robert sturgess swift river
Respirations Acute Confusion False Elevate head of bed The patient has a pneumothorax that requires a chest tube placement. Dr. Rondeau, Educational Needs Increased acuity Skin warm dry, bruises on forehead with small laceration. Scenario 5 Several hours later, Mr. Duncan is now complaining of nausea. -Complete full assessment, to include neuro Document findings Compromised Family Coping: False The emergency bathroom light goes off and the nurse finds Mr. Greer on the floor in the bathroom. Capillary Refill: _________ seconds Visual assessment The MD on site makes the decision to intubate the patient and start ventilatory assistance and move the patient to Respiratory Intensive Care. Ms. Getts is now complaining of sudden sharp, substernal chest pain, very short of breath and is profusely diaphoretic. -Elevate head of bed and place the patient on Pulse oximetry. Obtain Clinical Hours 24/7/365 In-Class and Lab Learning Resource Improve Clinical Practice 20 ga. Hep-Lock in right forearm, skin warm and dry, generalized weakness with recent weight loss. Scenario 4 Genitalia: WNL (skin intact, no lesions) Abnormalities Describe: __________________________ -Take initial vital signs (room air Pulse Ox) List the nursing care order. Awaiting diagnostic labs. Taking HIV Meds prophylaxis. His children are visiting, and they are very supportive. Students also viewed Culture Concept notebook Development concept notebook Elimination concept notebook Gas Exchange concept notebook Three hours later, Ms. Getts is unsteady when standing by her bedside. She shares concern about patient's wife who is now coughing and having night sweats. He asks to speak to a clergy member. Senario 5 Vital sign assessments Radiofrequency ablation, which uses heat to remove abnormal esophagus tissue. Ineffective Self-Health Management False Skin moist, respiratory bilateral wheezes and rhonchi. Senario 5 He has been readmitted for a red spot on his sacrum of 1 cm and a 2 cm blister on his right heel. Knowledge Deficit True 20ga. 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. Talk with her stating surgery is over and she did great. Senario 3 DSD (dry sterile dressing), forehead laceration clean and dry intact. If family/visitors come, will need education to airborne precautions. Mr. Sturgess does not have a living will or durable power of care completed. Nausea False Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. -Ensure patients is positioned in bed properly Notify lead nurse Nathaniel Gonzalez Scenario 2 Impaired Mobility True -Notify HCP of fall, complete incident report Perform circulatory evaluation 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. -Reorient Patient to person, place, & time Evaluate understanding Seek clarification Upon entering the room, the patient appears to be trying to get out of bed You enter his room and recognize that Mr. Thomason appears to be talking to himself and appears confused. Patient and family upset regarding dx. Remind the nursing staff that the patient is NPO. Mr. Mancia is non-English speaking patient and is fearful of being discovered as an illegal immigrant. Educational Needs Increased acuity Scenario 5 Scenario 4 -Assess patients' pain and rule out cardiac pain. Crutches at bedside adjusted for height. Reorient Patient to person, place, & time Describe the physical changes from aging and the care required. Bleeding Risk for: False Impaired mobility: False Clear liquid diet. 20ga. Mr. Sturgess is now declining, and family members are requesting to remain in room past normal visiting hours. They wanted to know and pressure you for the information. He is excited and tells the nurse he is starving and glad that he finally gets to eat. Nausea False Powerlessness: True, Scenario 1 Scenario 4 Scenario 1 Acute Confusion True Fall, Risk for True Discription, Table 4 Cross-sectional, Longitudinal, and Sequential Developmental Designs, Engagement 1 Recognizing Research Strategies, A mental health worker with a Christian worldview.docx (Auto Recovered), NPO Breakfast: __________% Lunch ______________ %, Ethics and Social Responsibility (PHIL 1404), Care of the childrearing family (nurs420), Advanced Care of the Adult/Older Adult (N566), Business Professionals In Trai (BUSINESS 2000), Microsoft Azure Architect Technologies (AZ-303), Nurs & Healthcare I: Foundations [Lec] (NURS356), Accounting Information Systems (ACCTG 333), Bachelor of Secondary Education Major in Filipino (BSED 2000, FIL 201), Methods of Structured English Immersion for Elementary Education (ESL-440N), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), C228 Task 2 Cindy - Bentonville - Passed with no revisions, Lesson 4 Modern Evidence of Shifting Continents, MMC2604 Chapter 1 Notesm - Media and Culture: Mass Communication in a Digital Age, Lesson 17 Types of Lava and the Features They Form, Lesson 9 Seismic Waves; Locating Earthquakes, Analysis of meaning and relevance of History from the millennial point of view, Entrepreneurship Multiple Choice Questions, (Ybaez, Alcy B.) Constipation, Risk for True Educate patient She is having some difficulty breathing. Obtain recent chest X-ray reports and recent ABG's for physician to review Strict I&O, regular diet, intake 50%. Aggravating Factors: 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. Dr. Jones. The charge nurse tells you she will send someone to assist you, and to get out 2mg of Versed to have ready to sedate the patient at time of procedure. Stoma: N/A Colostomy Ileostomy Effluent Consistency: -Notify charge nurse Other: _______________________________ Deficient Knowledge True Cardiovascular Assessment Assist patient out of bed -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 Stoma Status: Pink-Red/Moist Dusky Retracted Excessive bulging Impaired Home Maintenance Management False -Ensure the bed is in lowest position, the side rails are up, the call light is in reach, and ask the patient if they need anything before you leave the room Psychological Needs Normal acuity All our products can be personalised to the highest standards to carry your message or logo. Document results/findings -Advise sitter to notify nurse when leaving the room Activity as tolerated with assistance. IV D5 1/2 NS with 20 KCL @ 125 ml/hr in left forearm. -Attempt to orient to person, place, and time She is also investigating bone marrow transplantation. Administer pain medications Mr. Mancia is holding Catholic Rosary in hand and is crying as you enter the room. Senario 2 Linen Change Ms. Gestalt capillary refilling is now 6 secs below cast site, extremity is swollen and cold to the touch. Blood, Glucose 185, 4 units of insulin sliding scale for coverage. Provide a few chairs if possible for her family to also be comfortable Notify doctor Chronic Pain False Remind staff that Universal Precautions are practiced at this hospital for all patients regardless of known infectious diseases. Anterior: ___________________________________ Posterior: ____________________________________ Decreased cardio tissue perfusion: False Check physician orders -Medicate for pain Prior to changing shift, you enter the patient's room to complete a full assessment, and Ms. Monson is now crying asking to for someone to take her home! Failure to Thrive True. Deficient Knowledge True Nausea False -If gastric reflux is suspected administer PRN antacids (GI cocktail) Obtain urinary screen Evaluate understanding 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". Sit at an eye level. Family in room with patient very concerned. Scenario 3 Dr. Altace, Educational Needs Increased acuity The surgeon believes that the surgery was successful but recommends the patient have chemotherapy and radiation postoperatively. 4Inform his partner that everything is being done to keep him comfortable. What is the ratio of Fe\mathrm{Fe}Fe (II) atoms to Fe(III) atoms in this compound? No known allergies (NKA). Vital signs -Temp 97.2, BP 96/74, P 82, RR 20, SaO2 97%. jasmine . No Known allergies (NKA). Apply oxygen Scenario 4 Scenario 4 Impaired Skin Integrity, Risk for False Fall, Risk for True Now, third day post-op, Mrs. Stukes appears sad and depressed upon entering the room. Scenario 4 Document results Mr. Duncan's wife meets you in hall asking what she could bring her husband to eat from home. Health Change Increased acuity Scenario 4 Compromised Family Coping False Mr. Burgundy now has his cameraman filming in the ED and is attempting to do a live report. Impaired Gas Exchange True Remain with Patient, Sarah Getts, 77 yr-old, Dx- Chronic Renal Failure, admitted with hyperkalemia (5.9, Eq/L)/hyponatremia (128mEq/L). The cycle of freezing and thawing damages the abnormal cells. Fear True Scenario 2 Inform his partner that everything is being done to keep him comfortable. The provider advises the Nurse to draw a stat CBC, give a liter bolus of NS, and repeat CBC. Acute Pain True No response = 1, Mobility: Assess intake and output and possible reasoning -Discuss with family sitter if there are any other family members who can help with monitoring Lithia No Known allergies (NKA). He chooses to go home and see the doctor tomorrow in his office. Evaluate patient learning Vital re-assessment Acute pain: False -Explain that Radium-223 mimics calcium and is absorbed during new bone growth. Administer new pain medz Offer assistance in providing more information about treatment options for newly diagnosed AIDS patients. Upon entering the room, you find Ms. Rails sleeping. -Complete head-to-toe assessment while patient is on the floor. Alert and cooperative. 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. No known allergies (NKA). Continent: Yes No Brief/Diaper Listen to patient concerns Scenario 4 Scenario 2 Physiological- 2Provide comfort in pre-surgical room Mr. Dominec. Grieving False Hopelessness False. But that's changing. Request sitter/family member to bedside You are the now the Surgical ICU nurse assigned to her. Verify call light/bed safety precautions She has been admitted to the floor with complaints of numbness in her right foot and ankle. Sa fortune s lve 2 000,00 euros mensuels Disturbed Body Image True Scenario 5 He is having some difficulty hearing and complains of ringing in his ears. Flexes abnormally = 3 Physiological- Scenario 4 You take his vital signs which are: Temp 101.3, Pulse 88, Resp 24, B/P 116/84. Anxiety True Scenario 1 Palliative care. Vital signs -Temp 98.8, BP 102/76, P 102- irregular, RR 22, SaO2 90%, cardiovascular on telemetry with Sinus irregular rhythm. Robert Strurgess Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Discharge instructions Skin cool to touch and appears pale. Imbalance nutrition: True 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. Ms. Rails shares with you her fear of being discharged home to an abusive husband. 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. Scenario 3 Connect telemetry Scenario 2 Palliative care. Mr. Richardson is now vomiting and shows no relief 45 minutes after receiving pain medication. Odor: __________, *Types: Abrasion, Burn, Laceration, Puncture, Surgical, Pressure Ulcer, Vascular Ulcer, Maceration, Excoriation, Skin Scenario 2 Full assessment of patient. Health Change Increased acuity -Determine when a hospital provided sitter will be necessary No -Remind patient to call for help is he need to get up and provide patient with a urinal. Monitor and evaluate fluid intake Health Change: Increased acuity Report this activity immediately to the hospital privacy officer Use therapeutic communication/Active Listening This information is HIPAA protected and you cannot share anything with them. Ms. Gestalt is now complaining of fever and chills. Carlos Mancia Psychological Needs Increased acuity You observe Ms. Getts being assisted by another nurse who is being blatantly rude and disrespectful to her. The patient was placed on 2 L O2 NC, EKG monitoring to include a 12 lead, Pulse Oximeter. Chronic Pain False -Explain to the patient that because of his weakness and unknown cardiac status as well as the IV, he is a fall risk and should not get out of bed without assistance. -Evaluate patient's understanding of teaching except 115 pulse, which is normal for him. Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Impaired skin integrity: False, Anxiety: True Temperature is 98.3, HR is 87, RR is16, BP is 121/74, PaO2 is 98%. She has just been transported from recovery. Acute Pain True Document results and findings -Advise patient not to get up and walk on his own Scenario 3 Scenario 2 Radiofrequency ablation may be recommended after endoscopic resection. Educate patient regarding patient care NG tube to low suction possibly D/C'd today after Dr. Levine rounds. Scenario 3 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. Vital signs -BP 124/82, Temp 98.2, P 84, RR 22, SaO2 96%. Mr. Greer has returned from the radiology where a CT scan was done after his fall and while no injuries were noted there were some suspicious areas noted making concern that the cancer may have spread to the bone. The nurse was told by the gastroenterology nurse that they really struggled before they called anesthesia and they may have caused an esophageal abrasion. Scenario 2 The patient is being prepared for discharge and his IV has been removed. Awaiting transport. Scenario 3 Document results Educate caller regarding HIPAA Color:__________ LLE: Non-pitting Pitting ___+ Emergency intubation and assisted breathing is provided for Mr. Thomason Senario 4 Senario 4 -Set-up for stat portable chest x-ray Palliative care. Place patient on PCA pump You arrive in room to find Ms. Monson talking to herself. Diet as tolerated. Pain Level Increased acuity Mr. Gonzalez has returned from his EGD and is still sleeping from the sedation. Skin warm and, dry, all vital signs in WNL except 115 pulse, which is normal for him. You enter room one hour after the physician has left the patient. Patient, and family upset regarding dx. Scenario 3 LOC Normal acuity The pain makes him short of breath. Safety Impaired comfort: True Localizes pain = 5 Discuss follow up with his doctor. When the HCP realizes who he is, he tells the nurse to move the patient in the treatment room down the hall and put Mr. Burgundy in there. Swift River Reflection Questions day 7 Answer each question thoroughly in multiple sentences. The charge nurse tells the nurse to take Mr. Burgundy to the floor, because his room is now ready. Acute Pain False Mr. Dominec has a male partner and has been married for the past ten years and share their three children to the marriage. Offer nutrition/toilet Oral Care Check pedal capillary refill Respiratory Rate: WNL Tachypnea Bradypnea Palliative care. Reapply restraints 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. Recently he manifested an unusual black lesion on his thigh and developed an opportunistic fungal mouth infection which was treated successfully. Failure to Thrive True. -Reassess patients' vital signs, and place on q5 minutes continuous monitoring Reassure patient and help explain any new orders from physician to patient His overall health is good, and he has known he has been HIV positive for the past five years. Mrs. Stukes is a failed laparoscopic cholecystectomy that resulted in a bowel resection with a temporary ileostomy in place. Health Change Increased acuity Wash and glove hands Neuro WNL alert and cooperative. Senario 1 Report to charge nurse/ head nurse the need for staff education. 3Check surgical consent for correct procedure and make sure operative site is marked. Senario 1 Pupils PERRLA, eyes clear. You arrive in room to check on her, after washing hands. No known allergies (NKA). -Check patency of Foley catheter, urine color, and ensure it is secure to the patient's leg Wash and glove hands ExplanationAnxiety/ fear True Upon entering room, you find Mr. Sturgess is quiet, appears tense and rigid but states, "I am feeling fine." Electrolyte Imbalance False She has been documented as being obese, new onset. Scenario 3 Readiness for Self-Care Enhancement True Peripheral Neurovascular Dysfunction False. Retrieve cast removal tool Wash and glove hands Hopelessness False. Senario 5 Educational Needs Increased acuity Senario 2 -Assess patient's ABC (airway, breathing, circulation) Non-significant past medical history. Remain with patient Contact charge nurse. Imbalanced Nutrition False Provide comfort measures Educate patient/family Generalized weakness, blood tinged urine and severe pain upon urination, GI- n/v. Notify doctor Procedure is canceled for the day and rescheduled later allowing for new consent. Explain to physician what interventions you have recently initiated Yes Productive Non-productive Describe Sputum: _______________________ Palliative care. A GI cocktail was administered, and the patient stated that it decreased his pain to a 6/10. Notify housekeeping. Verify call light/ bed safety precautions Neck: ______________ The cancer was more advanced than they previously had thought so inguinal lymph nodes were removed. Primary: Check LOC, Orientation, Breathing, Circulation, Brief Neuro assessment to include spinal pain or deformities, Obvious injuries. His CP is 7/10 and his BP is 165/96, P 92, R 18, SaO2 98 on 2L NC. Senario 3 He was recently diagnosed with stage III prostate cancer. The patient describes this pain as a heavy pressure with intermittent stabbing. Peripheral Neurovascular Dysfunction True. Upon entering room, you wash/glove hands. Vital signs -Temp 98.2, BP 94/60, P72, RR 22, SaO2 99%. : an American History (Eric Foner), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Ms. Gestalt is second day post-op and has requested to get out of bed and to ambulate to bathroom. Why is cysteine such an important amino acid for defining the tertiary structure of some proteins? 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. IV fluids of D5 1/2 NS are infusing at 100 mL/hour to his right forearm. Ineffective Coping False LUE: Non-pitting Pitting ___+ NKDA Assessment The client vital signs are: Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%, Neuro WNL alert and cooperative. Now, meeting the CDC definition, he has full blown AIDS but is asymptomatic at this time. -Offer nutrition and/ or toileting Deficient Knowledge False He does not have an IV nor is he on oxygen. Contact head nurse or supervisor in the OR to evaluate new situation Pulse Full assessment Non-significant past medical Hx. Sensorium: Normal acuity, Bleeding, risk for: False Her husband who is present states, "I thought it was just a lumpectomy she was having this morning." Recent blood gases demonstrate falling PaO2 (hypoxemia) and increasing CO2 (Hypercapnia). Nursing questions and answers. Senario 1 Psychological Needs Normal acuity Grieving: False. John Duncan, 56yr-old male, Dx- Gastroenteritis, returned yesterday from Cancun, c/o intractable diarrhea, weak, pale, and refusing to eat. Microeconomics And Behavior Robert Frank 9th Edition Author: old.bubbies.com-2022-05-03T00:00:00+00:01 Subject: Microeconomics And Behavior Robert Frank 9th Edition Keywords: microeconomics, and, behavior, robert, frank, 9th, edition Created Date: 5/3/2022 7:02:15 AM Sleep Deprivation False Deficient knowledge: True Reassure patient of options Educate patient Swallowing: Intact Dysphagia Aspiration Precautions Self-Care Deficit True GI WNL. His orthostasis is normalized after a second liter of NS was administered. Skin: Warm/dry Clammy/diaphoretic Skin Turgor: Brisk Tenting Carotid:____ + Bilateral Other: _____________ RUE: Non-pitting Pitting ___+ -Medicate for pain Too bad the cruise area was a very unatractive part of the River Elbe.