new-patients-swift-river-med-surg-covid-new-patients-charlie-raymond-john-duncan-carlos-mancia-kenny

Document Content and Description Below

New Patients Swift river med surg covid New Patients Charlie Raymond , John Duncan, Carlos Mancia, kenny barrett, Tim advanced medical sJuorgnicealsn,urJsuinglia(CMMentoranl rOoheio Technical College... ) StuDocu is not sponsored or endorsed by any college or university **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 (for older swift river patients see other pdf files loaded at the bottom of this file) Preston Wright Room 301 Preston Wright, 73- year old male, patient of Dr. Greene, status post CVA 4 weeks ago. He has been readmitted for a red spot on his sacrum of 1 cm and a 2 cm blister on his right heel. IV fluids of D5 1/2 NS are infusing at 100 mL/hour to his right forearm. Mr. Wright is pleasant and cooperative, but needs to be reminded to avoid pressure on his heel and sacrum. He has orders for dressing changes q daily, and pain medications prior to the dressing change. You responded correctly to 6 out of 6 evaluations: Category Your respons e Explanation Education al Needs Fall Risk Health change Neurologi cal Pain level Psycholog ical Needs You correctly diagnosed 10 out of 12 options: Physiological Description Your Respon se Explanation Acute Pain Altered Body Image Constipation Impaired Communication Impaired Physical Mobility Impaired Tissue Integrity Ineffective Airway Clearance Ineffective Breathing Pattern Risk for Imbalanced Nutrition Safety Description Your Respon se Explanation Isolation Precaution Risk for Infection Risk for Injury related to Falls Preston Wright Scenario 1 Mr. Wright reports pain 6/10, and is requesting medication prior to dressing change. You correctly ordered 5 out of 5 actions: Yo Co ur rre or ct de ord r er Step Explanation 1 1 2 2 3 3 4 4 5 5 Preston Wright Scenario 2 Mr. Wright insists that he watches TV from the High Fowler’s position. The nurse repositioned the patient to the left side to decrease pressure on the sacrum and right heel. Sacrum pressure injury demonstrates underlying bone exposure wound measures 4 cm x 6 cm x 3 cm depth with tunneling noted on the right side. The right heel demonstrates a blister 2 cm x 1 cm with clear fluid noted. You correctly ordered 5 out of 5 actions: Yo Co ur rre or ct de ord r er Step Explanation 1 1 2 2 3 3 4 4 5 5 Preston Wright Scenario 3 The Healthcare Provider is requesting an update on sacral wound healing. You correctly ordered 5 out of 5 actions: Y Co o rre ur ct or or d de er r Step Explanation 1 1 2 2 3 3 4 4 5 5 Preston Wright Scenario 4 It is now time for Mr. Wright’s sacral dressing change as the dressing seal is compromised and drainage is visible on the outer layer. See the plan of care: 1. Sterile Normal Saline wet-to-dry dressing changes daily. 2. Apply Triple antibiotic ointment to edges of wound each dressing change 3. Notify MD of worsening changes to wound based on measurements and appearance 4. Medicate with Demerol 100 mg with Phenergan 25 mg IM prior to dressing change 5. Change diet to Heart Healthy Diet 6. D/C Docusate Sodium if patient complains of diarrhea 7. Change IV fluids to 75 mL/hr 8. Encourage PO fluids 9. Nutrition consult. You correctly ordered 5 out of 5 actions: Y Co o rre ur ct or or d de er r Step Explanation 1 1 2 2 3 3 4 4 5 5 Preston Wright Scenario 5 10 days later, Mr. Wright’s wounds are healing, and you have orders to prepare for discharge with home healthcare. Mr. Wright states “There is no way I can walk up the stairs to get into my house with this big dressing on my foot.” You correctly ordered 5 out of 5 actions: Y o ur or d er Co rre ct or de r Step Explanation 1 1 2 2 3 3 4 4 5 5 Tom Richardson Room 302 Tom Richardson, 46yr-old. Dx- urinary stones with 3 episodes/ 5yrs. Allergic to sulfa drugs. Vital signs -Temp 98.4,BP 178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. Skin warm and pale. Generalized weakness, blood tinged urine and severe pain upon urination, GI- n/v. Clear liquid diet. Strict I&O and strain all urine, filters in bathroom. Patient demonstrates urine strain procedure. Severe pain (10/10) medicated q 30 minutes x4 with IV Morphine 2mg with little relief. IV D5 1/2 NS @150ml/hr. Dr. Small at bedside with patient and family. Stat lithotripsy treatment ordered. Awaiting transport. You responded correctly to 6 out of 6 evaluations: Categ ory Educati onal Needs Fall Risk Health Chang e Pain Level Psycho logical Needs Sensori um Tom Richardson 46yr-old. Dx- urinary stones with 3 episodes/5yrs. Allergic to sulfa drugs. Vital signs -Temp 98.4,BP 178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. Skin warm and pale. Generalized weakness, blood tinged urine and severe pain upon urination, GI- n/v. Clear liquid diet. Strict I&O and strain all urine, filters in bathroom. Patient demonstrates urine strain procedure. Severe pain (10/10) medicated q 30 minutes x4 with IV Morphine 2mg with little relief. IV D5 1/2 NS @150ml/hr. Dr. Small at bedside with patient and family. Stat lithotripsy treatment ordered. Awaiting transport. You correctly diagnosed 7 out of 8 options: Physiological ..........................................................CONTINUED........................................................................... [Show More]

Last updated: 1 year ago

Preview 1 out of 131 pages