Fear True Other: _______________________________ Welcome [evolutionmkt.co.za] -Complete full assessment, to include neuro Also worth mentioning is the 'Alter Schwede' - a 217t . Patient demonstrates urine strain procedure. However, these abnormal cells do not have the capability to spread to other parts of the body. Waist belt restraint PRN; family sitter at bedside, assist with bath. Nausea False When she moves him to the hallway, Mr. Burgundy begins yelling at you "Do you know who I am, I demand a room! Sensorium Increased acuity, Physiological Skin Integrity: Intact No, describe below, Location Type Size Wound bed Drainage Noncompliance True Recently he manifested an unusual black lesion on his thigh and developed an opportunistic fungal mouth infection which was treated successfully. Shock, Risk for False Her chart reports she was extubated upon arrival to the recovery area, received three units (3000 mL) of fluid, receiving O2 @ 4L via nasal cannula, has Foley Catheter in place draining QS clear yellow urine, responds to verbal stimulation, chest dressing in place remains dry and intact, and has just received a small dose of IV morphine for pain. Notify family Upon assessment, you determined that she is confused to person, time, and place but is easily directable. -Tell the patient that they are being admitted to r/o any cardiac issues Senario 2 Safety- Intermittent/Continuous Other: -Administer the medication with a small sip of water and place an NPO sign at the entrance of the patient's room. -Contact HCP to determine when they are available to speak with the patient 3Check surgical consent for correct procedure and make sure operative site is marked. She has received a dose of Hydrocodone for PRN pain 20 minutes ago. Scenario 5 Skin warm dry, bruises on forehead with small laceration. It is unclear if he lost consciousness. He is emotionally distraught, and is insisting that he be allowed to report what is going on from the ED. Discuss follow up with his doctor. Stoma: N/A Colostomy Ileostomy Effluent Consistency: Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. Scenario 3 GI WNL. DSD (dry sterile dressing), forehead laceration clean and dry intact. No known allergies. No Known allergies (NKA). He is having some difficulty hearing and complains of ringing in his ears. GI WNL. Medical Surgical Flashcards | Quizlet -Check on patient/sitter hourly Neptune is an average distance of 4.5109km4.5 \times 10^{9} \mathrm{km}4.5109km from the Sun. Your coworkers are asking you questions about Mr. Dominec. NPO with small amount of ice chips only. Self-Care Deficit False The heartburn has become worse since he started treatment for his URI. Diet as tolerated, up ad lib after gait training. Because of the fall the provider has recommended that he stay in the hospital another night. She has IV access and has received a small dose of Valium to reduce apprehension. Offer masks to visitors Robert Sturgess Robert Sturgess 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. His, Joyce Workman Room 303 Joyce Workman Joyce Workman, 42- year old female who presents to the Diabetes Clinic with a new diagnosis of type II diabetes. Remain with patient Ms. Rails shares with you her fear of being discharged home to an abusive husband. John Duncan, 56yr-old male, Dx- Gastroenteritis, returned yesterday from Cancun, c/o intractable diarrhea, weak, pale, and refusing to eat. Assess for fall risk Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. -Ask Mr. Burgundy to lower his tone as it can be disturbing to other patients You also notice the patient is more difficult to orient. Impaired Comfort True SANE nurse to make second visit today. Make-Up Clinic Day 3 MS - Swift River Assignment: Make-up Day 3 Swift The patient tells the nurse that yesterday he was, "concerned about having an erection, and now they want to cut off my testicels". Strict I&O and strain all urine, filters in bathroom. Carotid:____ + Bilateral Other: _____________ RUE: Non-pitting Pitting ___+ Scenario 1 Verify call Light/bed safety precautions Robert Sturgess - Swift River Swift River University Nightingale College Course Concepts of Nursing I (BSN 246) Academic year2022/2023 Helpful? Scenario 5 Ms. Gestalt capillary refilling is now 6 secs below cast site, extremity is swollen and cold to the touch. Chronic Confusion False The bed arrives tomorrow. Constipation, risk for: True Scenario 2 Tibial: _____ + Bilateral Other: ______________ Generalized: Pedal: ______ + Bilateral Other: ____________ Sacrum: Non-pitting Pitting ___ +. High fall risk. -Provide the patient with the time when HCP will come discuss options with him Administer antipyretic meds Scenario 4 Paul Greer Tubes: None Salem Sump Nasoduodenal PEG J-Tube pH: ______ Mr. Duncan is now complaining of feeling "dizzy" when he stands. Physical Mobility, Impaired True Fall, risk for: True Outline an experimental approach to demonstrate the average RNA chain growth rate during transcription of a cloned gene in vitro. Allergic to sulfa drugs. Perform pain reassessment Due to this, the provider would like him to stay in the hospital for observation. Pain Level Increased acuity Imbalance nutrition: True It is determined that Mr. Sturgess could achieve better pain control w/ a PCA pump Scenario 5 Impaired Skin Integrity, Risk for True Blood Glucose 185, 4 units of insulin sliding scale for coverage. Grieving False Discuss his understanding about the plan of care. Cryotherapy, which uses an endoscope to apply a cold liquid or gas to abnormal cells in the esophagus. new-patients-swift-river-med-surg-covid-new-patients-charlie-raymond 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. Non-significant past medical Hx. The charge nurse tells the nurse to take Mr. Burgundy to the floor, because his room is now ready. The charge nurse asks you to assume the patient's nursing care. Fall, Risk for True Attempt to orient to person, place, and time -Reassess patient Educate caller regarding HIPAA Re-assess patient In the interim, start an IV and start infusing Ringers Lactate. Yes Productive Non-productive Describe Sputum: _______________________ Senario 2 Health Change Increased acuity Scenario 5 Patient and family upset regarding dx. Swift River Medical-Surgical Flashcards | Quizlet You arrive in room to find Ms. Monson talking to herself. Impaired comfort: True Ineffective Coping False Your response to all of them would be: Scenario 1 Vital signs are: B/P 112/78, temp. Psychological Needs: Increased acuity Offer assistance Stoma Status: Pink-Red/Moist Dusky Retracted Excessive bulging The patient got dizzy when he stood up from the commode. Scenario 2 Mrs. Stukes is feeling nauseated. Skin warm dry, bruises on forehead with small laceration. Scenario 3 Deficient knowledge: False Scenario #2. Retrieve cast removal tool Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. Escort patient Administer antipyretic medication Health Change: Increased acuity 1. Identify patient Ineffective Airway Clearance True Swift River Medical-Surgical. Notify family as to when they may come and visit. Neck: ______________ To access your Swift River Virtual Clinicals login to ATI's Student Portal and access the Virtual Clinical card in My ATI. Swift River Clinical Practice Chamberlain University - Homework Score Nutritional Intake: Adequate Inadequate BMI: and the GI cocktail given in the ER did relieve his CP but not completely. Senario 3 Administer new pain medz Regardez le Salaire Mensuel de Ticketmaster Beyonce Koln en temps rel. No weight bearing today. IV maintenance fluids with D5 1/2 NS at 125ml per hour in left forearm. Scenario 5 Leave to break room and not continue in conversation. They would also like to start Radium-223. Diet as tolerated. Esteem Bleeding, Risk for False Physiological- Assist patient Reassure patient of options Contact charge nurse. Check physician orders Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. He is experiencing new onset of shortness of breath and has a nasal cannula with 2L of Oxygen in place. The cells are allowed to warm up and then are frozen again. Radiofrequency ablation may be recommended after endoscopic resection. Scenario 4 156 terms. Offer bedpan Remain with Patient, Sarah Getts, 77 yr-old, Dx- Chronic Renal Failure, admitted with hyperkalemia (5.9, Eq/L)/hyponatremia (128mEq/L). Insert Foley catheter Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. Tom Richardson, 46yr-old. Psychological Needs Normal acuity Fall Risk Increased acuity He also complains that his throat is still very sore. Today's incentive spirometry Tidal Volume is 1250ml, improvement over yesterday's 900ml. Abdomen: Flat Rounded Scaphoid Distended Palpation: Soft Taut Rigid Stoma status: Pink-Red/Moist Dusky Retracted Excessive bulging Impaired Gas Exchange True No Known allergies (NKA). Scenario 4 Noncompliance True. Pain Level Normal acuity Take vital signs before leaving the hospital again. Deficient Fluid Volume True The provider explains that it is a pre-cancerous stage in where the cell develops abnormal features. Sleep deprivation: False -Complete initial post-op assessment Nausea False You determine to apply the restraint now. Safety Increased acuity, Physiological Palliative care. 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. Scenario 2 The patient has been scheduled for an EGD today and has an order for Omeprazole (Prilosec) and Carafate (sucralfate). Visual assessment Notify doctor of change in condition in particular: unproductive cough and low-grade fever. No known allergies (NKA). Blood-tinged mucous, productive cough. Scenario 3 No response = 1, Range of Motion: Full, Limited #ozerysnackingrounds I am so excited to be partnering with Ozery Family Bakery today. Senario 5 PT to educate patient Use therapeutic communication/active listening -Evaluate patient's understanding of teaching Neuro WNL, alert, and cooperative. Notify Physical Therapy (PT) Expresses fatigue, fear, concern, and desire for recovery. Students will assign correct nursing diagnosis for patients in a medical surgical virtual clinical environment. Wash and glove hands Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Awaiting diagnostic labs. Scenario 4 Amount: _______ Safety Increased fall risk. Scenario 5 Scenario 1 Medical-Surgical - Swift River 20ga. Respiratory Effort: Relaxed, Regular, Non-labored Pursed lip breathing Labored -Restart the IV and draw CBC Swift River Reflection Questions 1 - Swift River - Course Hero Fall, risk for True -Ensure there is suction in the room, and check Our Swift River Simulations are designed to help students and practicing nurses master their skills of Prioritization, Delegation, and Sequential thinkingwithout the requirement of being onsiteor even having to download software. : an American History (Eric Foner), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Perform full assessment and provide anti-nausea medicine. Document and provide copy for Mr. Dominec to share with his follow up appointment tomorrow. He does not have an IV nor is he on oxygen. Anxiety True Neuro WNL, alert, and cooperative but worried about scarring and is reluctance regarding walking on leg. Health Change Increased acuity The surgeon has just visited with Mr. Greer 2-days post op and has informed him that the lymph node biopsies have confirmed that the cancer has metastasized, and he will need further treatment. This will treat any cancer that may have metastasized to the bone. No Known allergies (NKA). Notify doctor if condition is abnormal Consult Social Service Nathaniel Gonzalez Sa fortune s lve 10 000,00 euros mensuels He was recently diagnosed with stage III prostate cancer. A special lowbed has been ordered that will lower to the ground. Enter the email address you signed up with and we'll email you a reset link. Assist patient out of bed Apply oxygen Scenario 1 Upon assessment, you determined that she is confused to person, time, and place but is easily directable. Capillary Refill: _________ seconds Apply restraint Notify lead nurse 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. Check PRN pain order Lithia Monson His partner is not with him at this time but will arrive soon to facilitate his discharge home. There is an order to apply a waist belt restraint if needed. Educate patient/family He requests no visitors at this time, but later asks for his family to be called to discuss a plan of care. Evaluation patient after consult Document results ASA is held but morphine 4 mg was given after his GI cocktail. Peripheral Neurovascular Dysfunction False Impaired Urinary Elimination True Her husband and children remain with her in the surgical holding area awaiting transport to the OR. IV D5 1/2 NS with 20 KCL @ 125 ml/hr in left forearm. Scenario 3 Need frequent reminder to stay in room and maintain mask precautions. Assess for bowel sounds c/o headache- medicated with Lortab 5mg PO at 0900, takes Lomotil 10ml PRN q 4 hours last dose at 0834. Urinary Catheter: N/A Indwelling Short-term Indwelling Long-term Date of Insertion:________ Size: _____F Safety Increased acuity, Physiological Mr. Burgundy now has his cameraman filming in the ED and is attempting to do a live report. Emergency intubation and assisted breathing is provided for Mr. Thomason RS Flashcards | Quizlet Report to charge nurse/ head nurse the need for staff education. You have them remain with you, seated in comfortable place, while you call ICU and attempt to locate physician for them. Imbalanced Fluid Volume, Risk for True Respirations Check pedal capillary refill You escort them with you to the ICU. Report this activity immediately to the hospital privacy officer Mr. Richardson is requesting assistance to ambulate to bathroom. Scenario 4 Sitting, BP 109/60, P 114, Standing the patient becomes very lightheaded and the nurse has them lay back down. Place call light and check bed for safety 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. Regular diet. Neuro WNL alert and cooperative. Re-assess patient Arthur Thomason Vital sign Temp 98.4, BP 136/78, P 72, RR 20, SaO2 97%. -Place patient on 100% O2 Scenario 4 The dinner tray is waiting for the patient in his room, and the nurse notices it is a regular diet. IV maintenance fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in left forearm. Several hours later, Mr. Duncan is now complaining of nausea. The pathology report shows no cancerous lesions. Mr. Sturgess does not have a living will or durable power of care completed. Document results and findings Grieving True She has just been transported from recovery. Request time she can arrive and staff to help with transfer Scenario 2 Fall, risk for: True Neuro WNL, except leg pain upon movement. -Provide a diversional activity to pass the time while waiting on the HCP and inform wife that the HCP will be coming soon Robert Sturgess Scenario 1 Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. Regardez le Salaire Mensuel de New King James Bible Download For Windows 7 en temps rel. Fall, Risk for True You arrive in room to find Ms. Monson talking to herself. ADA diet, intake 25%. A GI cocktail was administered, and the patient stated that it decreased his pain to a 6/10. Safety Knowledge Deficit True Scenario 1 Robert Sturgess 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Waist belt restraint PRN; family sitter at bedside, assist with bath. Raspberry and Cream Cheese Stuffed Blueberry French Toast with Ozery. Health Change Increased acuity Scenario 2 IV Assessment/ N/A Generalized weakness, blood tinged urine and severe pain upon urination, GI- n/v. Notify charge nurse that discharge will probably not occur today. Physiological- Amount:________ Mr. Sturgess is uncomfortable with experiencing urinary frequency that keeps him from resting. Auscultate peripheral pulses and ROM. "I am feeling fine." Ruth Cummings Trustee Vice Chair Audit Chair . Scenario 1 Document and prepare to transfer to Surgical ICU Abdominal Pain: Non-tender Tender/Pain Describe: -Notify charge nurse of patient's deteriorating condition Fall Risk Increased acuity 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. 45 terms. Deficient Knowledge False Comfort/Pain Assessment Document results 1. Social worker with patient this morning. Ineffective Renal Perfusion, Risk for True You are now preparing for discharge, place steps in order: Senario 1 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. Senario 4 Scenario 4 Then the bus splashed into the river for a cruise. Non-significant past medical Hx. Scenario 3 Vital signs -Temp 98.4,BP 178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. Vital signs -Temp 98.6, BP 114/62, P 100, RR 20, SaO2 94%. Senario 3 No known allergies (NKA). 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. Scenario 5 Mr. Dominec decides he does not want to see Infectious Disease doctor about his new cough. Mrs. Pittmon states she has had numbness for years but "now I can't . Love and belonging Use therapeutic communication/Active Listening -Call security for assistance and compliance officer LUE: Non-pitting Pitting ___+ Educational Needs Increased acuity RS Vclinical Flowsheet - Student Name : Date: NUR 113 Assessment Swift After two hours, Mr. Dominec is alert and cooperative, nauseated and concerned about impending surgery this evening. Bowel Movement Total: x________________, Hygiene Times Neuro WNL alert and cooperative. Chronic Pain False Senario 2 Mr. Dominec had his surgical procedure and is doing great. After 24 hours, Ms. Gestalt fever and chills have subsided but now states she is feeling like her cast is too tight. DOCX Swift River Online Learning - Taxonomy 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". It was diagnosed by a portable X-ray and quickly splinted by the ER staff. 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 . Self-Actualization Senario 4 Pupils: PERRLA Size: R: mm L: _mm Unequal Sluggish Non-reactive Contact Social Services Physiological- Mr. Dominec has a male partner and has been married for the past ten years and share their three children to the marriage. Safety Scenario 5 -When the HCP arrives, stay in the room to determine whether you can continue care with the patient Noncompliance False ADA diet, intake 25%. The 'Strandperle' (lit. He is pale, weak, diaphoretic, and appears anxious. Neuro WNL alert and cooperative. -Ensure patient privacy and call for help and assist patient to bed once help arrives No known allergies (NKA). Physiological Evaluate/modify plan of care Scenario 4 The charge nurse tells you not to move the patient, because there is no special treatment according to social status. Dr. Brown, Educational Needs Increased acuity Acute Pain True Document results Urination: WNL Burning Frequency Urgency -Attempt to orient to person, place, and time Apply nasal cannula Upon entering the room, the patient appears to be trying to get out of bed Localizes pain = 5 Communication/Speech: Clear Non-verbal Slurred Aphasia Other Evaluate caller understanding Full assessment of patient. Scenario 4 Scenario #3. Stools are decreasing but patient remains very weak. fallout 4 save wizard quick codes death and wheel of fortune tarot combination; gambling meaning in english urdu alpine spiced apple cider gluten free; how to use v2ray samsonas sequential gearbox subaru; lg magic remote power light stays on All opinions are mine alone. -Reorient Patient to person, place, & time Vital Assessment Lithia Monson Explain reason for assessment and procedure Neuro WNL alert and cooperative. Provide a few chairs if possible for her family to also be comfortable Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Scenario 5 He tells the nurse he has called his wife and wants to be discharged now. Non-significant past medical history. Aggravating Factors: Senario 3 Strict I&O, regular diet, intake 50%. You return to the break room on your floor. Scenario 2 Impaired home maintenance mgmg r/t client or family: False Obtain translator Remind physician to wash his hands before examining the patient Document Procedure Awaiting transport. Elevate Extremity swift river assignment: day swift river assignments dosage minimum score 90 med minimum score 80 minimum score 90 robert sturgess linda yu linda pittmon carlos Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions Keiser University Silver Creek High School (Colorado) Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Scenario 2 Scenario 3 Imbalanced Nutrition: True -Have patient remain in bed, head elevated 30 degrees -Discuss and determine sitter availability Cross), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. 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