robert sturgess swift river

Disturbed Sensory Perception True Until the recent diagnosis of cancer, the patient had only seen a physician once in the last ten years. Acute pain: True LUE: Non-pitting Pitting ___+ This shop has been compensated by Inmar Intelligence and its advertiser. Encourage fluids/fiber/ambulation Health Change: Increased acuity He does not have an IV nor is he on oxygen. Roger Clinton, 57-year-old male construction worker arrives at 0600 to be prepared for a partial thyroidectomy to determine if he has cancer. Assessment of bowel movement -Attempt to orient to person, place, and time Assess for fall risk Incomprehensible Evaluate/Modify Mobility Plan, Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical Hx. He is excited and tells the nurse he is starving and glad that he finally gets to eat. Scenario 5 The patient has been scheduled for an EGD today and has an order for Omeprazole (Prilosec) and Carafate (sucralfate). Obtain Spanish signs & brochure Vital signs- The Physician tells you to have everything ready including a 22 French chest tube, and he will be in shortly to position the chest tube. Scenario 1 IV NS is started, and lab work is sent. When completing the shift change neuro check, you notice the patient's left pupil is sluggish. Full assessment Document teaching moment. He has been taking his HIV medication daily. -Check on patient/sitter hourly His orthostasis is normalized after a second liter of NS was administered. Scenario 3 No Severe pain (10/10) medicated q 30 minutes x4 with IV Morphine 2mg with little relief. Administer antiemetic medication Hx of dementia, from nursing home, fall one day ago. Failure to Thrive: True. Ms. Gestalt is now complaining of fever and chills. Scenario 3 Ineffective Peripheral Tissue Perfusion False After washing and gloving hands, you then identify yourself and the patient, Ann Rails. Genitourinary Assessment Remain with patient Skin warm and dry, all vital signs in WNL except 115 pulse, which is normal for him. Scenario 4 Assist patient Deficient Knowledge True Review pain medication order Dr. Altace, Physiological- Ineffective Peripheral Tissue Perfusion False Scenario 1 Non-significant past medical Hx. Scenario 5 Visual assessment You enter room one hour after the physician has left the patient. Risk for Infection True 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 Skin warm and dry, daily dressing changes, T-tube without drainage. Scenario 1 Scenario #2. GI WNL. Scenario 1 Replace oxygen nasal cannula that had become disconnected Scenario 4 He does not want to return to the nursing home, and does not wish to burden or live with his children. Expresses fatigue, fear, concern, and desire for recovery. The client is onDemerol 25mgSlow Intravenous Push (SIVP) for pain. Scenario #3. Stoma Status: Pink-Red/Moist Dusky Retracted Excessive bulging Allow family to remain Why is cysteine such an important amino acid for defining the tertiary structure of some proteins? Dr. Starks, Physiological His past symptoms for three months have been that he noticed a slight hoarseness in speaking, a slight dry cough not related to a cold, and upon examination had a "pea-size lump on the center of his neck". "I am feeling fine." His difficulty voiding finally motivated him to seek care. 2Provide comfort in pre-surgical room Mr. Dominec. Encourage fluids Document Results/Findings Psychological Needs Normal acuity Contact dietary consult Noncompliance True. The patient is awake, alert, and oriented. -Remove the dinner tray and make sure the diet is soft food. -Take initial vital signs (room air Pulse Ox) -Teach the patient that there are several interventions for complications post-prostatectomy to include erectile dysfunction, post-op prostatectomies, and self-care involved with a foley catheter at home. Senario 4 Mr. Thomason appears now better oriented and MD arrives unexpectedly to examine him. Constipation False She has IV access and has received a small dose of Valium to reduce apprehension. Shock False We have more than 20 years' experience in the industry providing a quality service to our clients We pride ourselves on our customer-orientated service and commitment to delivering high end quality goods within quick turnaround times. Wash and glove hands Cardiovascular has pacer with rate of 82bpm on demand. Scenario 1 Safety Her pitcher has already been filled three times this shift. Obtain vital signs machine 1Perform full assessment and provide anti-nausea medicine. Mr. Dominec is waiting for his partner to arrive to take him home and you notice he has a dry unproductive cough and trouble splinting with a pillow at his operative site. Re-assess patient -Draw a repeat CBC per HCP order to determine current Hemoglobin status Yes Productive Non-productive Describe Sputum: _______________________ To access your Swift River Virtual Clinicals login to ATI's Student Portal and access the Virtual Clinical card in My ATI. -Explain that Docetaxel is a hormone therapy that suppresses the testosterone that your testicles produce producing similar results as surgical intervention. Give verbal report Readiness for Self-Care Enhancement True Your responsibilities are: Scenario 1 Offer masks to visitors Scenario 5 -Discuss with sitter that patient needs continual observation Put the patient on O2 NC and Fentanyl 25mcg IVP for pain. Chronic Sorrow False Impaired home maintenance mgmg r/t client or family: False His, Joyce Workman Room 303 Joyce Workman Joyce Workman, 42- year old female who presents to the Diabetes Clinic with a new diagnosis of type II diabetes. Physiological- Scenario 1 Dx- urinary stones with 3 episodes/5yrs. He has a 20-year one pack history of smoking. Talk with her stating surgery is over and she did great. Love and belonging- Skin integrity, impaired True Reassure patient of options Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Her chart reports she was extubated upon arrival to the recovery area, received three units (3000 mL) of fluid, receiving O2 @ 4L via nasal cannula, has Foley Catheter in place draining QS clear yellow urine, responds to verbal stimulation, chest dressing in place remains dry and intact, and has just received a small dose of IV morphine for pain. Pain and numbness in legs for one week. Offer nutrition and/ or toileting Scenario 3 Acute Pain True Scenario 1 Wash hands Chronic pain: True -Verify that discharge orders have been written, provide discharge instructions, and in inform provider about the chest pain. You now arrive in the recovery unit one hour post-surgery and you are told that the surgery went well. She has received a dose of Hydrocodone for PRN pain 20 minutes ago. Acute Confusion True Compromised Family Coping False Love and Belonging Then the bus splashed into the river for a cruise. Impaired Mobility False If patient statement differs from the surgical consent she has signed, notify surgeon immediately Generalized weakness, blood tinged urine and severe pain upon urination, GI- n/v. Skin warm and, dry, all vital signs in WNL except 115 pulse, which is normal for him. Full assessment -Medicate for pain Scenario 3 Skin: Warm/dry Clammy/diaphoretic Skin Turgor: Brisk Tenting Knowledge Deficit True Radiofrequency ablation may be recommended after endoscopic resection. Remind the nursing staff that the patient is NPO. Impaired Home Maintenance management r/t client or family False Fall Risk Increased acuity Course Hero is not sponsored or endorsed by any college or university. Document and provide copy for Mr. Dominec to share with his follow up appointment tomorrow. Diet as tolerated. Scenario 4 Inform his partner that everything is being done to keep him comfortable. Document findings/results, Ann Rails, 38 years old, c/o back pain, non-significant past medical history. Allow husband to come into recovery for a quick one-minute visit. Fear True Verify call Light/bed safety precautions Now, meeting the CDC definition, he has full blown AIDS but is asymptomatic at this time. 1. Sa fortune s lve 2 216,00 euros mensuels Abdominal Pain: Non-tender Tender/Pain Describe: Educate patient regarding condition Scenario 1 Senario 3 Deficient Knowledge False He is complaining of pain in his left arm, and pain in his left chest when he tries to take a deep breath. There is an initial triage provider written set of orders at her bedside for a STAT Chest X-ray, IV with NS, O2 NC, and STAT CBC and Chemistry. Fall Risk Increased acuity Regardez le Salaire Mensuel de New King James Bible Download For Windows 7 en temps rel. Safety Increased acuity, Physiological -Assess if the contents of lunch tray are intact. She is with her physician. It is now the second day post op and he is given discharge information. Palliative care. No known allergies (NKA). Regardez le Salaire Mensuel de Ubah Kalimat Efektif Online en temps rel. Nausea False Need frequent reminder to stay in room and maintain mask precautions. Vital assessment Demerol 25mg SIVP for pain, patient reports 7/10 on pain scale. Impaired Home Maintenance Management r/t Client or Family False Scenario 5 Mrs. Stukes is a failed laparoscopic cholecystectomy that resulted in a bowel resection with a temporary ileostomy in place. Tunneled, site _______________ Implanted port, accessed _____________________ Scenario 3 RLE: ______________ LLE: ______________, Casts/Splits: ____________________________, Motor response Verbal command = 6 Dr. Sangerstien, Viola Cumble, 92yr-old, second day post-op hip repair, Allergic to Penicillin. Neuro WNL, alert, and cooperative. ADA diet, intake 25%. Ambulates with assistance. Sensorium Normal acuity, Physiological He is aware that he may not have an erection and may need depends for bladder incontinence. Infection, Risk for True Genitalia: WNL (skin intact, no lesions) Abnormalities Describe: __________________________ Nutritional Intake: Adequate Inadequate BMI: Mr. Greer is on the floor still but is awake and oriented and is complaining of back pain below his right scapula. Upon entering the room, you find Ms. Rails sleeping. Disturbed body False Family at beside. Upon assessment, you determined that she is confused to person, time, and place but is easily directable. Senario 1 Do not disturb Patient and family upset regarding dx. Safety Scenario 4 Scenario 5 Health Change Increased acuity Wash and glove hands Teach Cameron. -Reinforce to the patient to not get out of bed Don Personal Protective Equipment Pain Level Normal acuity -Discuss effectiveness of sitter 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. Knowledge Deficit True Pain Level Increased acuity Increased fall risk. -Set-up for stat portable chest x-ray Senario 2 Tibial: _____ + Bilateral Other: ______________ Generalized: Pedal: ______ + Bilateral Other: ____________ Sacrum: Non-pitting Pitting ___ +. No known allergies (NKA). Document results/findings The sister of Mr. Mancia calls from home to speak with you. The 'Strandperle' (lit. Mr. Dominec has a male partner and has been married for the past ten years and share their three children to the marriage. Insertion Site: Dry/Intact Redness/Erythema Drainage Tenderness Maceration Health Change Increased acuity Heterotrophs include (1) autotrophs, saprophytes, and herbivores (2) omnivores, carnivores, and autotrophs (3) saprophytes, herbivores, and carnivores (4) herbivores, autotrophs, and omnivores. Document findings IV Fluids: INT lock IV Fluids ______________@ _____________ mL/hr Date on tubing: Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Chronic Pain, Risk for constipation, impaired nutrition, anxie, 4 units on insulin sliding scale for coverage, Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Give Me Liberty! LOC Increased acuity Upon assessment, you determined that she is confused to person, time, and place but is easily directable. She is also investigating bone marrow transplantation. IV D5 1/2 NS @150ml/hr. Regular diet. RLQ: RUQ: LUQ: LLQ: Health Change Increased acuity Safety- Reasses temp in 1 hour. It is determined that Mr. Sturgess could achieve better pain control with a PCA pump. Biopsies were sent to determine the treatment. Place patient on PCA pump Mr. Richardson is requesting assistance to ambulate to bathroom. Vital signs -Temp 98.4,BP 178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. Document Results, Robert Sturgess, 81 years old, Dx- Metastatic CA of Colon, Hx of diabetes. Call rapid response NG tube to low suction possibly D/C'd today after Dr. Levine rounds. Bowel sounds: Active, Hyperactive, Hypoactive, Absent (listen for full 5 minutes) She is having some difficulty breathing. Offer bedpan Combien gagne t il d argent ? Diet as tolerated. -Remind patient to call for help is he need to get up and provide patient with a urinal. If family/visitors come, will need education to airborne precautions. Dyspnea at rest Dyspnea with minimal activity Use of accessory muscles Wash and glove hands Chronic Confusion False Health Change Increased acuity You enter patient's room. Recent chest X-ray shows diffuse bilateral interstitial infiltrates in all lobes. , a 58-year-old male patient presents to the ER CO CP 10/10. -Ensure bed is in lowest position, and rails are in place Decreased Cardiac/perfusion: False You call his doctor to inform him the family has arrived. Ms. Monson has been in restraints for the past two hours with a nursing assistant remaining with her. Senario 4 20ga. Safety Increased acuity, Physiological Pain Level Increased acuity Ms. Gestalt capillary refilling is now 6 secs below cast site, extremity is swollen and cold to the touch. Pain re-assessment Fall Risk Increased acuity Peripheral Neurovascular Dysfunction False Evaluate outcome of dietary plan 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. Peripheral Neurovascular Dysfunction True. Electrolyte Imbalance False Scenario 2 The Swift River Nursing Simulation involves artificially representing real-world processes with sufficient fidelity to enable learning through immersion, practice, reflection, and feedback without facing the risks inherent in a similar real-life situation. This will treat any cancer that may have metastasized to the bone. Strict I&O, regular diet, intake 50%. Mr. Mancia's vital signs upon assessment are Temp 101.2, P 94, RR 20, BP 122/82, SaO2-91%. Sleep deprivation False Provide Operative summary of type of procedure, IV fluid and pain status. Escort patient to vehicle Verify call light/bed safety precautions Pain, Acute True RUE: ______________ LUE: _____________ Educate about recovery from appendectomy and care to wound. Dr. Roopes, Estelle Hatcher, 31yr-old, r/o appendicitis, 1st day post-op appendectomy; No known allergies (NKA); Vital signs - Temp 101.2, BP 108/74, P 92, RR 20, SaO2 99%, alert and cooperative. Impaired mobility: False She is also to receive radiation, chemotherapy, and hormone therapy post operatively. -Reassess patient Scenario 2 Neuro WNL alert and cooperative. He also complains that his throat is still very sore. 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. The charge nurse tells the nurse to take Mr. Burgundy to the floor, because his room is now ready. Noncompliance: False Safety- Perineal Care Evaluate caller understanding Pain Level Increased acuity Attempt to orient to person, place, and time Report to charge nurse/ head nurse the need for staff education. Scenario 5 Bladder distention Pelvic pain Low back/flank pain Remain with patient -Notify charge nurse of patient's deteriorating condition -Ensure there is suction in the room, and check Notify lead nurse/doctor Description: Sharp Stabbing Throbbing Aching Cramping Other: She has been admitted to the floor with complaints of numbness in her right foot and ankle. Ineffective Self-Health Management True The patient asks the nurse to explain about these medications and why they are in such a hurry. -Complete full assessment, to include neuro Sensorium Increased acuit, Physiological You arrive in room to find Ms. Monson talking to herself. Skin moist, respiratory bilateral wheezes and rhonchi. Educate patient/family Chronic Pain False You arrive in room to check on her, after washing hands. Imbalanced Fluid Volume, Risk for True Notify doctor Perform circulatory evaluation The nurse arrives and sees a tent is being erected as a triage area, and ambulances are lined up delivering trauma patients. The lesion was identified as Kaposi's Sarcoma. Notify Doctor for pain medz Senario 2 Scenario 3 He is restless with slight confusion but is easily orientated with attempts from nurse. When the nurse retunes to the room the patient tells the nurse that when he went to the bathroom he became very lightheaded. Vital Signs: B: 160/92, P: 96, R: 22, SpO2: 98, T: 98.9F, 37.1C. It is determined that Mr. Sturgess could achieve better pain control w/ a PCA pump He has a history of well controlled GERD with over-the-counter Tagamet (Cimetidine), and Tums.

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