Surgical Case 2: Stan Checketts 1. How did the scenario make you feel? This scenario was good practice in prioritizing care accurately, since many vital skills were presented during this simulation. 2. When reflecting on the care of Stan Checketts, what are signs and symptoms you can assess in the next patient you care for who might be at risk for dehydration ? Slow skin turgor, dry mucosa of the mouth and lips, complaining of nausea and vomiting the day prior. 3. Discuss signs and symptoms of hypovolemic shock. Common signs include weakness, fatigue, fainting, dizziness, dehydration, thirst, nausea and vomiting confusion and pallor in color. Poor skin turgor as well secondary to d ehydration. 4. Discuss assessment and expected findings in a small bowel obstruction. •A fever of 100 or greater •Tachycardia •Hyperactive sounds following hypoactive bowel sounds •Abdominal pain that’s dull and achy •Vomiting and diarrhea then following constipation •Absence of flatus 5. What key questions does the nurse ask in an acute abdominal pain assessment? ➢ Where is the pain? ➢ Have you ever had this pain before? When did it start? What is the quality of the pain (sharp, dull, tender, cramping, burning)? Is it intermittent or continuous? Does the pain travel anywhere (radiate) or is it localized? On the 0 to 10 pain scale, 0 bein g no pain and 10 being the worst pain ever felt, what is your pain level right now? ➢ Are there associated symptoms, such as nausea and vomiting and/ or diarrhea? ➢ Have you noticed any black stools or blood in your stool? Have your stools been white or chalky? ➢ Have you noticed blood in your urine? ➢ Have you had a fever related to the abdominal pain? ➢ Does anything make the pain better or worse? ➢ Have you taken any medication for the pain? If so, what did you take and how did it work? ➢ Is the pain associated with eating? Has the pain affected your food intake and appetite? Have you had any recent weight loss? If so, was it planned weight loss or not planned? ➢ Have you had any recent injuries? ➢ Have you had any abdominal surgeries? If so, what was the procedure and what was the outcome of the procedure? ➢ Do you have a history of ulcers, liver issues, gallbladder issues, colitis, hernias, or appendicitis? 6. In evaluati ng Stan Checketts ’ laboratory values, what if any abnormalities did you find?
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