Enter the email address you signed up with and we'll email you a reset link. -Reinforce the risk if patient has not been NPO and ask the patient when the last time they ate. Mr. Gonzalez's repeat troponin was negative and no significant elevation in his other enzymes. He is complaining of pain in his left arm, and pain in his left chest when he tries to take a deep breath. Psychological Needs Increased acuity Health Change Increased acuity They would also like to start Radium-223. It is now two weeks later; Mrs. Smith has returned. Assign nursing diagnosis and plan the appropriate intervention and evaluate outcomes while working through time pressure and distractions, including random call light requests. Scenario 5 DSD (dry sterile dressing), forehead laceration clean and dry intact. You are about to call the Surgical ICU and give report. Provide for physical and thermal comfort. Ronald Burgundy Wash and glove hands 20ga. You arrive in room to find Ms. Monson talking to herself. Imbalanced Fluid Volume, Risk for True Compromised Family Coping False Scenario 4 Visual assessment Scenario 2 Provide a few chairs if possible for her family to also be comfortable Anxiety True Notify housekeeping. Notify doctor for Foley catheter Color:__________ However, he quit three years ago when he remarried; he and his wife have a nine-month-old baby. Escort patient Document findings Impaired Home Maintenance Management False Re-assess patient Document results Stools are decreasing but patient remains very weak. As you enter the room, Mr. Duncan is refusing to eat foods from bland diet. Notify doctor -Call security for assistance and compliance officer Wound site clean, dry and intact NPO, NG-tube to low continuous suction. Urination: WNL Burning Frequency Urgency Constipation False Non-significant past medical Hx. Surrounding skin: Moist/Intact Red/Erythema Irritation Esteem Verify call light/ bed safety precautions Today's incentive spirometry Tidal Volume is 1250ml, improvement over yesterday's 900ml. The sister of Mr. Mancia calls from home to speak with you. Scenario 2 except 115 pulse, which is normal for him. Fall Risk Increased acuity 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. Apical/Radial Pulse Deficit: No Yes Murmur Valve Click -Offer nutrition/toilet Tunneled, site _______________ Implanted port, accessed _____________________ NURS 320 Med_Surg_Swift_River **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 Remind staff that Universal Precautions are practiced at this hospital for all patients regardless of known infectious diseases. Background Robert Sturgess the client was admitted with Metastatic cancer of Colon, with history of diabetes. Chronic Pain False Full assessment Full assessment Hx of dementia, from nursing home, fall one day ago. Senario 3 Senario 3 Assess food consumption and intake and output Perform pain reassessment Do not probe further The charge nurse tells the nurse to take Mr. Burgundy to the floor, because his room is now ready. Wash and glove hands All our products can be personalised to the highest standards to carry your message or logo. Administer new pain medz Use therapeutic communication/Active Listening GI WNL. Scenario 2 Assessment of bowel movement He also has metal fragments on his left side on his leg arm and torso. -Start IV Imbalanced Nutrition False Scenario 3 Safety Generalized weakness, blood tinged urine and severe pain upon urination, GI- n/v. Pain Level Increased acuity Acute Pain True The lesion was identified as Kaposi's Sarcoma. Assess for bowel sounds Gait: ______________________________, Skin Integrity Assessment His coughing, to clear his airway, appears ineffective. Provide Operative summary of type of procedure, IV fluid and pain status. 0800 1200 Patients within the Swift River Online Simulators Med Surg - Patients SROL Med Surg Female and Male Patients Female Male Ann Rails Carlos Mancia Estelle Hatcher John Duncan Kathy Gestalt Robert Sturgess Lithia Monson Tom Richardson Marcella Como Ramona Stukes Sarah Getts Viola Cumble Dosage Calc - Patients SROL Dosage Calc Female and Male Patients Hx of dementia, from nursing home, fall one day ago. Combien gagne t il d argent ? -Complete incident report. Check physician orders Excess Fluid Volume, Risk for False Impaired Urinary Elimination True Flexes abnormally = 3 Dr. Donofrio. Pain affecting: N/A Sleep Activity Exercise Relationships Appetite Concentration -Restart the IV and draw CBC Safety- Pain, Acute True Combien gagne t il d argent ? -Evaluate patient's understanding of teaching Diet as tolerated, up ad lib after gait training. Pain Level Increased acuity Failure to Thrive True. Needs frequent reminding due to determination to do things herself without assistance. Safety Increased acuity, Physiological Waist belt restraint PRN; family sitter at bedside, assist with bath. Grieving: True Increased fall risk. The patient asks the nurse to explain about these medications and why they are in such a hurry. Scenario 3 Full assessment Skin warm dry, bruises on forehead with small laceration. Fall Risk: Increased acuity Nausea False -Assess patient's ABC (airway, breathing, circulation) Attempt to orient to person, place, and time Wash and glove hands She has just been transported from recovery. Scenario 4 Students will assign correct nursing diagnosis for patients in a medical surgical virtual clinical environment. -Ensure bed is in lowest position, and rails are in place Perform circulatory evaluation Mr. Dominec had his surgical procedure and is doing great. -Administer the medication with a small sip of water and place an NPO sign at the entrance of the patient's room. You take his vital signs which are: Temp 101.3, Pulse 88, Resp 24, B/P 116/84. 4Inform his partner that everything is being done to keep him comfortable. Scenario 4 Normal Sinus Rhythm on telemetry. John Duncan Senario 5 student name date: nur 113 assessment swift river patient: robert sturgess handoff robert sturgess, 81 years old, metastatic ca of colon, hx of diabetes. Pulses: Strength & Symmetry Edema: Radiofrequency ablation may be recommended after endoscopic resection. Call Rapid Response protocol initiated Crutches at bedside adjusted for height. 2. Administer antipyretic meds Acute Pain: True How does the Med-surg simulator work? Deficient Knowledge False Health Change: Increased acuity Pain Level Increased acuity Wash and glove hands Date of insertion: _________________________ Date of dressing: _________________________________ The MD on site makes the decision to intubate the patient and start ventilatory assistance and move the patient to Respiratory Intensive Care. Notify lead nurse/doctor RUE: ______________ LUE: ______________ Cardiovascular has pacer with rate of 82bpm on demand. Psychological Needs Normal acuity -Explain that Docetaxel is a hormone therapy that suppresses the testosterone that your testicles produce producing similar results as surgical intervention. Chronic Confusion False Yes Productive Non-productive Describe Sputum: _______________________ Scenario 5 Powerlessness: True, Scenario 1 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. 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. Neck: ______________ What is the ratio of Fe\mathrm{Fe}Fe (II) atoms to Fe(III) atoms in this compound? Decreased Cardiac/perfusion: False Strict I&O, regular diet, intake 50%. Upon assessment, you determined that she is confused to person, time, and place but is easily directable. Contact dietary consult Oral Mucosa: Tongue: Teeth: Ambulates with minimal assistance. Carlos Mancia Neuro WNL, alert, and cooperative. Neuro WNL. Disturbed Sensory Perception False His partner is at the bedside asking, "how much longer will he have to wait until taken to surgery?" Impaired Gas Exchange True Provide comfort measures Use therapeutic communication/Active Listening Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. -Provide the patient with the time when HCP will come discuss options with him Mr. Richardson is now pain free and questioning why he is plagued with recurring urinary stones. 00 Comments Please sign inor registerto post comments. -Remove the lunch tray and ensure pre-operative consent has been signed. Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Biopsies were sent to determine the treatment. Education of Foley Cath Procedure -Reassess patient q 5 minutes until awake, then 15 minutes until they are fully awake (not Drowsy). Upon entering room, you find Mr. Sturgess is quiet, appears tense and rigid but states, "I am feeling fine." . Scenario 1 Vital signs -Temp 98.4,BP 178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. Provide emesis basin/cloth Scenario 1 Your coworkers are asking you questions about Mr. Dominec. The provider advises the Nurse to draw a stat CBC, give a liter bolus of NS, and repeat CBC. Scenario 1 Perform circulatory evaluation Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. His children are visiting, and they are very supportive. Blood Glucose 185, 4 units of insulin sliding scale for coverage. Expresses fatigue, fear, concern, and desire for recovery. Impaired Skin Integrity, Risk for True Administer antipyretic medication 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". Scenario 5 Scenario 1 Self-Care Deficit False List the nursing care order. Scenario 2 Mr. Burgundy now has his cameraman filming in the ED and is attempting to do a live report. She has been admitted to the floor with complaints of numbness in her right foot and ankle. Palliative care. Scenario 5 Safety Request time she can arrive and staff to help with transfer Love and Belonging Scenario 1 Deficient Knowledge False Wound clean dry and intact. Pain Level Increased acuity Sa fortune s lve 2 216,00 euros mensuels -When the HCP arrives, stay in the room to determine whether you can continue care with the patient Grieving: False Educate patient Stoma: N/A Colostomy Ileostomy Effluent Consistency: View Swift River Reflection Questions (1).docx from NRSG 4412 at South College. Educate patient Sleep deprivation: False You enter his room and recognize that Mr. Thomason appears to be talking to himself and appears confused.
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