Swift River Med Surg ClinicalExam for 2023/2024
COMPLETE SOLUTION 100% VERIFIED ANSWERS A+
GRADED Free
56-year-old MVA victim, fourth day post op with a splenectomy and femur repair. He is
experiencing new onset of shortness of breath and has a nasal cannula with 2L of
Oxygen in place. He is restless with slight confusion but is easily orientated with
attempts from nurse. Temperature spiked during the night to 102.4, BP now 146/94
which is slightly elevated, respirations at 30 bpm and slightly labored, heart rate 102
versus 84 from last night shift. Skin cool to touch and appears pale. His coughing, to
clear his airway, appears ineffective. Recent chest X-ray shows diffuse bilateral
interstitial infiltrates in all lobes. Recent blood gases demonstrate falling PaO2
(hypoxemia) and increasing CO2 (Hypercapnia). Mr. Thomason is anxious and is
obviously worsened from the shift before in overall condition. - ✔✔ANSW✔✔..
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
numeric 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 - ✔✔ANSW✔✔..Acute Pain
Impaired Comfort
Impaired Mobility
Disturbed Sensory Perception
Fall, Risk for
Peripheral Neurovascular Dysfunction
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. -
✔✔ANSW✔✔..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
Ann Rails Scenario 2
Ms. Rails was medicated with hydrocodone 5 mg PO two hours ago and is now
complaining of pain (8/10 pain scale). - ✔✔ANSW✔✔..Wash and glove hands
Assess
Provide comfort measures
Notify doctor
Document results and findings
Ann Rails Scenario 3
Ms. Rails shares with you her fear of being discharged home to an abusive husband. -
✔✔ANSW✔✔..Listen to patient concerns
Reassure patient of options
Notify lead nurse/doctor
Contact Social Services
Document results
Ann Rails Scenario 4
Upon entering the room, you find Ms. Rails sleeping. She has received a dose of
Hydrocodone for PRN pain 20 minutes ago. - ✔✔ANSW✔✔..Wash and glove hands
Visual assessment
Do not disturb
Verify Call Light/Bed Safety precautions
Document results
Ann Rails Scenario 5
Ms. Rails states that she has not had a bowel movement (BM) in the past two days. -
✔✔ANSW✔✔..Assess for bowel sounds
Encourage fluids/fiber/ambulation
Evaluate patient understanding
Attain fluids/fiber diet and assisted ambulation
Document results
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
numeric 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 - ✔✔ANSW✔✔..Educational Needs Increased
Fall Risk Increased
Health Change Increased
Pain Level Increased
Psychological Needs Normal
Sensorium Normal
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