Report from emergency room triage nurse: Red Yoder is an…

/in /by

Question Answered step-by-step Report from emergency room triage nurse: Red Yoder is an… Report from emergency room triage nurse: Red Yoder is an 80-year-old male with a pressure ulcer on his right great toe that developed about five weeks ago. His current medical problems include type 2 diabetes. He has been treated at home with an oral antibiotic and wet to damp saline dressings daily. The home health agency nurse has been checking the wound twice a week. Dr. Baker has admitted him with possible wound infection and has written preliminary orders. He has just arrived with his daughter-in-law, Judy, and they are waiting in room 2. The lab technician has been by to draw labs, obtain wound culture, and insert an IV.Patient DetailsPatient Data: Male- Age: 80 years. Weight: 109 kg (240 lbs). Height: 183 cm (72 in).Allergies: No knownPast Medical History: Diabetes type 2, diagnosed seven months agoHistory of Present Illness: The patient developed an ulcer on his big toe five weeks ago. He is currently being treated with an oral antibiotic and wet to moist saline soaked dressing daily. The home health nurse last assessed the foot three days ago.Social History: Widower, his son Jon and daughter-in-law Judy live nearby.Primary Medical Diagnosis: Possible wound infection.Surgeries/Procedures & Dates: L4-5 laminectomy 25 years ago, transurethral resection of the prostate six years ago.Provider’s OrdersEmergency room orders:IV 0.9% normal saline 500 mL bolus; may repeat onceLabs: CBC, electrolytes, BUN and creatinine, blood culture x 2, serum lactateWound culture and sensitivityOxygen at 2 liters per minute per nasal cannula; titrate to keep SpO2 > 94%If unable to void within 6 h after admission, insert urinary catheter to continuous drainage Continuous ECG and SpO2 monitoringCapillary blood glucose stat: Administer regular insulin per sliding scale below: vSim for Nursing | GerontologySherman “Red” Yoder Part 2- If less than 60, notify Dr. Baker- 61-130 – give no insulin- 131-200 – give 2 units subcutaneously- 201-250 – give 4 units subcutaneously- 251-300 – give 6 units subcutaneously- >300 notify Dr. Baker Ceftazidime 1 gram IVPB every 8 hoursTransfer to medical intensive care unit. please answer below for me .1. Be brief using bullet points to highlight main points of pathophysiology. Describe 5 statements re this health problem here  2.Medications review: Complete the table for each of the medications listed as preparation for the simulation following the example provided. Add rows as needed. Drug Name/Drug ClassHow the drug works/ is this a safe dose?Indication(For what specific reason is this drug ordered for your resident? Nursing assessmentsWhat nursing actions must be done when administering this medication?Side effects/ adverse reactions/ lab monitoring                    3.Lab Tests (blood, urine, sputum, cultures, etc): Please complete the table for laboratory tests listed in the preparation for vSim. Add rows as needed.TEST Normal RangePurposeWhy ordered for this health problemNursing actions that require assessment or follow up (npo, diet changes, med change)      4.PROCEDURES and DIAGNOSTIC TESTS (oxygen, O2 Sat level, radiography, etc.). Please complete the table for procedures listed in the preparation for vSim. Add rows as needed. TEST/DATE What is the purpose of this test (text reference)Why ordered for this patient (related to primary dx?) Plan of care implications?Nursing actions that require assess or follow up (npo, diet changes, med change)     5.GERO ASSESSMENT TOOLS.Describe the purpose of each assessment tool and what the scoring means for care planning.1.2.  6.Based on your review of pathophysiology, medications, procedures and assessment tools, list at least two problems (apply 3 step process:  problem, R/T, AEB) you anticipate the patient in the vSim may present:1.2.    Health Science Science Nursing FCNU 2030 Share QuestionEmailCopy link Comments (0)

You might also like
Hospital following a motor vehicle accident. She sustained multiple bruises and was being evaluated for back injury. She was placed in pelvic skin traction and had orders for Demerol 50mg IM every four(4) hours PRN for pain. On the day of admission she received two doses of Demerol and her chart notes that Ms. Parker repeatedly removed her traction. The unit was busy and two different nurses medicated Ms. Parker with the IM injection, 3 1/2 hours apart. Neither nurse documented the site used.Ms. Parker is now claiming that she received both injections on the same side that day, and has a permanent limp as a result of this improper IM injection technique. She claims that she can no longer do her job as a mail carrier as a result of this injury.Assess whether this case fits the criteria for malpractice. (8 points)Yes or no, should Ms. Parker win this malpractice case? (2 points)Why or why not? (5 points)
Outline 10 Watershed events that perhaps influenced the making of...
Question Answered step-by-step Patient profile Rebecca Bathchild is a 59 year old women who has... Patient profile Rebecca Bathchild is a 59 year old women who has been admitted to the gastrointestinal ward with increasing abdominal pain, nausea and vomiting, and anorexia over the past 4 days. Her brother has reported that her alcohol use had been substantial (he had counted 30 bottles of wine in the bin) over the past week. She has a known medical history of pancreatitis, alcohol induced liver disease and ethanol misuse. An abdominal CT scan was performed yesterday and confirmed a suspected diagnosis of necrotising pancreatitis. The nursing notes from the night shift report the following: 22/10/2021 at 06:10 hours - Patient slept well overnight. Diazepam 5mg administered at 23:30 hours for an alcohol withdrawal scale (AWS) of 10, and subcutaneous morphine at 03:00 hours for increased abdominal pain 7/10. Reviewed overnight by the night registrar at 05:00 due to the patient experiencing malena, full blood count taken, with Hb reported at 05:30hours of 88g/L (reduced from 101g/L 21/10/21 at 07:00 hours). Vital signs as documented. Night registrar to follow-up with treating team regarding malena, advised to monitor for further instances, and report if patient heart rate exceeds 100 beats/minute and if blood pressure decreases below 110mmHg systolic. Time Respiratory rate (breaths/min) Oxygenation (%) Temperature (degrees Celsius) Heart rate (beats/minute) Blood pressure(mmHg) Comments 23:30 24 96% on 2L via NP 36.2 97 156/86 Diazepam 5mg oral administered as per AWS 03:00 22 95% on 2L via NP 37.4 101 162/74 Abdominal pain 7/10 administered morphine 5mg S/C 05:00 20 92% on 2L via NP 37.2 105 122/56 Doctor notified - malena, FBC taken, Hb 88g/L, group and hold, and cross match taken. 06:00 21 93 on 2L via NP 36.6 92 118/62 Subjective data: At 08:05 hours Rebecca has pressed the nurse buzzer. She has vomited a large amount (estimated to be 200ml) of dark brown coffee ground like fluid. She appears distressed and is reporting increased abdominal pain. Physical assessment Neurological - orientated to person, place and time. Appears anxious, mildly diaphoretic Cardiovascular - pale, cool clammy skin to touch, blue tinge noted to fingernails, CRT approximately 3 seconds, pulse rapid and weak , HR 118 beats/minute and regular, Blood pressure 104/78mmHg, temperature 36.4 degrees Celsius. IV cannula insitu left cubital fossa - patent. Respiratory - siting up in bed, increased work of breathing, respiratory rate 26 breaths/min, SpO2 89% on 2L via NP. Gastrointestinal - sharp abdominal pain 7/10, decreased bowel sounds, BGL 4.1mmol, no further malena. Renal - last voided 04:00 hours and pass urine in the toilet. You have notified the team leader of your assessment findings and she/he is calling the treating to team to review. 1. What are the signs and symptoms?2. What is the priority problem?3. What is the intervention for this priority problem? Thank you. Health Science Science Nursing NURSING NSB236 Share QuestionEmailCopy link Comments (0)
Three behavioral objectives for a central line dressing change
1. A box contain 4 candies and 5 lollies. If Arthur will pick one...
Evaluate each of the following powers of i . 1. i 206 2. i 24 3. i...
Can you come up with a hypothetical scenario from your personal or...
Discuss the characteristics or attributes that should be appraised...