After 3 hours, Ms. Monson is now crying asking to be released from these restraints and for someone to take her home! Scenario 4 Outline an experimental approach to demonstrate the average RNA chain growth rate during transcription of a cloned gene in vitro. Obtain recent chest X-ray reports and recent ABG's for physician to review Provide emotional support. She has received a dose of Hydrocodone for PRN pain 20 minutes ago. Acute Confusion True Emergency intubation and assisted breathing is provided for Mr. Thomason Physical Mobility, Impaired True Students will prioritize medical surgical . Obtain urinary screen Nathaniel Gonzalez Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Extends abnormally = 2 Scenario 5 A special lowbed has been ordered that will lower to the ground. Wash and glove hands Abdominal Pain: Non-tender Tender/Pain Describe: Offer bedpan Neuro WNL, except leg pain upon movement. -Explain procedure to the patient Disoriented to time and place, speech slurred. Full assessment Vital signs -Temp 98.6, BP 114/62, P 100, RR 20, SaO2 94%. Due to this, the provider would like him to stay in the hospital for observation. -Tell the patient to call immediately if the chest pain gets worse or they become short of breath Report this activity immediately to the hospital privacy officer Next time we'll spend our 60 on some food and nice beers. Shock False She shares concern about patient's wife who is now coughing and having night sweats. 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 Waist belt restraint PRN; family sitter at bedside, assist with bath. Sleep Deprivation False. Recently he manifested an unusual black lesion on his thigh and developed an opportunistic fungal mouth infection which was treated successfully. Respiratory Rhythm: Regular Rhythmic Irregular Periods of Apnea Cheyne-Stokes Evaluate/Modify Mobility Plan, Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical Hx. It is determined that Mr. Sturgess could achieve better pain control w/ a PCA pump Shock, Risk for False Diet as tolerated. -Using therapeutic communication inform Mr. Greer that there are many treatment options, and not to leave until the HCP can come and speak with him Knowledge Deficit True Ask patient to explain to you what procedure she was expecting to have this morning. Grieving: True Temperature spiked during the night to 102.4, BP now 146/94 which is slightly elevated, respirations at 30 bpm and slightly labored, heart rate 102 versus 84 from last night shift. Scenario 1 Wash hands He was recently treated for a URI with a Z pack, prednisone, and Motrin for pain. Infection, Risk for False Connect telemetry 1Perform full assessment and provide anti-nausea medicine. -Medicate for pain Acute Confusion True He also complains that his throat is still very sore. -Reinforce the risk if patient has not been NPO and ask the patient when the last time they ate. Inform and educate spouse of dietary orders Scenario 5 No known allergies (NKA). You take his vital signs which are: Temp 101.3, Pulse 88, Resp 24, B/P 116/84. No Known allergies (NKA). Respirations Richard Dominec, A 47-year-old married father of three children has been admitted for an emergent appendectomy in the evening as soon as there is space available in the OR. Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Mr. Thomason appears now better oriented and MD arrives unexpectedly to examine him. Non-significant past medical history. Senario 2 Love and belonging Lithia Monson The patient asks the nurse to explain about these medications and why they are in such a hurry. Regular diet. His children are visiting, and they are very supportive. The bed arrives tomorrow. Scenario 5 -If cardiac is suspected call the provider and the rapid response team. -Verify that discharge orders have been written, provide discharge instructions, and in inform provider about the chest pain. -Assess patients' pain and rule out cardiac pain. -Complete incident report. -Explain that Radium-223 mimics calcium and is absorbed during new bone growth. Cryotherapy, which uses an endoscope to apply a cold liquid or gas to abnormal cells in the esophagus. This will treat any cancer that may have metastasized to the bone. Seek clarification -Start IV They were also concerned about the next patient going into that room and the use of the lavatory. His partner is not with him at this time but will arrive soon to facilitate his discharge home. Respiratory Rate: WNL Tachypnea Bradypnea He does not want to return to the nursing home, and does not wish to burden or live with his children. Disturbed Body True Scenario 1 Re-assess patient Carotid:____ + Bilateral Other: _____________ RUE: Non-pitting Pitting ___+ -Begin q15 minute neuro checks Electrolyte Imbalance False The MD on site makes the decision to intubate the patient and start ventilatory assistance and move the patient to Respiratory Intensive Care. Imbalanced Nutrition: True Full head to toe neuro assessment. Health Change: Increased acuity Pupils PERRLA, eyes clear. He also states he is feeling weak. GI WNL. No Known allergies (NKA). Skin moist, respiratory bilateral wheezes and rhonchi. -Notify HCP of fall, complete incident report Scenario 2 Imbalanced Fluid Volume, Risk for True 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. Assessment of bowel movement Sensorium Increased acuity, Physiological No known allergies (NKA). Scenario 1 As you enter the room, Mr. Duncan is refusing to eat foods from bland diet. Pain affecting: N/A Sleep Activity Exercise Relationships Appetite Concentration Water/Flush: View Swift River Reflection Questions (1).docx from NRSG 4412 at South College. 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. Evaluate understanding -Remove the lunch tray and ensure pre-operative consent has been signed. 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 . Fall, risk for: True Glasgow Coma Scale 0-15 Musculoskeletal A new graduate nurse receives a call from the hospital telling them to report to the ER immediately for a disaster. Fall Risk Increased acuity You now arrive in the recovery unit one hour post-surgery and you are told that the surgery went well. Scenario 1 Scenario 5 -Ask the patient to verbalize understanding of teaching and reassure them that yourself or any member of their care team will be available to answer questions. Document results and findings Infection, Risk for True Senario 4 Scenario 1 He has not had his BP medication today. Fall, risk for True Imbalance nutrition: True Safety He has been ruled out for an MI. Check PRN pain order The ER nurse reports that his cardiac enzymes were borderline, (Troponin?, CK/CKMB?) Grieving True 20 ga. Hep-Lock in right forearm, skin warm and dry, generalized weakness with recent weight loss. Scenario 2 Fall Risk Increased acuity He is emotionally distraught and is insisting that he be allowed to report what is going on from the ER. Read PT report Dr. Rondeau, Educational Needs Increased acuity Love and Belonging Scenario 4 Escort patient to vehicle Scenario 3 I need to be reporting!" The surgeon believes that the surgery was successful but recommends the patient have chemotherapy and radiation postoperatively. Anterior: ___________________________________ Posterior: ____________________________________ She is having some difficulty breathing. Impaired Comfort True Regardez le Salaire Mensuel de Ticketmaster Beyonce Koln en temps rel. ADA diet, intake 25%. Notify doctor Safety Increased acuity, Physiological When you enter the room, the patient is having chest pain again, and they are pale and diaphoretic. Wash and glove hands Mr. Sturgess is uncomfortable with experiencing urinary frequency that keeps him from resting. Insertion Site: Dry/Intact Redness/Erythema Drainage Tenderness Maceration 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 Senario 2 Upon assessment, you determined that she is confused to person, time, and place but is easily directable. What order are you providing the information to the receiving nurse? Scenario 5 Full assessment Disoriented, confused = 4 Pain Scale: 0 to 10: _______________ Obtain Spanish signs & brochure Self-Care Deficit True Compromised Family Coping False Observe closely first hour Scenario 3 Leave to break room and not continue in conversation. -Complete neuro checks as ordered Temp 98, BP 114/67, P 115, RR 20, SaO2 98%. 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. Purposive Communication Module 2, Chapter 1 - Summary Give Me Liberty! Physiological- Vital signs -Temp 97.2, BP 96/74, P 82, RR 20, SaO2 97%. Scenario 4 Evaluate understanding Wash and glove hands Anxiety True LUE: Non-pitting Pitting ___+ Impaired Home Maintenance management r/t client or family False Home; Our Focus; Our Legacy; Our Partners; Our People; Our Fellows; Our Investments Psychological Needs Increased acuity Neuro WNL alert and cooperative. Upon entering room, you find Mr. Sturgess is quiet, appears tense and rigid but states, "I am feeling fine." . You have them remain with you, seated in comfortable place, while you call ICU and attempt to locate physician for them. Scenario 1 Arthur Thomason Impaired Home Maintenance Management r/t Client or Family False 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". Include patient condition change in shift report Neck: ______________ -Perform neuro assess You call his doctor to inform him the family has arrived. His overall health is good, and he has known he has been HIV positive for the past five years. 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 Disturbed Sensory Perception False Document results Give verbal report Evaluate learning He was initially sedated with versed 2mg, and Fentanyl 100 mg by the EGD nurse, but the patient was not tolerating the procedure, so anesthesia was called to administer propofol. Scenario 1 and the GI cocktail given in the ER did relieve his CP but not completely. Psychological Needs Increased acuity Imbalanced Nutrition True 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. After 24 hours, Ms. Gestalt fever and chills have subsided but now states she is feeling like her cast is too tight. Assess vital results Oriented to: Person Place Time Diet as tolerated. Ronald Burgundy Perineal Care Safety Reapply restraints Fatigue True Kathy Gestalt -Tell the patient that they are being admitted to r/o any cardiac issues Senario 5 -Reorient Patient to person, place, & time Deficient Fluid Volume True Stoma Status: Pink-Red/Moist Dusky Retracted Excessive bulging Safety- Her husband who is present states, "I thought it was just a lumpectomy she was having this morning." Mr. Sturgess is recently dx w/ metastatic cancer of colon and he and his family have chosen only Ineffective Peripheral Tissue Perfusion False Filmotka filmu Najvyia ponuka (2013). Scenario 5 Sa fortune s lve 1 900,00 euros mensuels 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) Respiratory Effort: Relaxed, Regular, Non-labored Pursed lip breathing Labored Apply fall risk bracelet 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. Robert Strurgess Senario 3 LOC Normal acuity Encourage fluids/fiber/ambulation Dysfunctional Gastrointestinal Motility False Document results. Dr. Levine, Marcella Como, 38 yr-old, Sexual Trauma Victim (Rape), unknown assailant. Scenario 5 Increased fall risk. His partner is at the bedside asking, "how much longer will he have to wait until taken to surgery?" Mr. Dominec decides he does not want to see Infectious Disease doctor about his new cough. Chronic Pain False Explain to her family and provide contact information. 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! -Ensure patients is positioned in bed properly -Draw a repeat CBC per HCP order to determine current Hemoglobin status IV NS is started, and lab work is sent. -Perform admission assessment Nursing questions and answers. It is unclear if he lost consciousness. Clear liquid diet. You correctly diagnosed 11 out of 16 options. Explain to Mr. Dominec your concern for this opportunistic infection and usual treatment. ExplanationAnxiety/ fear True Document results and findings Toggle navigation Swift River. Ineffective airway clearance True His original lymph node biopsy was negative. Allow for non-compliance of request Remain with patient Senario 2 Ineffective Self-Health Management True Swift River Reflection Questions day 7 Answer each question thoroughly in multiple sentences. Crutches at bedside adjusted for height. Mrs. Smith's surgery has now ended. Skin warm dry, bruises on forehead with small laceration. Deficient knowledge: True Scenario 1 Vital signs are: B/P 112/78, temp. This shop has been compensated by Inmar Intelligence and its advertiser. The cycle of freezing and thawing damages the abnormal cells. Document and prepare to transfer to Surgical ICU Assist patient Explain reason for assessment and procedure Fear/Anxiety True. Administer antipyretic medication Dr. Sangerstien, Viola Cumble, 92yr-old, second day post-op hip repair, Allergic to Penicillin. Constipation False Fall, risk for: True 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 Acute Pain True When the nurse enters the room later that day to inform him that the procedure is scheduled for 1430, they see Mr. Gonzalez is sitting in front of a lunch tray. Evaluate understanding IV maintenance fluids with D5 1/2 NS at 125ml per hour in left forearm. Robert Sturgess Robert Sturgess 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Document results Head/Face: Symmetric Asymmetric Drooping Request sitter/family member to bedside Acute Confusion: True Pain Level Increased acuity Noncompliance False Two housekeepers, who were refusing to clean the room, are in the break room. SANE nurse to make second visit today. Scenario 4 Document teaching moment. Two hours later, Mr. Duncan is asked how frequent his stools have been today. Sit at an eye level. -Complete initial post-op assessment Why is cysteine such an important amino acid for defining the tertiary structure of some proteins? Full assessment including both lying/standing Obtain translatorT Elevate Extremity You enter patient's room. Pain and numbness in legs for one week. 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. Compromised Family Coping: False -Explain to patient why his throat may be sore Scenario 3 Deficient Knowledge False Your response to all of them would be: Scenario 1 Clinical 2. Educate patient Skin warm and, dry, all vital signs in WNL except 115 pulse, which is normal for him. Scenario 2 She receives the pre-op medication. Tom Richardson, 46yr-old. RUE: ______________ LUE: _____________ Alleviating Factors: Last pain medication: -Assess patient's understanding of the teaching and discuss home support, os de la main et de la ceinture pelvienne, Julie S Snyder, Linda Lilley, Shelly Collins. Perform neuro assess Sensorium Increased acuit, Physiological Notify doctor Scenario 2 Fall, Risk for True Scenario 5 Notify lead nurse He also has metal fragments on his left side on his leg arm and torso. It was diagnosed by a portable X-ray and quickly splinted by the ER staff. Retrieve cast removal tool IV D5 1/2 NS @150ml/hr. He has partial thickness burns to his left arm and the left side of his face. Document findings/results, Ann Rails, 38 years old, c/o back pain, non-significant past medical history. : an American History (Eric Foner), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. BP 154/89, P 94 F, R 22, T 98.3F, SaO2 95% on room air. Rapid Response team arrived including anesthesia. Document results and findings Ms. Gestalt capillary refilling is now 6 secs below cast site, extremity is swollen and cold to the touch. Impaired home maintenance mgmg r/t client or family: False Deficient Knowledge True Document findings -Explain to Mr. Burgundy that space in the ED is allocated based off of patient need Senario 4 Senario 3 To access your Swift River Virtual Clinicals login to ATI's Student Portal and access the Virtual Clinical card in My ATI. Compromised Family Coping False No known allergies (NKA). The patient has been scheduled for an EGD today and has an order for Omeprazole (Prilosec) and Carafate (sucralfate). The nurse was told by the gastroenterology nurse that they really struggled before they called anesthesia and they may have caused an esophageal abrasion. 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. The patient got dizzy when he stood up from the commode. Verify call light/bed safety precautions Social worker with patient this morning. Peripheral Neurovascular Dysfunction False. Scenario 2: 1Educate about recovery from appendectomy and care to wound. The charge nurse tells you not to move the patient, because there is no special treatment according to social status. IV Fluids: INT lock IV Fluids ______________@ _____________ mL/hr Date on tubing: Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Chronic Pain, Risk for constipation, impaired nutrition, anxie, 4 units on insulin sliding scale for coverage, Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Give Me Liberty! You discuss this cough with Mr. Dominec to determine how long he has had it. LLE: Non-pitting Pitting ___+ -Reapply the NC that he was admitted with at 2L Scenario 5 Scenario 2 Mrs. Stukes is feeling nauseated. Use therapeutic communication/Active Listening Notify doctor of change in condition in particular: unproductive cough and low-grade fever. Document Results, Robert Sturgess, 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. IV D5 1/2 NS with 20 KCL @ 125 ml/hr in left forearm. Senario 5 Scenario 3 Family at beside. Mrs. Pittmon states she has had numbness for years but "now I can't . How does the Med-surg simulator work? Perform full assessment and provide anti-nausea medicine. It is determined that Mr. Sturgess could achieve better pain control with a PCA pump. Blood Glucose 185, 4 units of insulin sliding scale for coverage. Apical Pulse Rate: Heart Sounds: Normal S 1 S 2 S 3 Contact Social Services Take vital signs before leaving the hospital again. Scenario 4 Expresses fatigue, fear, concern, and desire for recovery. Family in room with patient very concerned. Senario 4 Administer antipyretic medication Ronald Burgundy You arrive in room to check on her, after washing hands. Document Procedure Peripheral Neurovascular Dysfunction False -Take initial vital signs (room air Pulse Ox) Administer antipyretic meds Check pedal capillary refill You arrive in room to find Ms. Monson talking to herself. Cardiovascular has pacer with rate of 82bpm on demand. Ms. Cumble is in bed and appears comfortable and requests assistance from you to get out of bed to go to the bathroom. Health Change Increased acuity Encourage to ambulate with assistance to void if needed Vital signs- He was recently diagnosed with stage III prostate cancer. Report current urinary output quantify per hour and color of urine He insists that he is not hungry and refuses assistance with his meal. Allow family to remain Powerlessness True. Nausea: False Lithia Monson Linen Change Check PRN pain order The heartburn has become worse since he started treatment for his URI. Severe pain (10/10) medicated q 30 minutes x4 with IV Morphine 2mg with little relief. She is also to receive radiation, chemotherapy, and hormone therapy post operatively. Education of Foley Cath Procedure Scenario 1 No known allergies. Educate patient regarding condition The oncologist is recommending Docetaxel as opposed to an orchiectomy.

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