Situation Reason for admission: Stroke May 2, 2018, with left…

Question Answered step-by-step Situation Reason for admission: Stroke May 2, 2018, with left… Situation Reason for admission:Stroke May 2, 2018, with left hemiplegia, global aphasia. He has become less responsive in the last 48 hours. The neurologist has noted that damage to the brain from the last stroke was extensive. IV: s/c butterfly, Stays in bed Background Medical/Surgical History:June2,2018:TracheostomySept. 1, 1990: AppendectomyIn the last 2 days, he has refused all meals and medications. The family has asked for palliative care.  Assessment VS: Today 0800:36.6 C98 HR16 RR128/95 BP94% on room air. SPO2Social work: involved due to change in status to palliative care.  Recommendations Assessments: Resp q1hNVS: on holdVS: on hold Skin integrity: turn q2hTrach dressing q2days. Done this morning. Oxygenation: Resp Assessment q1h…trach suction and titrate O2 to keep SpO2 > 90%MAR PRN Medication Date/Time Drug: Hydromorphone Dose: 2 mg Route: S/C butterfly Frequency: Q2H PRN Instructions: change butterfly weekly. Start-stop Trans/Check:mg/gm PRN Medication: Date/Time Drug: Midazolam Dose: 1 mg Route: s/c butterfly Frequency: q4h prn Instructions: change butterfly weekly. Trans/Check: mg/gm Drug: scopolamine Dose: 0.6 mg Route: S/c butterfly Frequency: q6h prn Instructions: change butterfly weekly Trans/Check: mg/gm Instructions: Use the script provided to role play this situation. Remember that this is a very upsetting and emotional time for everyone. Please review the MAR and provide any necessary medications. DAR note to demonstrate competence in providing care.Script:Report from Night nurse: I cared for Mr. William all night. He was unresponsive but opens eyes to command and has limited strength in his arms. …Dr. ALMAN came in last night and met with the son, William Jones. The plan is to transition him to the palliative care team. The patient will be transported to Stones Hospice as soon as a bed is available.Dr.Alman has written new orders that are transcribed on the SBAR Kardex and MAR already. Can you please spend some time with the family…jQuery2240805947768064621_1612937088243? I have to get to bed. Take care and have a good shift. Day Nurse:Enter the room and greet the one family member that is present. The patient is unresponsive to questions but opens eyes and blinks.Social worker: Explain to the family what they can expect from hospice care…..ask them what their wishes are.Loved one (not William Jones the STM, any other loved one): Ask lots of questions about why he has become worse and what will happen as he gets sicker. When the Social Worker is in, you will ask about the hospice care and how the staff will take care of the client. You want the client to come home to die. You insist on this. …but you are not the designated substitute decision-maker. What does each medication do? Health Science Science Nursing Share QuestionEmailCopy link Comments (0)