Respiratory Rhythm: Regular Rhythmic Irregular Periods of Apnea Cheyne-Stokes Non-significant past medical Hx. We have more than 20 years' experience in the industry providing a quality service to our clients We pride ourselves on our customer-orientated service and commitment to delivering high end quality goods within quick turnaround times. Scenario 3 Yes Now, third day post-op, Mrs. Stukes appears sad and depressed upon entering the room. Vital signs -BP 124/82, Temp 98.2, P 84, RR 22, SaO2 96%. Senario 1 He is having some difficulty hearing and complains of ringing in his ears. Rich Dad, Poor Dad (Robert T. Kiyosaki) The Methodology of the Social Sciences (Max Weber) Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.) . Cardiovascular has pacer with rate of 82bpm on demand. Recently he manifested an unusual black lesion on his thigh and developed an opportunistic fungal mouth infection which was treated successfully. Give verbal report The patient describes this pain as a heavy pressure with intermittent stabbing. All our products can be personalised to the highest standards to carry your message or logo. Refer call to contact health department Assess food consumption and intake and output 1. Scenario 3 Genitourinary Assessment Impaired Comfort True Imbalance nutrition: 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. Document results Ms. Gestalt is now complaining of fever and chills. Mr. Sturgess does not have a living will or durable power of care completed. Sensorium Increased acuit, Physiological Pain Level Increased acuity Scenario 3 IV maintenance fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in left forearm. Neuro WNL, alert, and cooperative. Physiological- Noncompliance True. Shock, Risk for: False Mr. Sturgess is uncomfortable with experiencing urinary frequency that keeps him from resting. You arrive in room to check on her, after washing hands. You take his vital signs which are: Temp 101.3, Pulse 88, Resp 24, B/P 116/84. No response = 1, Range of Motion: Full, Limited Chronic Pain False Nausea False You are concerned about preventing the patient from falling. Remain with patient Remain with patient Ronald Burgundy Upon entering the room, you find Ms. Rails sleeping. Safety- Scenario 5 Inform patient about the progression and risk a PCP infection has for a patient with AIDS. Non-significant past medical history. Verify Call Light/Bed Safety precautions Scenario 5 -Complete incident report. -Explain that Radium-223 mimics calcium and is absorbed during new bone growth. Health Change Increased acuity Alleviating Factors: Last pain medication: Encourage fluids -Determine when a hospital provided sitter will be necessary Bleeding, Risk for False river part Answers to the questions; Fillable SOC 1 DLA 1; Fillable SOC 1 DLA 2 - Notes on Environmental effects through sociology . -Discuss and determine sitter availability Love and Belonging Scenario 5 Vital signs- Constipation, Risk for True 2. The patient is asking you where her son is, the last place she saw him was right before the explosion. -Discuss with sitter that patient needs continual observation 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) Senario 5 Scenario 3 Verify call light/bed safety precautions Scenario 2 Verify call light/bed safety precautions Impaired Mobility True Scenario 3 Vital signs are: B/P 112/78, temp. His partner is not with him at this time but will arrive soon to facilitate his discharge home. Reorient Patient to person, place, & time Impaired Home Maintenance management r/t client or family False Scenario 3 Patient and family upset regarding dx. DSD (dry sterile dressing), forehead laceration clean and dry intact. Scenario 3 Assessment of bowel movement Scenario 1 Obtain Spanish signs & brochure Visual assess Remain with patient and reassure Pain: No Yes: Location: ______________________ Acute Chronic Constant Intermittent Esteem Combien gagne t il d argent ? Vital signs -Temp 98.2, BP 94/60, P72, RR 22, SaO2 99%. Perform neuro assess Senario 3 Inform his partner that everything is being done to keep him comfortable. 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. Educate caller regarding HIPAA Start secondary large bore IV line Hx of dementia, from nursing home, fall one day ago. Safety- Blood Glucose 185, 4 units of insulin sliding scale for coverage. Use therapeutic communication/Active Listening Background Robert Sturgess the client was admitted with Metastatic cancer of Colon, with history of diabetes. Chronic pain: True -Continue to observe urine for hematuria and document findings Discharge instructions Psychological Needs Normal acuity Contact dietary consult His CP is 7/10 and his BP is 165/96, P 92, R 18, SaO2 98 on 2L NC. Alert and cooperative. Emergency intubation and assisted breathing is provided for Mr. Thomason Scenario 1 Mr. Greer has just been visited by his wife. 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. Adjust crutches Skin: Warm/dry Clammy/diaphoretic Skin Turgor: Brisk Tenting Scenario 3 Linen Change You escort them with you to the ICU. : an American History, EMT Basic Final Exam Study Guide - Google Docs, Philippine Politics and Governance W1 _ Grade 11/12 Modules SY. Provide comfort measures Neuro WNL alert and cooperative. The patient asks the nurse to explain about these medications and why they are in such a hurry. Contact Social Services -Offer nutrition and/ or toileting Mr. Dominec has a male partner and has been married for the past ten years and share their three children to the marriage. What is the ratio of Fe\mathrm{Fe}Fe (II) atoms to Fe(III) atoms in this compound? Physiological Scenario 5 Impaired Gas Exchange True The nest morning the gastroenterologist informs Mr. Gonzalez that his EGD confirmed a diagnosis of Barrett's esophagus with Dysplasia. Nathaniel Gonzalez Document results, Care of the Patient with a Cardiovascular or, NCLEX - Care of Patient with an Immune Disord, Quiz: Chapter 54, Care of the Patient with an, Chapter 54: Care of the Patient with an Immun, Chapter 17, Section 5; Providing First Aid fo. The ER nurse reports that his cardiac enzymes were borderline, (Troponin?, CK/CKMB?) Senario 5 LOC Increased acuity Waist belt restraint PRN; family sitter at bedside, assist with bath. Wash and glove hands Vital signs Temp 99.4, BP 106/72, P 96, RR 20, SaO2 91%. Mrs. Stukes is a failed laparoscopic cholecystectomy that resulted in a bowel resection with a temporary ileostomy in place. The oncologist is recommending Docetaxel as opposed to an orchiectomy. Oriented to: Person Place Time Odor: __________, *Types: Abrasion, Burn, Laceration, Puncture, Surgical, Pressure Ulcer, Vascular Ulcer, Maceration, Excoriation, Skin #1: _________, No Vital sign Temp 98.4, BP 136/78, P 72, RR 20, SaO2 97%. Connect telemetry Nutrition True 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 Document pt's statements. He is pale, weak, diaphoretic, and appears anxious. Fall Risk: Increased acuity IV Assessment/ N/A Request time she can arrive and staff to help with transfer The surgeon has suggested Androgen-deprivation therapy (ADT) with surgical castration (orchiectomy). Do not probe further Excess Fluid Volume, Risk for False Needs frequent reminding due to determination to do things herself without assistance. No response = 1, Mobility: To access your Swift River Virtual Clinicals login to ATI's Student Portal and access the Virtual Clinical card in My ATI. Scenario 2 He warns the patient that if he does not comply with the treatment and preventive measures, he will need other treatments that may include. After two hours, Mr. Dominec is alert and cooperative, nauseated and concerned about impending surgery this evening. Therapeutic communication. Notify lead nurse Identify patient jasmine . Ms. Cumble states that she has not had a BM for three days. Document results Evaluate medication effectiveness Perform pain re-assessment Scenario 4 -Use therapeutic communication/active listening Due to this, the provider would like him to stay in the hospital for observation. Document Results, Robert Sturgess, 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Scenario 5 Dx- urinary stones with 3 episodes/5yrs. -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 and provide copy for Mr. Dominec to share with his follow up appointment tomorrow. -Remind patient to call for help is he need to get up and provide patient with a urinal. The pain makes him short of breath. No Known allergies (NKA). Vital assessment John Duncan Infection, Risk for False Senario 4 He also states he is feeling weak. Ineffective Peripheral Tissue Perfusion False Decreased Cardiac/perfusion: False Place patient on PCA pump Chronic Confusion False sounds= 2 Upon assessment, you determined that she is confused to person, time, and place but is easily directable. Safety You are about to call the Surgical ICU and give report. Blood Glucose 185, 4 units of insulin sliding scale for coverage. Full assessment John Duncan, 56yr-old male, Dx- Gastroenteritis, returned yesterday from Cancun, c/o intractable diarrhea, weak, pale, and refusing to eat. Wash and glove hands 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. Encourage fluids and fiber diet Scenario 2 Acute Pain True Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Students will prioritize medical surgical . Need frequent reminder to stay in room and maintain mask precautions. It is determined that Mr. Sturgess could achieve better pain control w/ a PCA pump 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". Skin Color: Consistent with ethnicity pinkish-tan light-tan dark-tan light-brown dark-brown Rapid Response team arrived including anesthesia. Scenario 4 Cough: Peripheral Neurovascular Dysfunction: False : beach pearl), in walking distance of the velgnne ferry stop, is considered the mother of all urban beach clubs. Take vital signs before leaving the hospital again. Scenario 2 Sleep deprivation: False Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Evaluate outcome of dietary plan He is emotionally distraught and is insisting that he be allowed to report what is going on from the ER. Recent blood gases demonstrate falling PaO2 (hypoxemia) and increasing CO2 (Hypercapnia). Ineffective Airway Clearance True You have them remain with you, seated in comfortable place, while you call ICU and attempt to locate physician for them. Document results Health Change: Increased acuity He has a history of hypertension and is not compliant with medication. Mr. Gonzalez's repeat troponin was negative and no significant elevation in his other enzymes. This will treat any cancer that may have metastasized to the bone. She is also investigating bone marrow transplantation. LOC Normal acuity Deficient Knowledge False Scenario 3 Listen to patient concerns The cells are allowed to warm up and then are frozen again. He is emotionally distraught, and is insisting that he be allowed to report what is going on from the ED. ADA diet, intake, 25%. The emergency bathroom light goes off and the nurse finds Mr. Greer on the floor in the bathroom. Notify Physical Therapy (PT) She is with her physician. Replace oxygen nasal cannula that had become disconnected Deficient knowledge: True Sensorium Increased acuity, Physiological -Explain to Mr. Greer that it may take several days for healing, and he may have temporary incontinence, but it will resolve over time. -When the HCP arrives, stay in the room to determine whether you can continue care with the patient Diet as tolerated. Evaluate understanding NKDA Assessment The client vital signs are: Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%, Neuro WNL alert and cooperative. Document results Vital signs -Temp 98.4,BP 178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. Use therapeutic communication/Active Listening The patient tells the nurse that yesterday he was, "concerned about having an erection, and now they want to cut off my testicels". Pupils: PERRLA Size: R: mm L: _mm Unequal Sluggish Non-reactive -Provide a diversional activity to pass the time while waiting on the HCP and inform wife that the HCP will be coming soon Estimate the length of the Neptunian year given that the Earth is 1.50108km1.50 \times 10^{8} \mathrm{km}1.50108km from the Sun on the average. Evaluate understanding. Evaluation patient after consult Psychological Needs Increased acuity -Verify that discharge orders have been written, provide discharge instructions, and in inform provider about the chest pain. -Remove the dinner tray and make sure the diet is soft food. Hep-Lock in place left AC. The sister of Mr. Mancia calls from home to speak with you. Fall, risk for: False -Assess for fall risk NPO with small amount of ice chips only. Scenario 4 Noncompliance: False -Ensure IV is patent, Lithia Monson Leave to break room and not continue in conversation. Acute Confusion: True Home; Our Focus; Our Legacy; Our Partners; Our People; Our Fellows; Our Investments -Offer nutrition/toilet Scenario 5 Notify Doctor for pain medz Provide for physical and thermal comfort. ADA diet, intake 25%. Temperature is 98.3, HR is 87, RR is16, BP is 121/74, PaO2 is 98%. Endoscopic resection, which uses an endoscope to remove damaged cells to aid in the detection of dysplasia and cancer. Deficient Fluid Volume True Ann Rails Ineffective breathing pattern False He is excited and tells the nurse he is starving and glad that he finally gets to eat. Scenario 5 Dr. Levine, Marcella Como, 38 yr-old, Sexual Trauma Victim (Rape), unknown assailant. The patient is being prepared for discharge and his IV has been removed. -Explain to patient why his throat may be sore No known allergies (NKA). 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. The MD on site makes the decision to intubate the patient and start ventilatory assistance and move the patient to Respiratory Intensive Care. Offer assistance in providing more information about treatment options for newly diagnosed AIDS patients. Obtain Clinical Hours 24/7/365 In-Class and Lab Learning Resource Improve Clinical Practice Scenario 2 They were also concerned about the next patient going into that room and the use of the lavatory. You are the now the Surgical ICU nurse assigned to her. Educate patient/family No known allergies. Imbalanced Nutrition True Retrieve cast removal tool Communication/Speech: Clear Non-verbal Slurred Aphasia Other He is questioning the nurse as to why he has been admitted for heartburn. Disturbed Body True It is determined that Mr. Sturgess could achieve better pain control with a PCA pump. Notify doctor When she moves him to the hallway, Mr. Burgundy begins yelling at you "Do you know who I am, I demand a room! Cardiovascular Assessment The surgeon believes that the surgery was successful but recommends the patient have chemotherapy and radiation postoperatively. No Known allergies (NKA). Wash and glove hands Also worth mentioning is the 'Alter Schwede' - a 217t . Dr. Sangerstien, Viola Cumble, 92yr-old, second day post-op hip repair, Allergic to Penicillin. Regular diet. Observe closely first hour Scenario 3 Peripheral Neurovascular Dysfunction False. You question her while reviewing her operative consent and determine that everything is correct. Students also viewed Culture Concept notebook Development concept notebook Elimination concept notebook Gas Exchange concept notebook Scenario 5 Stoma: N/A Colostomy Ileostomy Effluent Consistency: Scenario 1 Scenario 2 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. Chronic Pain True Gait: ______________________________, Skin Integrity Assessment Provide comfort in pre-surgical room Mr. Dominec. Risk for Infection True LOC Normal acuity Assess for bowel sounds Assess Scenario 5 Document results Senario 2 Health Change Increased acuity 20ga. Roger Clinton, 57-year-old male construction worker arrives at 0600 to be prepared for a partial thyroidectomy to determine if he has cancer. -Explain to Mr. Burgundy that space in the ED is allocated based off of patient need When you arrive to room 4, you are told to assume the care for the patient and get ready to transport them to the floor ASAP. Her husband who is present states, "I thought it was just a lumpectomy she was having this morning." Evaluate patient understanding Urine Color: Clarity: Odor: Apical/Radial Pulse Deficit: No Yes Murmur Valve Click She has arrived in pre-op and about to have surgery this morning. Use therapeutic communication/active listening Remind staff that Universal Precautions are practiced at this hospital for all patients regardless of known infectious diseases. Vital signs -Temp 98.8, BP 102/76, P 102- irregular, RR 22, SaO2 90%, cardiovascular on telemetry with Sinus irregular rhythm. Grieving: True -Restart the IV and draw CBC Scenario 3 Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Mr. Duncan is now complaining of feeling "dizzy" when he stands. Pain Level Normal acuity Students will form a preliminary assessment based on reported assessment data for medical surgical patients in a virtual clinical environment. Assist patient out of bed Educate patient regarding condition Begin post op education for day one Self-Care Deficit: True Dr. Small at bedside with patient and family. You enter patient's room. Evaluate understanding -Begin q15 minute neuro checks Assess for fall risk He also has metal fragments on his left side on his leg arm and torso. Chronic Sorrow False Provide emotional support. Chronic Pain False She has been admitted to the floor with complaints of numbness in her right foot and ankle. Full assessment Respiratory Effort: Relaxed, Regular, Non-labored Pursed lip breathing Labored -Medicate for pain Senario 3 Remind the nursing staff that the patient is NPO. Pulse Wash and glove hands Deficient knowledge: True His coughing, to clear his airway, appears ineffective. Mr. Dominec had his surgical procedure and is doing great. and the GI cocktail given in the ER did relieve his CP but not completely. Dr. Suculo, Physiological Constipation False Acute pain: True Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Check monitor Acute Confusion False Scenario 3 Ramona Stukes, 69 yr-old, third day post-op cholecystectomy. Today, clubs like Hamburg City Beach Club, Lago Bay, Hamburg del Mar and StrandPauli provide a relaxed summer atmosphere with a view over the Elbe. Mr. Richardson is now pain free and questioning why he is plagued with recurring urinary stones. -Ask the patient if it is okay to discuss his care in front of his children. Sa fortune s lve 2 216,00 euros mensuels Bleeding False Assess pain Love and belonging Mr. Dominec decides he does not want to see Infectious Disease doctor about his new cough. Decreased Cardiac/perfusion False They feel that you should share with them if he was a "real AIDS" patient or not. Provide verbal report to team members who respond to rapid response Nausea False No Document results and findings Sleep Deprivation False No known allergies (NKA). Skin warm and pale. 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. Mr. Greer is on the floor still but is awake and oriented and is complaining of back pain below his right scapula. Social worker with patient this morning. Palliative care. Electrolyte Imbalance False Upon entering room, you find Mr. Sturgess is quiet, appears tense and rigid but states, "I am feeling fine." . The patient has a pneumothorax that requires a chest tube placement. Compromised Family Coping: False Radiofrequency ablation, which uses heat to remove abnormal esophagus tissue. He is married, and his wife is requesting to stay at his side. Filmotka filmu Najvyia ponuka (2013). Impaired Urinary Elimination True Grieving: False. -Document and contact nursing supervisor/Charge nurse Contact head nurse or supervisor in the OR to evaluate new situation Hypothermia False Record intake and output 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. Mr. Sturgess is recently dx w/ metastatic cancer of colon and he and his family have chosen only Scenario 3 Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. -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. Urination: WNL Burning Frequency Urgency Scenario 5 Notify housekeeping. Therapeutic communication No weight bearing today. Skin Integrity: Intact No, describe below, Location Type Size Wound bed Drainage Then the bus splashed into the river for a cruise. He is restless with slight confusion but is easily orientated with attempts from nurse. Diet as tolerated, up ad lib after gait training. Deficient Diversional Activity False Last pain medicine 2hrs ago at 1300(Demerol 50mg/ Zofran 4mg IV). Apply fall risk bracelet Pain, Acute True Remain with Patient, Sarah Getts, 77 yr-old, Dx- Chronic Renal Failure, admitted with hyperkalemia (5.9, Eq/L)/hyponatremia (128mEq/L). Offer nutrition/toilet Scenario 4 Several hours later, Mr. Duncan is now complaining of nausea. Nausea False Scenario 1 Include patient condition change in shift report Disoriented, confused = 4 Obtain and provide the infectious disease doctor's contact information for him. Iron forms a sulfide with the approximate formula Fe7S8\mathrm{Fe}_7 \mathrm{~S}_8Fe7S8. Palliative care. IV D5 1/2 NS @150ml/hr. Explain reason for assessment and procedure Offer nutrition and/ or toileting Dr. Altace, Educational Needs Increased acuity Pain = 2 Evaluate understanding -Medicate for pain -Complete secondary assessment once the patient is in bed focusing on complaint of pain resulting from the fall Fall, risk for: True Disturbed Body Image True Therapeutic communicationT Read PT report Scenario 2: 1Educate about recovery from appendectomy and care to wound. Hep-Lock in place left AC. He was recently diagnosed with stage III prostate cancer. Seek clarification No Known allergies (NKA). Grieving False Awaiting transport. The oncologist is insistent that the treatment begin immediately. Family at beside. Dr. Donofrio, Physiological Failure to Thrive False. No Known allergies (NKA). Bleeding, Risk for True Airborne Isolation. is a 57 y/o who has been admitted for a radical prostatectomy. Abnormal left leg weakness, gait unsteady, 5/10 on numeric pain scale. Document results/findings Flexes abnormally = 3 Scenario 4 -Complete full assessment, to include neuro Scenario 4 Palliative care. -Perform neuro assess Failure to Thrive True. Ms. Rails was medicated with hydrocodone 5 mg PO two hours ago and is now complaining of pain (8/10 pain scale). Blood-tinged mucous, productive cough. Sa fortune s lve 2 000,00 euros mensuels He also has a history of hypertension and takes Tenormin (Atenolol) and Atorvastatin (Lipitor). Palliative care. Allow family to remain -Assess patient LOC, by walking patient and asking them to take deep breaths. Allow for non-compliance of request Awaiting diagnostic labs. Paul Greer Dr. Starks, Physiological Family arrive one hour after event to his prior room and find Mr. Thomason's room is empty and have no idea of the events that have just occurred. Blood, Glucose 185, 4 units of insulin sliding scale for coverage. Scenario 1 Impaired skin integrity: False, Anxiety: True Full assessment 2Provide comfort in pre-surgical room Mr. Dominec. -Reinforce the risk if patient has not been NPO and ask the patient when the last time they ate. Dr. Rondeau, Educational Needs Increased acuity Clinical 2. Stay with patient for surgeon's arrival to explain intended surgical procedure Impaired comfort: True PT to educate patient Verbal command = 3 Activity as tolerated with assistance. -Call security for assistance and compliance officer Regardez le Salaire Mensuel de New King James Bible Download For Windows 7 en temps rel. Type of Line: Peripheral, location ______________ CVL, location _____________ PICC, location _______________ Scenario 4 The 'Strandperle' (lit. How does the Med-surg simulator work? -Evaluate patient's understanding of teaching His orthostasis is normalized after a second liter of NS was administered. High fall risk. He also complains that his throat is still very sore. Mr. Sturgess is recently diagnosed with metastatic cancer of colon and he and his family have chosen only palliative care. Educational needs: Increased acuity Sitting, BP 109/60, P 114, Standing the patient becomes very lightheaded and the nurse has them lay back down. Encourage to ambulate with assistance to void if needed Educate patient Wash and glove hands You, his prior nurse, notice the family and respond to them. Mr. Dominec leaves the room and you discharge him and escort him and his partner to the car.

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