Question Matthew a 16 year old male who is brought to the urgent care after… Matthew a 16 year old male who is brought to the urgent care after collapsing at basketball. He is currently alert, but pale and weak.  A blood glucose is performed by the paramedics and was read on the blood glucose meter as MAX or High.What are two additional nursing assessments that should be performed at this time? (2 points) What three history questions would you like to ask of the patient and/or her parents?  (3 points) Upon further questioning, the parents report that their son has been weak a lot lately.  Matthew reports that he is always hot and exhausted.  He reports a 10-pound weight loss over 1 month despite eating all the time and agrees that he has been thirsty and peeing a lot.  Additionally, the nurse notes Kussmaul respirations (define this) ___________________________ (1 point) and fruity breath.What three diagnostic tests should be run for Miss Matthews? (3 points) A serum glucose revealed that Matthew blood glucose is 567 mg/dl.  What is the normal range of blood glucose (define this) (1 point) ____________________and the urine was positive for ketones (define this) (1 point) ____________________________________.  The provider explains that he is likely diabetic (define this) (1 point) ________________. His parents are shocked as he has always been an athletic and healthy child.  The parents ask the healthcare team “How can he be diabetic?  He is so skinny and is so active!”  Matthew is transferred to the medical center for admission to the pediatric unit.What is an appropriate evidence based response that the nurse gives to the patient and parents? (2 points)   What treatments would you expect to be ordered for Matthew at this time? (2 points)  Matthew is treated for diabetic ketoacidosis (define this) (1 point) _________________.  Over the next two days and is now feeling much better.  The diabetic nurse educator meets with Matthew to help him better understand how to self-administer SubQ insulin using a pen.  Which teaching style will the diabetic educator use to ensure that Matthew understands how to administer the education? ­­­­­­­­­­­­­­­­________________________________ (1 point)Additionally, provide one example of the SubQ insulin type ______________________________________ (1 point).  Matthew states “I can’t stand needles, isn’t there a pill I can take instead?  (1 point)What is the most appropriate response by the nurse? (1 point)  List two possible options that Matthew has as what the dr will order for his insulin administration? (2 points)  Matthew is able to demonstrate proper technique for glucose monitoring and self-administration of insulin with the insulin pen.  His blood glucose levels are stable between 130-180 mg/dl (is this the normal range?  Y/N) (1 point) and has been discharged to home.In addition to the insulin education, he has already received, what other education topics should be included in discharge teaching for Matthew? (2 points)    Adison Jamie a 37 year old male that presents to his primary care office with chest pain. He reports that his pain started an hour after dinner, while working.  He describes the pain as “crushing” located in the middle of his chest and radiating down his right arm and to his back.  He rates his pain a 3/10.  On assessment Adison is diaphoretic and has pain.  Additionally, he reports shortness of breath (SOB).List two interventions that you as the LPN will perform as ordered by the provider? (2 points) Upon further assessment, the patient has no jugular vein distention (JVD) and no edema. His heart sounds are normal lungs are clear with scattered wheezes on auscultation.  Vital signs are as follows.  BP 140/90 mmHG Spo2 90% on room air.  HR 92 bpm and regular height of 72in.  Respriations 32 bpm, weight 166 lb.  Temp 98.6. His 12 lead report reads “Normal sinus rhythm with frequent premature ventricular contractions PVC’s (define this)_________________________. (1 point)  And three to four beat runs of ventricular tachycardia (define this)_________________________. (1 point)  ST segment elevation in leads I, aVL, and V2 through V6. ST segment depression in leads III and aVF.”Cardiac enzymes were drawn.  However, lab is still pending what would a normal cardiac enzyme level be?___________________________________________________________.  (1 point)The provider orders the following:  Aspirin 81 mg PO once, Nitroglycerin 0.4 mg SL (what is this abbreviation)___________________________________ (1 point)every (q) 5 minutes for up to 3 doses.  If all 3 doses were administered how much Nitro would the patient have received? ________________________________________________. (1 point)  Morphine 4mg IPV PRN (define IPV and PRN )________________________________________________ (1 point)for unrelieved chest pain.   As an LPN in the state of ND are you able to administer Morphine?  Y/N?  Continue to administer Oxygen to keep SP O2>92%. From the nursing interventions from the interventions listed above which should you perform first?  And WHY? (3 points)  After the above intervention has been completed which medication will you administer first?  And WHY?  Will you have to administer more than one medication? (3 points) What is the significance of the ST-segment changes on Adison’s 12-lead EKG? (1 point)Adison’s chest pain was unrelieved after three doses of SL nitro. Morphine 5 mg IVP was administered, as well as 81 mg ASA.  His pain is still unrelieved at this point.  Additional lab results are reported at: CK (what is this abbreviation)_________________________ (1 point) 254 U/L.  Is CK an approved abbreviation?  Y/N?  CK-MB 10% and Troponin I 3.5 ng/ml.  What is the provider looking for when drawing a troponin? (1 point)Based on the results of Adison’s labs and his response to medications, what is the next intervention you anticipate? Why? (3 points)  Adison is transferred by ambulance to the ED and was taken directly to the cath lab for a Percutaneous Coronary Intervention (PCI) (define this)_________________________.              (1 point) What is the expected outcome of the PCI? (1 point) Adison tolerated the PCI well and was admitted to the cardiac telemetry unit for overnight observation.  Four hours after the procedure, Adison reports no chest pain.  His most recent vital signs are:  BP 128/92, SPO2 99% on room air.  HR 78 bpm and regular respirations of 18bpm.  Temp 99.1.  He will be discharged home 24 hours after his arrival at his primary care office and will follow up with cardiology next week.What is a patient education topic that would need to be covered with Adison following the cardiac testing and events that have happened while in the care of medical professionals? (1 point)  A 7 year old comes to the clinic with complaints of a rash for 6 days.  Upon inspection of the rash, you as the nurse notice small itchy blisters across the childs chest, arms, abdomen and back. Some of which have crusts on them with some that are wet and oozing.  The child is itching the rash and look uncomfortable.  The childs temperature is 102.6 all other vital signs are within normal limits.   What other vitals are important to obtain when assessing this patient?  (8 points) What is the most important question that the nurse needs to ask the parents at this time and WHY?  (6 points) What kind of preventable disease has this child likely contracted? (1 point) What kind of precautions does this child need to be placed under and WHY?  (6 points)What education does the nurse need to provide to the patient and parents to help decrease the spread of the fluid in the blisters and the virus? (4 points)  4.  A 27 year old female is 25 weeks pregnant and arrives to her Primary OB cinic with complaints of a headache that will not go away with acetaminophen (Tylenol).  The nurse gathers the patient’s vitals and reports them all as normal.The nurse notes that the patients’ blood pressure is 156/98 mm hg and asks the patient “have you had any blurred vision, floaters, or any other changes similar to those?  Have you had any sudden swelling weight gain?The patient responds “Yes, I keep seeing floaters and have even been throwing up as a result of the floaters.  I do have some swelling and my upper abdomen has really been hurting.  Any sudden swelling or weight gain?” What additional questions will you ask the patient as a part of your focused assessment?  (List at least 3)  (3 points) The nurse goes to call the Dr to the exam room.  What is the nursing report that you will give to the Dr?  (5 points)   What additional tests do you expect the Dr to order?  (List at least 2) (2 points)  The nurse re-enters the patients’ room to gather further assessments with includes the fetal heart tone, apply oxygen and calls the Dr back into the exam room after the results of the above tests have been completed.  As the Dr is entering the room the patient starts to have a seizure.  What is happening with the patient now as a result of the seizure activity?  (5 points)                 Health Science Science Nursing NURSING PNSG1528 Share QuestionEmailCopy link Comments (0)

Question Matthew a 16 year old male who is brought to the urgent care after… Matthew a 16 year old male who is brought to the urgent care after collapsing at basketball. He is currently alert, but pale and weak.  A blood glucose is performed by the paramedics and was read on the blood glucose meter as MAX or High.What are two additional nursing assessments that should be performed at this time? (2 points) What three history questions would you like to ask of the patient and/or her parents?  (3 points) Upon further questioning, the parents report that their son has been weak a lot lately.  Matthew reports that he is always hot and exhausted.  He reports a 10-pound weight loss over 1 month despite eating all the time and agrees that he has been thirsty and peeing a lot.  Additionally, the nurse notes Kussmaul respirations (define this) ___________________________ (1 point) and fruity breath.What three diagnostic tests should be run for Miss Matthews? (3 points) A serum glucose revealed that Matthew blood glucose is 567 mg/dl.  What is the normal range of blood glucose (define this) (1 point) ____________________and the urine was positive for ketones (define this) (1 point) ____________________________________.  The provider explains that he is likely diabetic (define this) (1 point) ________________. His parents are shocked as he has always been an athletic and healthy child.  The parents ask the healthcare team “How can he be diabetic?  He is so skinny and is so active!”  Matthew is transferred to the medical center for admission to the pediatric unit.What is an appropriate evidence based response that the nurse gives to the patient and parents? (2 points)   What treatments would you expect to be ordered for Matthew at this time? (2 points)  Matthew is treated for diabetic ketoacidosis (define this) (1 point) _________________.  Over the next two days and is now feeling much better.  The diabetic nurse educator meets with Matthew to help him better understand how to self-administer SubQ insulin using a pen.  Which teaching style will the diabetic educator use to ensure that Matthew understands how to administer the education? ­­­­­­­­­­­­­­­­________________________________ (1 point)Additionally, provide one example of the SubQ insulin type ______________________________________ (1 point).  Matthew states “I can’t stand needles, isn’t there a pill I can take instead?  (1 point)What is the most appropriate response by the nurse? (1 point)  List two possible options that Matthew has as what the dr will order for his insulin administration? (2 points)  Matthew is able to demonstrate proper technique for glucose monitoring and self-administration of insulin with the insulin pen.  His blood glucose levels are stable between 130-180 mg/dl (is this the normal range?  Y/N) (1 point) and has been discharged to home.In addition to the insulin education, he has already received, what other education topics should be included in discharge teaching for Matthew? (2 points)    Adison Jamie a 37 year old male that presents to his primary care office with chest pain. He reports that his pain started an hour after dinner, while working.  He describes the pain as “crushing” located in the middle of his chest and radiating down his right arm and to his back.  He rates his pain a 3/10.  On assessment Adison is diaphoretic and has pain.  Additionally, he reports shortness of breath (SOB).List two interventions that you as the LPN will perform as ordered by the provider? (2 points) Upon further assessment, the patient has no jugular vein distention (JVD) and no edema. His heart sounds are normal lungs are clear with scattered wheezes on auscultation.  Vital signs are as follows.  BP 140/90 mmHG Spo2 90% on room air.  HR 92 bpm and regular height of 72in.  Respriations 32 bpm, weight 166 lb.  Temp 98.6. His 12 lead report reads “Normal sinus rhythm with frequent premature ventricular contractions PVC’s (define this)_________________________. (1 point)  And three to four beat runs of ventricular tachycardia (define this)_________________________. (1 point)  ST segment elevation in leads I, aVL, and V2 through V6. ST segment depression in leads III and aVF.”Cardiac enzymes were drawn.  However, lab is still pending what would a normal cardiac enzyme level be?___________________________________________________________.  (1 point)The provider orders the following:  Aspirin 81 mg PO once, Nitroglycerin 0.4 mg SL (what is this abbreviation)___________________________________ (1 point)every (q) 5 minutes for up to 3 doses.  If all 3 doses were administered how much Nitro would the patient have received? ________________________________________________. (1 point)  Morphine 4mg IPV PRN (define IPV and PRN )________________________________________________ (1 point)for unrelieved chest pain.   As an LPN in the state of ND are you able to administer Morphine?  Y/N?  Continue to administer Oxygen to keep SP O2>92%. From the nursing interventions from the interventions listed above which should you perform first?  And WHY? (3 points)  After the above intervention has been completed which medication will you administer first?  And WHY?  Will you have to administer more than one medication? (3 points) What is the significance of the ST-segment changes on Adison’s 12-lead EKG? (1 point)Adison’s chest pain was unrelieved after three doses of SL nitro. Morphine 5 mg IVP was administered, as well as 81 mg ASA.  His pain is still unrelieved at this point.  Additional lab results are reported at: CK (what is this abbreviation)_________________________ (1 point) 254 U/L.  Is CK an approved abbreviation?  Y/N?  CK-MB 10% and Troponin I 3.5 ng/ml.  What is the provider looking for when drawing a troponin? (1 point)Based on the results of Adison’s labs and his response to medications, what is the next intervention you anticipate? Why? (3 points)  Adison is transferred by ambulance to the ED and was taken directly to the cath lab for a Percutaneous Coronary Intervention (PCI) (define this)_________________________.              (1 point) What is the expected outcome of the PCI? (1 point) Adison tolerated the PCI well and was admitted to the cardiac telemetry unit for overnight observation.  Four hours after the procedure, Adison reports no chest pain.  His most recent vital signs are:  BP 128/92, SPO2 99% on room air.  HR 78 bpm and regular respirations of 18bpm.  Temp 99.1.  He will be discharged home 24 hours after his arrival at his primary care office and will follow up with cardiology next week.What is a patient education topic that would need to be covered with Adison following the cardiac testing and events that have happened while in the care of medical professionals? (1 point)  A 7 year old comes to the clinic with complaints of a rash for 6 days.  Upon inspection of the rash, you as the nurse notice small itchy blisters across the childs chest, arms, abdomen and back. Some of which have crusts on them with some that are wet and oozing.  The child is itching the rash and look uncomfortable.  The childs temperature is 102.6 all other vital signs are within normal limits.   What other vitals are important to obtain when assessing this patient?  (8 points) What is the most important question that the nurse needs to ask the parents at this time and WHY?  (6 points) What kind of preventable disease has this child likely contracted? (1 point) What kind of precautions does this child need to be placed under and WHY?  (6 points)What education does the nurse need to provide to the patient and parents to help decrease the spread of the fluid in the blisters and the virus? (4 points)  4.  A 27 year old female is 25 weeks pregnant and arrives to her Primary OB cinic with complaints of a headache that will not go away with acetaminophen (Tylenol).  The nurse gathers the patient’s vitals and reports them all as normal.The nurse notes that the patients’ blood pressure is 156/98 mm hg and asks the patient “have you had any blurred vision, floaters, or any other changes similar to those?  Have you had any sudden swelling weight gain?The patient responds “Yes, I keep seeing floaters and have even been throwing up as a result of the floaters.  I do have some swelling and my upper abdomen has really been hurting.  Any sudden swelling or weight gain?” What additional questions will you ask the patient as a part of your focused assessment?  (List at least 3)  (3 points) The nurse goes to call the Dr to the exam room.  What is the nursing report that you will give to the Dr?  (5 points)   What additional tests do you expect the Dr to order?  (List at least 2) (2 points)  The nurse re-enters the patients’ room to gather further assessments with includes the fetal heart tone, apply oxygen and calls the Dr back into the exam room after the results of the above tests have been completed.  As the Dr is entering the room the patient starts to have a seizure.  What is happening with the patient now as a result of the seizure activity?  (5 points)                 Health Science Science Nursing NURSING PNSG1528 Share QuestionEmailCopy link Comments (0)