Her husband and children remain with her in the surgical holding area awaiting transport to the OR. Request sitter/family member to bedside Place call light and check bed for safety This will treat any cancer that may have metastasized to the bone. Obtain translator He has not had his BP medication today. Combien gagne t il d argent ? Purposive Communication Module 2, Chapter 1 - Summary Give Me Liberty! Social worker with patient this morning. His original lymph node biopsy was negative. Home; Our Focus; Our Legacy; Our Partners; Our People; Our Fellows; Our Investments Imbalanced Fluid Volume, Risk for True Fall Risk Increased acuity Day 2 admission, Thomas Richardson is complaining of severe pain and is now begging you for some relief; states pain scale 10/10. Mr. Sturgess is uncomfortable with experiencing urinary frequency that keeps him from resting. They were also concerned about the next patient going into that room and the use of the lavatory. Head/Face: Symmetric Asymmetric Drooping IV NS is started, and lab work is sent. Your response to all of them would be: Scenario 1 -Continue to observe urine for hematuria and document findings Sleep Deprivation False Imbalanced Nutrition True He is aware that he may not have an erection and may need depends for bladder incontinence. He is emotionally distraught, and is insisting that he be allowed to report what is going on from the ED. Validate NPO Status Document results Extends abnormally = 2 Sensorium Increased acuit, Physiological Upon entering the room, the patient appears to be trying to get out of bed Outline an experimental approach to demonstrate the average RNA chain growth rate during transcription of a cloned gene in vitro. You enter patient's room. Report and document results Safety Ask patient to explain to you what procedure she was expecting to have this morning. Scenario 1 The patient has sustained an injury to her head, that is bandaged, and is bleeding from a wound to her right arm and chest area. Health Change Increased acuity The cycle of freezing and thawing damages the abnormal cells. Mr. Greer has just returned from surgery. Safety- Robert Domenic Stoma: N/A Colostomy Ileostomy Effluent Consistency: Patient, and family upset regarding dx. Nutrition True Acute Pain True To access your Swift River Virtual Clinicals login to ATI's Student Portal and access the Virtual Clinical card in My ATI. -Have patient remain in bed, head elevated 30 degrees Biopsies were sent to determine the treatment. -Ensure there is a full O2 tank on the gurney, place patient on Nasal Cannula Use therapeutic communication/Active Listening Fall, Risk for True Assess vital results Check monitor No known allergies (NKA). -Instruct Mr. Burgundy and his cameraman to stop immediately She has arrived in pre-op and about to have surgery this morning. Scenario 5 Insert Foley catheter Peripheral Neurovascular Dysfunction False Palliative care. -Explain procedure to the patient Scenario 3 Wash and glove hands Scenario 3 Health Change Increased acuity There is an order to apply a waist belt restraint if needed. Ineffective Peripheral Tissue Perfusion False Dr. Rondeau, Educational Needs Increased acuity No Known allergies (NKA). Therapeutic communicationT The patient is awake, alert, and oriented. Educational needs: Increased acuity Skin warm and pale. Senario 5 Esteem The charge nurse tells you she will send someone to assist you, and to get out 2mg of Versed to have ready to sedate the patient at time of procedure. Document Results/Findings Notify lead nurse/doctor Evaluation patient after consult Remind staff that Universal Precautions are practiced at this hospital for all patients regardless of known infectious diseases. He tells the nurse he has called his wife and wants to be discharged now. -Reassure patient that he will be moved to a private room as soon as possible Activity as tolerated with assistance. Family in room with patient very concerned. Verify Call Light/Bed Safety precautions **New Patients from 2020, Post- Covid-19 Update:** **Charlie Raymond , John Duncan, Carlos Mancia, kenny barrett, Tim Jones, Julia Monroe, Donald Lyles, John Wiggins, Richard Dominec, Preston Wright, Tom Richardson, Joyce Workman, Karen Cole, Jose Martinez, Mary Barkley Charlie Raymond (for older swift river patients see other pdf files loaded at the bottom of this file) Preston Wright Room . Students will prioritize medical surgical . Mr. Dominec has a male partner and has been married for the past ten years and share their three children to the marriage. Impaired Mobility False Palliative care. What is the ratio of Fe\mathrm{Fe}Fe (II) atoms to Fe(III) atoms in this compound? Obtain translatorT Infection, Risk for True Educational Needs Increased acuity RLE: ______________ LLE: _____________ Regular diet. Scenario 2 Stay with patient for surgeon's arrival to explain intended surgical procedure Temperature is 98.3, HR is 87, RR is16, BP is 121/74, PaO2 is 98%. Radial: ____ + Bilateral Other: _____________ RLE: Non-pitting Pitting ___ + The heartburn has become worse since he started treatment for his URI. Sensorium Normal acuity, Physiological He has a 20-year one pack history of smoking. -Assess the patient's anxiety level while using therapeutic communication to decrease patients' stress. r/o Tuberculosis. c/o headache- medicated with Lortab 5mg PO at 0900, takes Lomotil 10ml PRN q 4 hours last dose at 0834. -Ensure the bed is in lowest position, the side rails are up, the call light is in reach, and ask the patient if they need anything before you leave the room Where is my camera man!! Scenario 4 Full assessment Acute pain: True Obtain vital signs machine Assess food consumption and intake and output Dysfunctional Gastrointestinal Motility False Regardez le Salaire Mensuel de Nba 2k23 Pc Review en temps rel. Scenario 2 Arthur Thomason Safety- Notify family as to when they may come and visit. Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Vital assessment Senario 3 Chronic Pain False -Remove the lunch tray and ensure pre-operative consent has been signed. -Discuss and determine sitter availability Flexes abnormally = 3 Document results, Care of the Patient with a Cardiovascular or, NCLEX - Care of Patient with an Immune Disord, Quiz: Chapter 54, Care of the Patient with an, Chapter 54: Care of the Patient with an Immun, Chapter 17, Section 5; Providing First Aid fo. In the interim, start an IV and start infusing Ringers Lactate. Electrolyte Imbalance True Senario 1 Gait: ______________________________, Skin Integrity Assessment Endoscopic resection, which uses an endoscope to remove damaged cells to aid in the detection of dysplasia and cancer. Two housekeepers, who were refusing to clean the room, are in the break room. DSD (dry sterile dressing), forehead laceration clean and dry intact. Administer PRN constipation medications Deficient Diversional Activity False Scenario 1 Blood Glucose 185, 4 units of insulin sliding scale for coverage. Senario 4 Senario 4 After 3 hours, Ms. Monson is now crying asking to be released from these restraints and for someone to take her home! Check input/output for possible dehydration Mr. Richardson is now pain free and questioning why he is plagued with recurring urinary stones. Paul Greer Assist physician in physical exam of patient Respiratory Assessment Psychological Needs: Increased acuity -Explain to the patient that he has a procedure, and he cannot eat. Educate pt regarding changes to POC Check PRN pain order Report this activity immediately to the hospital privacy officer Fall Risk Increased acuity Nathaniel Gonzalez His left humerus is fractured and splinted. Her husband who is present states, "I thought it was just a lumpectomy she was having this morning." Widespread Color Change: N/A pallor cyanosis jaundice erythema Love and belonging- Ms. Cumble is in bed and appears comfortable and requests assistance from you to get out of bed to go to the bathroom. IV maintenance fluids with D5 1/2 NS at 125ml per hour in left forearm. Notify doctor Primary: Check LOC, Orientation, Breathing, Circulation, Brief Neuro assessment to include spinal pain or deformities, Obvious injuries. -Start an IV Retrieve cast removal tool -Call security for assistance and compliance officer Deficient knowledge: False Peripheral Neurovascular Dysfunction False -Begin q15 minute neuro checks After leaving the room the provider tells the nurse that he hopes that he scared him into compliance with the treatment options. Document Results, Robert Sturgess, 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Physiological- Vital signs are to be taken BID, and it is now time. Talk with her stating surgery is over and she did great. The oncologist is insistent that the treatment begin immediately. Scenario 3 Acute Pain: True Radiofrequency ablation, which uses heat to remove abnormal esophagus tissue. Wash and glove hands Scenario 1 Discuss his understanding about the plan of care. No known allergies (NKA). Dr. Altace, Educational Needs Increased acuity Cardiovascular has pacer with rate of 82bpm on demand. Inappropriate words = 3 Explain to her family and provide contact information. No known allergies. #1: _________, No Scenario 2 No known allergies (NKA). Skin integrity at risk True Health Change Increased acuity Love and belonging Encourage Mr. Dominec to discuss with his partner his best treatment options. Disturbed Body True Ineffective Renal Perfusion, Risk for True Document results -Explain to Mr. Burgundy that space in the ED is allocated based off of patient need Deficient Knowledge True Therapeutic Communication Deficient Fluid Volume True Hep-Lock in place left AC. Scenario 3 Vital signs -Temp 98.4,BP 178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. Scenario 2 Vital assessment 45 terms. -Explain that Radium-223 mimics calcium and is absorbed during new bone growth. Scenario 3 When the nurse enters the room later that day to inform him that the procedure is scheduled for 1430, they see Mr. Gonzalez is sitting in front of a lunch tray. LUE: Non-pitting Pitting ___+ Secondary: Assess vital signs, auscultate heart, lungs, and bowl sounds. He insists that he is not hungry and refuses assistance with his meal. Contact Social Services Psychological Needs Normal acuity Mr. Greer has just been visited by his wife. He is complaining of pain in his left arm, and pain in his left chest when he tries to take a deep breath. Impaired Urinary Elimination True Scenario 1 IV D5 1/2 NS @150ml/hr. Begin post op education for day one Scenario 2 You also notice the patient is more difficult to orient. Fall, Risk for False Combien gagne t il d argent ? Patients within the Swift River Online Simulators Med Surg - Patients SROL Med Surg Female and Male Patients Female Male Ann Rails Carlos Mancia Estelle Hatcher John Duncan Kathy Gestalt Robert Sturgess Lithia Monson Tom Richardson Marcella Como Ramona Stukes Sarah Getts Viola Cumble Dosage Calc - Patients SROL Dosage Calc Female and Male Patients RLE: ______________ LLE: ______________, Casts/Splits: ____________________________, Motor response Verbal command = 6 Sensorium Normal acuity, Physiological Notify doctor if condition is abnormal Vital signs -Temp 99.1, BP 124/62, P 77, RR 20, SaO2 91%. IV Assessment/ N/A Determine from medical record if partner is aware of his recent AIDS diagnosis. Patient and family upset regarding dx. Therapeutic communication. Document results and findings Anxiety True -Offer nutrition/toilet Alleviating Factors: Last pain medication: The provider advises the Nurse to draw a stat CBC, give a liter bolus of NS, and repeat CBC. He does not have an IV nor is he on oxygen. Escort patient LLE: Non-pitting Pitting ___+ Sleep Deprivation False. Crutches at bedside adjusted for height. Anxiety True Impaired skin integrity: False, Anxiety: True Attain fluids/fiber diet and assisted ambulation Strict I&O, regular diet, intake 50%. Physiological- Some hair on the left side of his head has been burned off, as well. Safety Put the patient on O2 NC and Fentanyl 25mcg IVP for pain. You are now preparing for discharge, place steps in order: Senario 1 He was recently diagnosed with stage III prostate cancer. You take his vital signs which are: Temp 101.3, Pulse 88, Resp 24, B/P 116/84. Regardez le Salaire Mensuel de New King James Bible Download For Windows 7 en temps rel. Dr. Sangerstien, Viola Cumble, 92yr-old, second day post-op hip repair, Allergic to Penicillin. Type of Line: Peripheral, location ______________ CVL, location _____________ PICC, location _______________ You explain that his condition has worsened and now he has been taken to ICU. Senario 3 Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. IV maintenance fluids with D5 1/4 NS @ 150 ml/hr X 3 then reduce rate to 75 ml/hr. Bowel Movement Total: x________________, Hygiene Times Visual assessment Cardiovascular Assessment Scenario 5 Upon entering room, you wash/glove hands. You enter room one hour after the physician has left the patient. You enter his room and recognize that Mr. Thomason appears to be talking to himself and appears confused. At Risk, Impaired Comfort False A special lowbed has been ordered that will lower to the ground. Deficient Knowledge False Senario 4 #ozerysnackingrounds I am so excited to be partnering with Ozery Family Bakery today. -Check patency of Foley catheter, urine color, and ensure it is secure to the patient's leg Scenario 5 Notify doctor and charge nurse Re-assess patient Scenario 4 Obtain translator Localizes pain = 5 Provide for physical and thermal comfort. Administer antipyretic meds Do not disturb The Swift River is one of the most unique and popular trout fishing destinations in Massachusetts, yet the dynamics of this exceptional fishery have not been well understood. -When the HCP arrives, stay in the room to determine whether you can continue care with the patient Neuro WNL alert and cooperative. Scenario 2 Mrs. Stukes is feeling nauseated. Encourage fluids and fiber diet Noncompliance: False Deficient Knowledge False Use therapeutic communication/Active Listening Senario 5 Scenario 4 -Explain to the patient that he is now considered stable, you are taking him to the hallway, and he will be admitted to an impatient room within a few hours Pain, Acute True Bowel sounds: Active, Hyperactive, Hypoactive, Absent (listen for full 5 minutes) Several hours later, Mr. Duncan is now complaining of nausea. Stoma status: Pink-Red/Moist Dusky Retracted Excessive bulging Scenario 3 Safety Scenario 4 Mr. Mancia is holding Catholic Rosary in hand and is crying as you enter the room. Contact Social Services RLQ: RUQ: LUQ: LLQ: Verbal command = 3 Powerlessness: True, Scenario 1 Fear True Mr. Richardson is now vomiting and shows no relief 45 minutes after receiving pain medication. Document and provide copy for Mr. Dominec to share with his follow up appointment tomorrow. Electrolyte Imbalance False Scenario 5 Scenario 4 Apical pulse rhythm: Regular Irregular Location: Administer antipyretic medication Grieving: False. Scenario 5 Bed Bath: Assist or Total When you enter the room, the patient is having chest pain again, and they are pale and diaphoretic. Scenario 5 Linen Change Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Acquire daily weight and food intake Impaired Home Maintenance management r/t client or family False Pain re-assessment Include patient condition change in shift report Noncompliance False -Take initial vital signs (room air Pulse Ox) Yes Notify doctor -Ask the patient if it is okay to discuss his care in front of his children. Tom Richardson The pathology report shows no cancerous lesions. Scenario 4 Scenario 3 Viola Cumble Scenario 5 -Explain to the patient that because of his weakness and unknown cardiac status as well as the IV, he is a fall risk and should not get out of bed without assistance. Provide verbal report to team members who respond to rapid response Remain with patient and reassure Tear, Ecchymosis, Contusions, Bruising Now, third day post-op, Mrs. Stukes appears sad and depressed upon entering the room. -Ensure there is suction in the room, and check Heterotrophs include (1) autotrophs, saprophytes, and herbivores (2) omnivores, carnivores, and autotrophs (3) saprophytes, herbivores, and carnivores (4) herbivores, autotrophs, and omnivores.