swift river med surg pt scenarios Updated 2024/2025 Actual Questions and answers with complete solutions
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Course
Swift river med surg pt scenarios
Institution
Swift River Med Surg Pt Scenarios
Ann Rails
Scenario 1
You enter patient's room. After washing and gloving hands, you then identify yourself and the patient,
Ann Rails. You notice she is crying and is expressing fear that she "will always have this pain and
numbness" and she doesn't think she can cope.
Scenario 2
Ms. Rails wa...
swift river med surg pt scenarios Ann Rails Scenario 1 You enter patient's room. After washing and gloving hands, you then identify yourself and the patient, Ann Rails. You notice she is crying and is expressing fear that she "will always have this pain and numbness" and she doesn't think she can cope. Scenario 2 Ms. Rails was medicated with hydrocodone 5 mg PO two hours ago and is now complaining of pain (8/10 pain scale). Scenario 3 Ms. Rails shares with you her fear of being discharged home to an abusive husband. Scenario 4 Upon entering the room, you find Ms. Rails sleeping. She has received a dose of Hydrocodone for PRN pain 20 minutes ago. Scenario 5 Ms. Rails states that she has not had a bowel movement (BM) in the past two days. - Scenario 1 Use therapeutic communication/Active Listening Educate patient regarding patient care Evaluate patient learning Place call light and check bed for safety Document results and findings Scenario 2 Wash and glove hands Assess Provide comfort measures Notify doctor Document results and findings Scenario 3 Listen to patient concerns Reassure patient of options Notify lead nurse/doctor Contact Social Services Document results Scenario 4 Wash and glove hands Visual assessment Do not disturb Verify Call Light/Bed Safety precautions Document results Scenario 5 Assess for bowel sounds Encourage fluids/fiber/ambulation Evaluate patient understanding Attain fluids/fiber diet and assisted ambulation Document results Ann Rails - Physiological Acute Pain True Bleeding, Risk for False Chronic Pain False Impaired Comfort True Impaired Mobility True Nausea False Safety Deficient Knowledge False Disturbed Sensory Perception True Fall, Risk for True Grieving False Infection, Risk for False Peripheral Neurovascular Dysfunction True Ann Rails, 38 years old, c/o back pain, non -significant past medical history. No known allergies (NKA). Vital signs -BP 124/82, Temp 98.2, P 84, RR 22, SaO2 96%. Pain and numbness in legs for one week. Abnormal left leg weakness, gait unsteady, 5/10 on num eric pain scale. Neuro WNL, except leg pain upon movement. Activity as tolerated with assistance. D/C plan - decrease pain and restore normal gait. Regular diet. Dr. Suculo - Educational Needs Increased acuity Fall Risk Increased acuity Health Change Increased acuity Pain Level Increased acuity Psychological Needs Normal acuity Sensorium Normal acuity Arthur Thomason Scenario 1 You enter his room and recognize that Mr. Thomason appears to be talking to himself and appears confused. Scenario 2 Mr. Thomason appears now better oriented and MD arrives unexpectedly to examine him. Scenario 3 You enter room one hour after the physician has left the patient. Your notice Mr. Thomason is lying supine, appears slightly cyanotic in his lips, is exhibiting more effort to breathe, and is increasingly restless. Lung sounds are worse. Scenario 4 Rapid Response team arrived including anesthesia. The MD on site makes the decision to intubate the patient and start ventilatory assistance and move the patient to Respiratory Intensive Care. Scenario 5 Family arrive one hour after event to his prior room and find Mr. Thomason's room is empty and have no idea of the events that have just occurred. You, his prior nurse, notice the family and respond to them. - Scenario 1 Replace oxygen nasal cannula that had become disconnected Therapeutic communication Assess Notify doctor and charge nurse Scenario 2 Remind physician to wash his hands before examining the patient Explain to physician what interventions you have recently initiated Assist physician in physical exam of patient Obtain recent chest X -ray reports and recent ABG's for physician to review Reassure patient and help explain any new orders from physician to patient
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