Swift River Jack Hammond Room 305 Scenario 1-5 NEW 2022
100 views 0 purchase
Course
BSN 346
Institution
BSN 346
Swift River Jack Hammond Room 305 Scenario 1-5 NEW 2022/Swift River Jack Hammond Room 305 Scenario 1-5 NEW 2022/Swift River Jack Hammond Room 305 Scenario 1-5 NEW 2022/Swift River Jack Hammond Room 305 Scenario 1-5 NEW 2022/Swift River Jack Hammond Room 305 Scenario 1-5 NEW 2022/Swift River Jack Ha...
swift river jack hammond room 305 scenario 1 5 new 2022swift river jack hammond room 305 scenario 1 5 new 2022swift river jack hammond room 305 scenario 1 5 new 2022swift river jack hammond room 30
Jack Hammond Room 305
Jack Hammond, 10 -year old boy who was admitted last night for cystic fibrosis exacerbation and possible pneumonia. He has an IV of D5 NS infusing
to his right arm at 75 mL/hour. Oxygen per nasal cannula is in place at 3 L/min, chest x-ray results and sputum culture are pending. He is alert and oriented, both parents are currently at the bedside. He does complain of intercostal pain, especially with coughing. Current oxygen saturation is 94%
You responded correctly to 5 out of 6 evaluations:
CategoryYour
response Explanation
HealthIncreased acuityExacerbation of cystic fibrosis and possible pneumonia
LOCNormal
acuityThe child is reported as alert and oriented
Pain levelIncreased acuityThe child reports pain with coughing
PsychologicalNormalThere is no mention of increased psychological
Needsacuityneeds
SafetyNormal
acuityThere is no mention of safety concerns in the report
EducationalIncreased acuityThe child is admitted for an exacerbation of his
cystic fibrosis, education is needed to help manage this chronic
Physiological
DescriptionYour
Respons
eExplanation
Activity intoleranceTRUEThe child has an exacerbation of
cystic fibrosis and requires
supplemental oxygen
Disturbed sensory
perceptionFalseCystic fibrosis does not adversely
affect sensory perception
Imbalanced TRUEWith cystic fibrosis, the body DescriptionYour
Respons
eExplanation
nutrition, less than
body requirementsdoes not produce pancreatic enzymes leading to nutritional
deficits
Impaired gas
exchangeTRUEDamage from cystic fibrosis and possible pneumonia will decrease
the body’s ability for gas
exchange
Impaired skin integrityFalseCystic fibrosis affects the pancreas, GI system, respiratory system, and increased sodium
loss through excessive perspiration
Impaired swallowingFalseThere is no indication of impaired
swallowing with cystic fibrosis
Ineffective airway
clearanceTRUECystic fibrosis leads to increased production of thick mucous, making it more difficult for
airway clearance
Ineffective health
maintenanceTRUEThe child is admitted with an
exacerbation of his chronic health problem, cystic fibrosis
Risk for infectionFalseThe child has a current infection,
and is at risk for further infection
Safety
Descriptio
n
Self- care deficitYour
Response Explanation
FalseA 10- year old child is capable of bathing, dressing and grooming self
Scenario 1
The nurse enters the room, washes hands, and introduces self to Jack and his parents. Visual assessment of Jack demonstrates the use of accessory muscles with breathing, he is sitting in a tenting position, Oxygen is being delivered via nasal cannula. Jack coughs up thick green mucous into a tissue, and grimaces when coughing. Vital signs are Temp 101*F, B/P 115/74, HR 84, Respiratory rate 28 and labored, Oxygen saturation 89%. Orders are written for nebulizer treatments PRN, chest physiotherapy QID, Pancrease (pancreatic enzymes) with each meal and snack, Oxygen via nasal cannula.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Millenialnurse. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.49. You're not tied to anything after your purchase.
