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NRSG 4412 Swift River Answers

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NRSG 4412 Swift River Answers NRSG 4412 Swift River Answers

Arthur Thomason Room 301
Arthur Thomason, 56 year old MVA victim, fourth day post op with a splenectomy and femur repair. He is experiencing new onset of shortness of breath and has a nasal cannula with 2L of Oxygen in place. He is restless with slight confused, but is easily orientated with attempts from nurse. Temperature spiked during the night to 102.4, BP now 146/94 which is slightly elevated, Respiration's at 30 bpm and slightly labored, heart rate 102 versus 84 from last night shift. Skin cool to touch and appears pale. His coughing, to clear his airway, appears ineffective. Recent chest X-ray shows diffuse bilateral interstitial infiltrates in all lobes. Recent blood gases demonstrate falling PaO2 (hypoxemia) and increasing CO2 ( Hypocapnia). Mr Thomason is anxious and from the shift before is obviously worsened in overall condition.
•    Educational Needs- Increased acuity      
•    Health Change-     increased acuity 
•    LOC- increased acuity     
•    Pain Level- increased acuity 
•    Psychological Needs- normal Acuity 
•    Safety- increased acuity 
2.     Carlos Mancia Room 302
Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical Hx. r/o Tuberculosis. Vital signs -Temp 99.1, BP 124/62, P 77, RR 20, SaO2 91%. Airborne Isolation. Neuro WNL. Skin moist, respiratory bilateral wheezes and rhonchi. Blood-tinged mucous, productive cough. Diet as tolerated. IV maintance fluids with D5 1/4 NS @ 150 ml/hr X 3 then reduce rate to 75 ml/hr. Expresses fatigue, fear, concern, and desire for recovery. Need frequent reminder to stay in room and maintain mask precautions. If family/visitors come, will need education to airborne precautions. Spanish interpreter available at ext: 61178. Dr. Rondeau
•    Educational Needs- Increased acuity
•    Fall Risk- Increased acuity.
•    Health Change-Increased 
•    Pain Level- Normal 
•    Psychological Needs-Increased acuity 
•    Sensorium-Normal acuity
3.    Estelle Hatcher Room 303
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. Wound site clean, dry and intact NPO, NG-tube to low continuous suction. IV maintance fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in left forearm. Ambulates with minimal assistance. Family at beside. Dr Sangerstien
•    Educational Needs- Increase 
•    Fall Risk-increase 
•    Health Change- Increase 
•    Pain Level- Increase 
•    Psychological Needs- Normal    
•    Sensorium- Normal
4.    Ann Rails Room 304
Ann Rails, 38yr-old, c/o back pain, non-significant past medical history. No known allergies (NKA). Vital signs -BP 124/82, Temp 98.2, P 84, RR 22, SaO2 96%. Pain and numbness in legs for one week. Abnormal left leg weakness, gait unsteady, 5/10 on numeric pain scale. Neuro WNL, except leg pain upon movement. Activity as tolerated with assistance. D/C plan- decrease pain and restore normal gait. Regular diet. Dr Suculo
•    Educational Needs- Increase 
•    Fall Risk-increase 
•    Health Change- Increase 
•    Pain Level- Increase 
•    Psychological Needs- Normal    
•    Sensorium- Normal
5.    Kathy Gestalt Room 305
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 ( NKA). Vital signs -Temp 98.4, BP 116/76, P 96, RR 20, SaO2 99%. Neuro WNL, alert, and cooperative but worried about scarring and is reluctance regarding walking on leg. Diet as tolerated, up ad lib after gait training. Crutches at bedside adjusted for height. Dr. Anderson
•    Educational Needs- Increase 
•    Fall Risk-increase 
•    Health Change- Increase 
•    Pain Level- Increase 
•    Psychological Needs- Increase     
•    Sensorium- Normal
6.    John Duncan Room 306
John Duncan, 56yr-old male, Dx- Gastroenteritis, returned yesterday from Cancun, c/o intractable diarrhea, weak, pale, and refusing to eat. No known allergies (NKA). Non-significant past medical Hx. Vital signs Temp 99.4, BP 106/72, P 96, RR 20, SaO2 91%. Neuro WNL's, alert and cooperative. IV maintance fluids with D5 1/2 NS at 125ml per hour in left forearm. c/o headache- medicated with Lortab 5mg PO at 0900, takes Lomotil 10ml PRN q 4 hours last dose at 0834. Stools are decreasing but patient remains very weak. Wife at bedside. Diet as tolerated. Dr. Jones.
•    Educational Needs- increase
•    Fall Risk- increase 
•    Health Change- increase 
•    Pain Level- increase 
•    Psychological Needs- normal     
•    Sensorium-normal 
7.    Viola Cumble Room 307
Viola Cumble, 92yr-old, second day post-op hip repair, Allergic to Penicillin. Vital sign Temp 98.4, BP 136/78, P 72, RR 20, SaO2 97%. Normal Sinus Rhythm on telemetry. Alert and cooperative. No weight bearing today. Skin warm and dry, may sit up on edge of bed today. 
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[Solved] NRSG 4412 Swift River Answers

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  • Submitted On 20 Aug, 2020 10:14:34
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NRSG 4412 Swift River Answers NRSG 4412 Swift River Answers Arthur Thomason Room 301 Arthur Thomason, 56 year old MVA victim, fourth day post op with a splenectomy and femur repair. He is experiencing new onset of shortness of breath and has a nasal cannula with 2L of Oxygen in place. He is restless with slight confused, but is easily orientated with attempts from nurse. Temperature spiked during the night to 102.4, BP now 146/94 which is slightly elevated, Respiration's at 30 bpm and slightly labored, heart rate 102 versus 84 from last night shift. Skin cool to touch and appears pale. His coughing, to clear his airway, appears ineffective. Recent chest X-ray shows diffuse bilateral interstitial infiltrates in all lobes. Recent blood gases demonstrate falling PaO2 (hypoxemia) and increasing CO2 ( Hypocapnia). Mr Thomason is anxious and from the shift before is obviously worsened in overall condition. •    Educational Needs- Increased acuity       •    Health Change-     increased acuity  •    LOC- increased acuity      •    Pain Level- increased acuity  •    Psychological Needs- normal Acuity  •    Safety- increased acuity  2.     Carlos Mancia Room 302 Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical Hx. r/o Tuber...
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NRSG 4412 Swift River Answers

NRSG 4412 Swift River Answers NRSG 4412 Swift River Answers Arthur Thomason Room 301 Arthur Thomason, 56 year old MVA victim, fourth day post op with a splenectomy and femur repair. He is experiencing new onset of shortn...

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