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Swift River Med Surg Clinical Questions and answers Updated 2024/25
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Swift River Med Surg Clinical Questions and answers Updated 2024/25
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Swift River Med Surg Clinical Questionsand answers \ Updated 2024/25
Estelle Hatcher, 31yr-old, r/o appendicitis, 1st day post-op appendectomy; No known
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allergies (NKA); Vital signs - Temp 101.2, BP 108/74, P 92, RR 20, SaO2 99%, alert and
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cooperative. Wound site clean, dry and intact NPO, NG-tube to low continuous suction. IV
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maintenance fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in left forearm. Ambulates with
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minimal assistance. Family at beside. Dr. Sangerstien - Educational Needs Increased
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Fall Risk Increased
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Health Change Increased ii ii
Pain Level Increased
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Psychological Needs Normal ii ii ii
Sensorium Normal ii
Ann Rails, 38 years old, c/o back pain, non-significant past medical history. No known
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allergies (NKA). Vital signs -BP 124/82, Temp 98.2, P 84, RR 22, SaO2 96%. Pain and
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numbness in legs for one week. Abnormal left leg weakness, gait unsteady, 5/10 on
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numeric pain scale. Neuro WNL, except leg pain upon movement. Activity as tolerated with
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assistance. D/C plan- decrease pain and restore normal gait. Regular diet. Dr. Suculo -
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Educational Needs Increased
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Fall Risk Increased
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Health Change Increased ii ii
Pain Level Increased
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Psychological Needs Normal ii ii ii
Sensorium Normal ii
Virginia Smith, 57-year-old who has elected to have a total mastectomy based on
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consultation with her surgeon, a total mastectomy removes all breast tissue but leaves all
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or most of axillary lymph nodes and chest muscles intact. She is also to receive radiation,
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chemotherapy, and hormone therapy post operatively. She is with her physician. She is
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also investigating bone marrow transplantation. She has arrived in pre-op and about to
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have surgery this morning. Her husband and two grown children are also with her as she is
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prepared with gown and head cap awaiting transport to the operating room. She has IV
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access and has received a small dose of Valium to reduce apprehension. Temperature is
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98.3, HR is 87, RR is16, BP is 121/74, PaO2 is 98%. - Educational Needs Increased
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Health Change Increased ii ii ii
LOC Normal ii ii
Pain Level Normal
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Psychological Needs Normal ii ii ii
Safety Increased ii
Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. Hx of dementia, from
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nursing home, fall one day ago. No known allergies (NKA). Vital signs -Temp 97.2, BP
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96/74, P 82, RR 20, SaO2 97%. Neuro- confusion to time and place, but oriented to self,
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, speech clear, poor historian, did not recognize son today which is new for her; Neuro
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assessment and vital signs q1 hr. Skin warm dry, bruises on forehead with small
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laceration. Increased fall risk. DSD (dry sterile dressing), forehead laceration clean and
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dry intact. 20ga. Hep-Lock in place left AC. GI WNL. Cardiovascular has pacer with rate of
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82bpm on demand. Strict I&O, regular diet, intake 50%. Waist belt restraint PRN; family
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sitter at bedside, assist with bath. Dr. Altace - Educational Needs Increased
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Fall Risk Increased
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Health Change Increased ii ii
Pain Level Increased ii ii ii
Psychological Needs Increased ii ii
Sensorium Increased ii
Linda Pittmon, a 74 -year old female patient who is a noncompliant diabetic, and frequently
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stays at the local homeless shelter. She has been admitted to the floor with complaints of
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numbness in her right foot and ankle. Mrs. Pittmon states she has had numbness for years
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but "now I can't feel it at all, and my toes don't look the right color.". - Educational Needs
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Increased
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Fall Risk Increased
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Health Change Increased ii ii
Neurological Increased ii ii
Pain Level Normal ii ii ii
Psychological Needs Normal ii ii
Sarah Kathryn Horton, 25 -year old graduate student was brought to the emergency room
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via ambulance after being shot on the local college campus. Sarah was admitted to Med-
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Surg at 2am. She has two through and through gun-shot wounds. One to her right thigh
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and one to her right shoulder. She has a 20- gauge peripheral IV to left forearm with 75
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mL/hr. of 0.9% saline infusing. Vital signs are stable at this time, alert and oriented x3,
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reports pain 6/10. She remains tearful and has been told that her best friend died on the
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scene. - Educational Needs Increased
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Fall Risk Increased
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Health Change Increased ii ii
Pain Level Increased ii ii
Psychological Needs Increased ii ii
Sensorium Normal ii
Lithia Monson
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93 years old, c/o head injury, r/o subdural hematoma. Hx of dementia, from nursing home,
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fall one day ago. No known allergies (NKA). Vital signs -Temp 97.2, BP 96/74, P 82, RR 20,
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SaO2 97%. Neuro- confusion to time and place, but oriented to self, speech clear, poor
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historian, did not recognize son today which is new for her; Neuro assessment and vital
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signs q1 hr. Skin warm dry, bruises on forehead with small laceration. Increased fall risk.
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DSD (dry sterile dressing), forehead laceration clean and dry intact. 20ga. Hep-Lock in
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place left AC. GI WNL. Cardiovascular has pacer with rate of 82bpm on demand. Strict
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I&O, regular diet, intake 50%. Waist belt restraint PRN; family sitter at bedside, assist with
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bath. Dr. Altace - Bleeding, Risk for
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