This is Mr. Burns. Mr. Burns is an 88-year-old male who had an emergent partial gastrectomy today because of a perforated ulcer. Mr. Burns has a history of CHF, hypertension, and he takes warfarin for atrial fibrillation. Because of the perforation, Mr. Burns lost quite a bit of blood prior to surgery, so he received 3 units of packed red blood cells in addition to 2 units of fresh frozen plasma for an elevated INR (it was 5 prior to surgery now it is 1.6). He also received 2 Liters of lactated ringers in the OR. He has a large abdominal incision with a cover dressing intact. There is some bloody drainage present on the dressing, which has been marked. He has an NG tube in the left nare to low intermittent suction. There is a small amount of dark drainage noted in the collection container. There is a central line present in the left neck that was placed by anesthesiology during surgery. He has an indwelling urinary catheter that is draining clear yellow urine. He reports incisional pain 5/10 and states this is tolerable. He is drowsy, but arousable and answers questions appropriately. He's received a total of 0.5 mg hydromorphone while int the PACU. VS are as follows: BP 110/84, HR 96, RR 16, SPO2 98% 2L/NC, T 98.6 F
What assessment data in this report is MOST concerning to you? *
1 urinary catheter draining clear yellow urine
2 abdominal dressing with some bloody drainage
3 NG tube with small amount of dark drainage
4 patient received 3 units PRBCs, 2 units FFP and 2 liters of LR
Other:
What complication are you concerned about based on the priority identified above? *
1 hypervolemia
2 urinary retention
3 hypovolemia
4 hemorrhage
5 electrolyte imbalance
6 aspiration
Mr. Burns arrives to the floor
You perform a full head to toe assessment and obtain a set of VS. Your VS are as follows: BP 148/86, HR 122, RR 26, SPO2 90% 2L/NC. You also note the following when you listen to the lungs:
You note crackles in Mr. Burns' lung assessment. What causes lungs to make this sound? *
1 air moving over a constricted airway
2 air moving over fluid
3 air moving past an obstruction in the larynx
4 movement of inflamed pleural surfaces
Based on your assessment, you notify the provider and expect which order? *
1 increase IV fluid rate
2 administer furosemide (lasix) 40 mg IVP x1 now
3 start ceftriaxone (rocephin) 2 grams IVPB Q6H
4 prepare the patient to return to surgery
In: Nursing
Why does the patient with prostate cancer present with symptoms later in the disease?
In: Nursing
from Surgical Technology for the Surgical Technologist: A Positive Care Approach, 5th ed.
Dr. Falcone is an emergency department physician who has just called the OR desk concerning a patient. He tells the charge nurse, "We have a 23-year-old male patient status post MVA, no air bag deploy, moderate facial injuries, bruising and swelling about the left eye, diplopia, and enophthalmos. CT confirms left orbital floor fracture. He'll be up in 10 minutes."
APA FORMAT SOURCE!
In: Nursing
Infectious Diseases. Please explain.
In: Nursing
Assume that you are working for the Ministry of Health in the geriatric department. The department is planning to create a specific geriatric care model for older adults to meet their needs and enable them to be healthy while they are aging. Your supervisor asks you to address one of the common geriatric syndromes to be used in that model.
1. What is the geriatric syndrome that you are going to address?
2. Explain your approach/policy that you will use to help prevent/reduce the health issue? Explain it thoroughly.
3. Why do you think your approach is appropriate for that issue?
In: Nursing
what are the activities we can use with preschoolers to teach them math espcially in the kitchen?
In: Nursing
Nine principles of successful nursing leadership
Principle #4: Create and develop leaders
An old adage is, “If your unit or department can run without you, you have done your job.” This is true, so develop your succession plan early. You can’t doo it all alone. Identify your informal and formal leaders and invest in them. Take them to meetings with you; have them provide presentations to the staff and senior-level leaders. Find opportunities to highlight their strengths and minimize their weaknesses. Train them to be the next leaders.
I need to write a response to why this would be a good leadership style for a discussion board
In: Nursing
Becky is a 33 year old woman. She is a G4 P3. She had a spontaneous vaginal delivery of a 4100 live female 4 hours ago following a precipitous delivery. Post-delivery, she received 10u of Pitocin IM. Her perineum is intact and she is feeling good. She breastfed her infant after delivery for 20 minutes without any issues. In the postpartum unit her fundus is firm at the umbilicus, her lochia is small to moderate. V.S. are stable. She rings her call bell and states "I feel dizzy and lightheaded". Upon entering the room, Becky is pale and there is a pool of blood on the floor. What are 4 interventions that the nurse should do? What are the risk factors for postpartum hemorrhage? What medical management should be initiated? Develop one nursing diagnosis and 3 nursing interventions for a patient experiencing a postpartum hemorrhage.
In: Nursing
discuss the two types of diabetes and what you think
you should know as a medical assistant?
type 1 diabetes:
type 2 diabetes:
In: Nursing
Scenario #1 You have been working at University Medical Center for five years. A few months ago, you struggled through some personal issues and abused alcohol to cope. You received treatment at a local Drug and Alcohol Inpatient Center and are in an out-patient recovery program. Your best friend, who also works with you at the Medical Center, knows about this and told your supervisor during a related discussion one day. Later that week, your supervisor told another colleague that you had a history of substance abuse and should not be left alone in the medication room. |
Question 1 Did your supervisor violate HIPAA? Why or why not? |
Question 2 Did your co-worker violate HIPAA? Why or why not? |
In: Nursing
In: Nursing
As you are an Oral health educator, please discuss the importance of a Preventive Dental Unit in Oral health education to children.
NOTE: "Talk about Preventive Dental Unit specifically and how it should be setting up and what should include or not, for children and why it is important to setting it"
In: Nursing
Professional groups enhance the practice of members through the following:
Healthcare associations work with government agencies and health organizations to regulate standards of risk management and to ensure the quality of services and patient safety.
How do external regulatory institutions support healthcare organizations to establish standards for managing risks, and what is the role of internal governance in fostering such relationships?
In: Nursing
Based on the label instructions, adding 4.5 mL of diluent to a vial containing 500 mg of powder will result in a concentration of 100 mg/mL. Calculate the volume of diluent to use if the desired concentration is 50mg/mL.
In: Nursing
1. A 33 year old female who is 32 weeks pregnant comes in to the clinic for prenatal care. The nurse notices fingertip bruising around the client’s neck and on her abdomen. She is accompanied by her boyfriend into the examining room.
2. Describe what the nurse can do to create an environment of trauma informed care on admission for a patient who has overdosed on Tylenol prior to admission.
3. The patient on the mental health unit is pacing in the hallways, yelling out, “shut up,” and begins punching and kicking into the air. As the nurse how should you respond?
In: Nursing