenario 4 3Check surgical consent for correct procedure and make sure operative site is marked. Senario 2 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. The nurse identifies self to the nurse triaging patients and is directed to trauma room 4. Physiological- Full assessment The Swift River Nursing Simulation involves artificially representing real-world processes with sufficient fidelity to enable learning through immersion, practice, reflection, and feedback without facing the risks inherent in a similar real-life situation. Regardez le Salaire Mensuel de Ticketmaster Beyonce Koln en temps rel. 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. No Known allergies (NKA). Deficient Fluid Volume False Assist patient out of bed Safety Scenario 3 Escort patient Safety Wash and glove hands Scenario 2 Noncompliance True. RS Flashcards | Quizlet Fear True Combien gagne t il d argent ? Scenario 4 The surgeon has suggested Androgen-deprivation therapy (ADT) with surgical castration (orchiectomy). Scenario 4 Mr. Richardson is requesting assistance to ambulate to bathroom. Flexes & withdraws = 4 Assist patient Acute Pain True Knowledge Deficit True Scenario 1 -Notify HCP of neuro findings Scenario 4 Love and belonging- -Discuss effectiveness of sitter -Perform admission assessment Scenario 4 ExplanationAnxiety/ fear True He insists that he is not hungry and refuses assistance with his meal. Fall, Risk for True No known allergies (NKA). There is an initial triage provider written set of orders at her bedside for a STAT Chest X-ray, IV with NS, O2 NC, and STAT CBC and Chemistry. Scenario 5 "I am feeling fine." Verify call light/bed safety precautions Educational Needs Increased acuity No Known allergies (NKA). Vital Signs: B: 160/92, P: 96, R: 22, SpO2: 98, T: 98.9F, 37.1C. Educate about recovery from appendectomy and care to wound. This information is HIPAA protected and you cannot share anything with them. Deficient knowledge: False Dr. Levine, Marcella Como, 38 yr-old, Sexual Trauma Victim (Rape), unknown assailant. -Reassess patient Hep-Lock in place left AC. He requests no visitors at this time, but later asks for his family to be called to discuss a plan of care. Fall Risk Increased acuity Document results/findings Document results. Teach Cameron. Color:__________ Perform pain reassessment -Ensure bed is in lowest position, and rails are in place Health Change: Increased acuity His partner is not with him at this time but will arrive soon to facilitate his discharge home. Describe the physical changes from aging and the care required. Senario 5 Ambulates with assistance. -Explain to patient why his throat may be sore Check PRN pain order The surgeon believes that the surgery was successful but recommends the patient have chemotherapy and radiation postoperatively. Chronic Confusion False Administer antipyretic medication Sensorium Normal acuity, Physiological Scenario 5 97.4, Resp 16 and Pulse Ox 94%. Scenario 2 Bowel Movement Total: x________________, Hygiene Times Bleeding Risk for: False He is a local TV news reporter that was filming an event at the county fair when there was an explosion. Ineffective self-health mgmt: False, Disturbed body: False Scenario 2 -Explain to Mr. Greer that it may take several days for healing, and he may have temporary incontinence, but it will resolve over time. Palliative care. Scenario 5 The cells are allowed to warm up and then are frozen again. Evaluate understanding IV maintenance fluids with D5 1/4 NS @ 150 ml/hr X 3 then reduce rate to 75 ml/hr. -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. Vital signs -BP 124/82, Temp 98.2, P 84, RR 22, SaO2 96%. Therapeutic communicationT Esteem Dr. Roopes, Estelle Hatcher, 31yr-old, r/o appendicitis, 1st day post-op appendectomy; No known allergies (NKA); Vital signs - Temp 101.2, BP 108/74, P 92, RR 20, SaO2 99%, alert and cooperative. Scenario 1 Scenario 2 Dr. Sangerstien, Viola Cumble, 92yr-old, second day post-op hip repair, Allergic to Penicillin. Sensorium Normal acuity, Physiological Wash and glove hands Robert Sturgess Robert Sturgess 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Fall, risk for: True Assess food consumption and intake and output The patient got dizzy when he stood up from the commode. Ms. Getts is being transferred as an emergency to Critical Care. Inform his partner that everything is being done to keep him comfortable. Document results Ms. Rails shares with you her fear of being discharged home to an abusive husband. 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. Students will assign correct nursing diagnosis for patients in a medical surgical virtual clinical environment. Alert and cooperative. Electrolyte Imbalance, Risk for True Glasgow Coma Scale 0-15 Musculoskeletal Radial: ____ + Bilateral Other: _____________ RLE: Non-pitting Pitting ___ + Grieving: True Vital signs -Temp 98.4,BP 178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. Scenario 1 Provide comfort measures Pupils: PERRLA Size: R: mm L: _mm Unequal Sluggish Non-reactive Temp When a physician makes an incision into a body cavity just superior to the diaphragm and inferior to the neck, what body cavity will be exposed? Use therapeutic communication/active listening 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. Stoma: N/A Colostomy Ileostomy Effluent Consistency: You arrive in room to check on her, after washing hands. IV NS is started, and lab work is sent. Rich Dad, Poor Dad (Robert T. Kiyosaki) The Methodology of the Social Sciences (Max Weber) Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.) . Disturbed Body True Scenario 2 You determine to apply the restraint now. Scenario 3 Scenario 2 Widespread Color Change: N/A pallor cyanosis jaundice erythema Give verbal report Aggravating Factors: You are concerned about preventing the patient from falling. Chronic Pain False Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. 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. Notify doctor of change in condition in particular: unproductive cough and low-grade fever. LLE: Non-pitting Pitting ___+ Inform and educate spouse of dietary orders Acute Pain True Inspect cast site -Assess the patient's anxiety level while using therapeutic communication to decrease patients' stress. -If cardiac is suspected call the provider and the rapid response team. Fall, Risk for True Full assessment including both lying/standing -Perform neuro assess He is excited and tells the nurse he is starving and glad that he finally gets to eat. -Reassure patient that he will be moved to a private room as soon as possible Social Isolation, Risk for True Neuro WNL alert and cooperative. Scenario 1 Encourage fluids and fiber diet Nathaniel Gonzalez His past symptoms for three months have been that he noticed a slight hoarseness in speaking, a slight dry cough not related to a cold, and upon examination had a "pea-size lump on the center of his neck". Reassure patient of options She receives the pre-op medication. Vital assessment Remain with patient Safety Scenario 1 LOC Normal acuity You now arrive in the recovery unit one hour post-surgery and you are told that the surgery went well. Acute pain: False They wanted to know and pressure you for the information. Document teaching moment. Call Rapid Response protocol initiated 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 She has IV access and has received a small dose of Valium to reduce apprehension. Grieving False You arrive in room to find Ms. Monson talking to herself. Impaired Skin Integrity, Risk for False Family in room with patient very concerned. Safety ADA diet, intake 25%. Continent: Yes No Occasional Incontinence Frequent Incontinence Brief The MD on site makes the decision to intubate the patient and start ventilatory assistance and move the patient to Respiratory Intensive Care. Mr. Wright is pleasant and cooperative, but needs to be reminded to avoid pressure on his heel and sacrum. Pain, Acute True Ronald Burgundy The lesion was identified as Kaposi's Sarcoma. -Reassess patient q 5 minutes until awake, then 15 minutes until they are fully awake (not Drowsy). Decreased Cardiac/perfusion False Construct dietary consult (plan) Extends abnormally = 2 Scenario 2 Remind the nursing staff that the patient is NPO. Love and belonging IV D5 1/2 NS @150ml/hr. DOCX Swift River Online Learning - Taxonomy Skin warm and dry, all vital signs in WNL Impaired comfort: True Skin moist, respiratory bilateral wheezes and rhonchi. Cough: 4Inform his partner that everything is being done to keep him comfortable. This shop has been compensated by Inmar Intelligence and its advertiser. -Start an IV -Check on patient/sitter hourly Eclectic Recipes Fast And Easy Family Dinner Recipes Scenario 5 Impaired Gas Exchange True Recently he manifested an unusual black lesion on his thigh and developed an opportunistic fungal mouth infection which was treated successfully. She has been admitted to the floor with complaints of numbness in her right foot and ankle. Arthur Thomason Peripheral Neurovascular Dysfunction True. Scenario 4 How does the Med-surg simulator work? Bed Bath: Assist or Total Dx- urinary stones with 3 episodes/5yrs. Ask patient to explain to you what procedure she was expecting to have this morning. Scenario 3 Fatigue True #1: _________, No Verify call light/ bed safety precautions Scenario 3 Deficient Knowledge False It is now the second day post op and he is given discharge information. Medical Surgical Flashcards | Quizlet Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. He is questioning the nurse as to why he has been admitted for heartburn. Dr. Small at bedside with patient and family. Scenario 5 Establish second IV Constipation False The patient is being prepared for discharge and his IV has been removed. Hopelessness True Skin cool to touch and appears pale. -Offer nutrition and/ or toileting Your coworkers are asking you questions about Mr. Dominec. 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. No known allergies (NKA). Place patient on PCA pump Explain to Mr. Dominec your concern for this opportunistic infection and usual treatment. Wash and glove hands Evaluate medication effectiveness The patient has been scheduled for an EGD today and has an order for Omeprazole (Prilosec) and Carafate (sucralfate). Water/Flush: The Physician tells you to have everything ready including a 22 French chest tube, and he will be in shortly to position the chest tube. Place call light and check bed for safety Explain to physician what interventions you have recently initiated Impaired Skin Integrity, False Home - Swift River Scenario 3 Nutrition True Request sitter/family member to bedside Head/Face: Symmetric Asymmetric Drooping Senario 1 Impaired mobility: False Exam January 9 Spring 2020, questions - Studocu Hafencity Riverbus (Hamburg) - All You Need to Know BEFORE You Go 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 . Scenario 2 Hopelessness: True Identify patient Acute pain: True A new graduate nurse receives a call from the hospital telling them to report to the ER immediately for a disaster. Document results. Scenario 1 Scenario 1 This will treat any cancer that may have metastasized to the bone. Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Remain with patient Scenario 2 Full assessment Scenario 2 Mrs. Stukes is feeling nauseated. Acute Pain True Pain Scale: 0 to 10: _______________ It was diagnosed by a portable X-ray and quickly splinted by the ER staff. The patient is awake alert and oriented. Assess pain Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Blood Glucose 185, 4 units of insulin sliding scale for coverage. Scenario 1 Palliative care. Vital Assessment It is determined that Mr. Sturgess could achieve better pain control with a PCA pump. -Reassess patient's physical status prior to leaving him in the hallway He is having some difficulty hearing and complains of ringing in his ears. No known allergies (NKA). A special lowbed has been ordered that will lower to the ground. The client is onDemerol 25mgSlow Intravenous Push (SIVP) for pain. -Take initial vital signs (room air Pulse Ox) Use therapeutic communication/active listening The patient tells the nurse that yesterday he was, "concerned about having an erection, and now they want to cut off my testicels". Scenario 1 Re-assess patient 1. **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 . Document results Due to this, the provider would like him to stay in the hospital for observation. Peripheral Neurovascular Dysfunction False Bleeding, Risk for True Safety Scenario 5 Escort patient to vehicle Vital signs- Swift River MedSurg 1.pdf - MED-SURG SCORE: 100 TIME Notify lead nurse/doctor Fall, Risk for True You explain that his condition has worsened and now he has been taken to ICU. -Offer nutrition/toilet Palliative care. -When the HCP arrives, stay in the room to determine whether you can continue care with the patient LUE: Non-pitting Pitting ___+ They were also concerned about the next patient going into that room and the use of the lavatory. Lung sounds are worse. The oncologist is insistent that the treatment begin immediately. Don Personal Protective Equipment Administer antiemetic medication Document results 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. Offer nutrition and/ or toileting Hopelessness False. Scenario 1 Scenario 3 Document results and findings Toileting, Medications List/Times of Medications/Routes of medication, Neurological Assessment Verbal response Oriented converses = 5 Encourage fluids/fiber/ambulation He does not want to return to the nursing home, and does not wish to burden or live with his children. He was recently treated for a URI with a Z pack, prednisone, and Motrin for pain. Neuro WNL. Ineffective Coping False Amount: _______ Dr. Starks, Physiological The Elbe River - hamburg.com Full assessment Scenario 4
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