Other: _______________________________ Educational Needs Increased acuity Fall, Risk for False NKDA Assessment The client vital signs are: Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%, Neuro WNL alert and cooperative. -Assess for fall risk Scenario 3 You have them remain with you, seated in comfortable place, while you call ICU and attempt to locate physician for them. He also has metal fragments on his left side on his leg arm and torso. Contact Social Services Health Change: Increased acuity Stoma: N/A Colostomy Ileostomy Effluent Consistency: Mr. Dominec decides he does not want to see Infectious Disease doctor about his new cough. jasmine . Cardiovascular has pacer with rate of 82bpm on demand. When the HCP realizes who he is, he tells the nurse to move the patient in the treatment room down the hall and put Mr. Burgundy in there. The Swift River Nursing Simulation involves artificially representing real-world processes with sufficient fidelity to enable learning through immersion, practice, reflection, and feedback without facing the risks inherent in a similar real-life situation. Decreased Cardio Tissue Perfusion False Skin moist, respiratory bilateral wheezes and rhonchi. Pulse Family at beside. Robert Strurgess Scenario 2 Scenario 3 Impaired Urinary Elimination True Grieving: True Ineffective breathing pattern False Temp Urination: WNL Burning Frequency Urgency 1. A special lowbed has been ordered that will lower to the ground. How does the Med-surg simulator work? Document results and findings Evaluate understanding -Place patient on 100% O2 Swift River Reflection Questions day 7 Answer each question thoroughly in multiple sentences. Ms. Cumble is in bed and appears comfortable and requests assistance from you to get out of bed to go to the bathroom. LUE: Non-pitting Pitting ___+ The patient tells the nurse that yesterday he was, "concerned about having an erection, and now they want to cut off my testicels". Skin warm and pale. Regular diet. RLE: ______________ LLE: _____________ Mr. Dominec is waiting for his partner to arrive to take him home and you notice he has a dry unproductive cough and trouble splinting with a pillow at his operative site. Mr. Richardson is requesting assistance to ambulate to bathroom. No response = 1, Range of Motion: Full, Limited Scenario 2 Encourage fluids/fiber/ambulation IV D5 1/2 NS with 20 KCL @ 125 ml/hr in left forearm. nursing care plan for Linda Pittmon, a 74 -year old female patient who is a noncompliant diabetic, and frequently stays at the local homeless shelter. Deficient Fluid Volume False Educate caller regarding HIPAA The charge nurse tells you to get the Mr. Burgundy to the hallway because six more patients are inbound, and we need to clear out our trauma-bays. Safety Localizes pain = 5 This information is HIPAA protected and you cannot share anything with them. Scenario 1 Scenario 2 Put the patient on O2 NC and Fentanyl 25mcg IVP for pain. Electrolyte Imbalance False Remind physician to wash his hands before examining the patient Need frequent reminder to stay in room and maintain mask precautions. Educational needs: Increased acuity Sensorium Normal acuity, Physiological Palliative care. She has just been transported from recovery. It is now third day post-op, the order is for Ms. Cumble to stand by bedside on both legs for 5 minutes, three times a day. Scenario 1 palliative care. Patient and family upset regarding dx. Generalized weakness, blood tinged urine and severe pain upon urination, GI- n/v. Next time we'll spend our 60 on some food and nice beers. Scenario 3 Call Rapid Response protocol initiated Contact charge nurse. The patient describes this pain as a heavy pressure with intermittent stabbing. High fall risk. Provide for physical and thermal comfort. IV fluids of D5 1/2 NS are infusing at 100 mL/hour to his right forearm. Grieving: False The patient has been scheduled for an EGD today and has an order for Omeprazole (Prilosec) and Carafate (sucralfate). Fall Risk Increased acuity -Explain that Docetaxel is a hormone therapy that suppresses the testosterone that your testicles produce producing similar results as surgical intervention. Deficient Fluid Volume True Waist belt restraint PRN; family sitter at bedside, assist with bath. Contact dietary consult Yes Vital sign assessments Swift River Medical-Surgical. -Offer nutrition/toilet He is restless with slight confusion but is easily orientated with attempts from nurse. Evaluate understanding Health Change Increased acuity Pain Level Increased acuity Expresses fatigue, fear, concern, and desire for recovery. Acquire daily weight and food intake Disturbed body False Evaluate understanding Viola Cumble Paul Greer Decreased cardio tissue perfusion: False Self-Care Deficit False He is currently febrile with temperature 100.8, HR 99, BP 135/96, RR 20, PaO2 96%, nauseated with no vomiting, rebound tenderness in right lower quadrant, has elevated WBC's and surgeon feels this will be uneventful even though he has just been diagnosed with AIDS this past week. Scenario 3 Awaiting transport. Raspberry and Cream Cheese Stuffed Blueberry French Toast with Ozery. Compromised Family Coping False Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. Seznam uivatel, kte vlastn, prodvaj nebo shnj film. -Provide a diversional activity to pass the time while waiting on the HCP and inform wife that the HCP will be coming soon Skin warm and dry, may sit up on edge of bed today. He is married, and his wife is requesting to stay at his side. The lesion was identified as Kaposi's Sarcoma. Scenario 1 Refer call to contact health department Deficient knowledge: True His, Joyce Workman Room 303 Joyce Workman Joyce Workman, 42- year old female who presents to the Diabetes Clinic with a new diagnosis of type II diabetes. They would also like to start Radium-223. Until the recent diagnosis of cancer, the patient had only seen a physician once in the last ten years. Notify Doctor for pain medz The nurse observes an elderly lady who is crying and has not been taken care of yet. Reassure patient and help explain any new orders from physician to patient Nausea: False : an American History (Eric Foner), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Scenario 4 Airborne Isolation. Risk for Infection True Neuro WNL. Encourage fluids Filmotka filmu Najvyia ponuka (2013). Upon entering the room, the patient appears to be trying to get out of bed Pain and numbness in legs for one week. Educate patient Type of Line: Peripheral, location ______________ CVL, location _____________ PICC, location _______________ -Ensure patients is positioned in bed properly Start secondary large bore IV line jessdevan. Document results and findings -Explain that Radium-223 mimics calcium and is absorbed during new bone growth. Non-significant past medical Hx. Ineffective Renal Perfusion, Risk for True Notify Physical Therapy (PT) Waist belt restraint PRN; family sitter at bedside, assist with bath. Disturbed Body Image True Administer antipyretic medication Scenario 1 -Discuss with sitter that patient needs continual observation You arrive in room to find Ms. Monson talking to herself. Electrolyte Imbalance True Full assessment A GI cocktail was administered, and the patient stated that it decreased his pain to a 6/10. The surgeon has just visited with Mr. Greer 2-days post op and has informed him that the lymph node biopsies have confirmed that the cancer has metastasized, and he will need further treatment. Sleep Deprivation False. The patient has a Foley catheter in place and is reporting 8/10 incisional pain and he is asking why his throat is sore. school system of the host country and may not know how to choose the programme, Question 34 Correct Mark 100 out of 100 Flag question Question text hr tag, efefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefefef, arbitrary parameters a b will be a complete solution of 38 The main problem then, Reduces costs of providing on site office space To individual Makes more time, METHYLXANTHINE DRUGS-Chemistry FinalsExam PrepNotes.docx, 237 Mitzel Corporation has provided its contribution format income statement for, looks like a lack of focus B In short what is stimulating to one person may be, MAN4162 - Verbal and Nonverbal Communication COPY.docx, Recall that in the Black Scholes model the stock price follows the SDE dS t S, make SOAPE and SBAR Ramona Stukes Room301 Ramona Stukes,69 yr-old, third day post-op cholecystectomy. Peripheral Neurovascular Dysfunction False. NPO with small amount of ice chips only. -If cardiac is suspected call the provider and the rapid response team. At Risk, Impaired Comfort False The sister of Mr. Mancia calls from home to speak with you. You enter room one hour after the physician has left the patient. He asks to speak to a clergy member. Scenario 2 You now arrive in the recovery unit one hour post-surgery and you are told that the surgery went well. Educational Needs Increased acuity Arthur Thomason, 56-year-old MVA victim, fourth day post op with a splenectomy and femur repair. Neuro- confusion to time and place, but oriented to self, speech clear, poor historian, did not recognize son today which is new for her; Neuro assessment and vital signs q1 hr. Impaired Skin Integrity, Risk for True Bleeding: True Anterior: ___________________________________ Posterior: ____________________________________ Senario 1 The patient got dizzy when he stood up from the commode. Mr. Greer has just returned from surgery. Scenario 2 Home; Our Focus; Our Legacy; Our Partners; Our People; Our Fellows; Our Investments The pathology report shows no cancerous lesions. Mr. Gonzales H/H is 12.7/38. Scenario 5 -Inform Mr. Burgundy that he cannot report from the ED, as patient privacy is strictly protected by HIPPA Acute Confusion False Grieving: False. Senario 2 Flexes & withdraws = 4 Scenario 4 Explain to physician what interventions you have recently initiated and the GI cocktail given in the ER did relieve his CP but not completely. Consult Social Service Provide comfort measures -Remind patient to call for help is he need to get up and provide patient with a urinal. Vital signs- Temp 98.7, BP 114/67, P 115, RR 20, SaO2 98%. Rapid Response team arrived including anesthesia. Explain that he will probably not be going home at least until his doctor sees him. Today's weight 226. Scenario 5 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. He is questioning the nurse as to why he has been admitted for heartburn. Combien gagne t il d argent ? Dr. Roopes, Estelle Hatcher, 31yr-old, r/o appendicitis, 1st day post-op appendectomy; No known allergies (NKA); Vital signs - Temp 101.2, BP 108/74, P 92, RR 20, SaO2 99%, alert and cooperative. Senario 1 The cycle of freezing and thawing damages the abnormal cells. Senario 3 No known allergies (NKA). In the interim, start an IV and start infusing Ringers Lactate. Needs frequent reminding due to determination to do things herself without assistance. Document conversation Notify doctor if condition is abnormal You observe Ms. Getts being assisted by another nurse who is being blatantly rude and disrespectful to her. Decisional Conflict True Wash and glove hands Scenario 5 Vital signs are: B/P 112/78, temp. Patients within the Swift River Online Simulators Med Surg - Patients SROL Med Surg Female and Male Patients Female Male Ann Rails Carlos Mancia Estelle Hatcher John Duncan Kathy Gestalt Robert Sturgess Lithia Monson Tom Richardson Marcella Como Ramona Stukes Sarah Getts Viola Cumble Dosage Calc - Patients SROL Dosage Calc Female and Male Patients
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