Swift River: Medical-Surgical Exam
Questions & Answers (Grade A+)
Wight Goodman | Room 301
Patient Overview
wight_goodman.jpgWight GoodmanPatient was admitted to the
floor last night from the ER for an orbital fracture. He was hit in the
left eye by a softball yesterday. Apparently, he was pitching, and the
batter hit a line drive hitting him in the right side of the face. They
applied some ice to his face, and he decided to go to the post game
keg party instead of coming to the ER. The patient stated that there
was significant swelling, but his vision was fine, and the pain was
controlled with beer and 800mg of Motrin. He was unable to sleep
later in the evening as the pain became worse, and his vision
became more impaired. Patient states, "I'm afraid I will be
permanently scarred"! The Maxillofacial surgeon was consulted,
and they will see him this morning. They were not concerned as his
intraocular pressure was normal in the ER. There is significant
edema and discoloration to th -
correct answer ✅Educational Needs- Increased
Fall Risk- Increased
Health Change- Increased
Neurological- Increased
Pain Level- Increased
Psychological Needs- Increased
,Swift River: Medical-Surgical Exam
Questions & Answers (Grade A+)
Wight Goodman
Wight Goodman Patient was admitted to the floor last night from
the ER for an orbital fracture. He was hit in the left eye by a softball
yesterday. Apparently, he was pitching, and the batter hit a line
drive hitting him in the right side of the face. They applied some ice
to his face, and he decided to go to the post game keg party instead
of coming to the ER. The patient stated that there was significant
swelling, but his vision was fine, and the pain was controlled with
beer and 800mg of Motrin. He was unable to sleep later in the
evening as the pain became worse, and his vision became more
impaired. Patient states, "I'm afraid I will be permanently scarred"!
The Maxillofacial surgeon was consulted, and they will see him this
morning. They were not concerned as his intraocular pressure was
normal in the ER. There is significant edema and discoloration to
the left side of his face, and his left eye is -
correct answer ✅Acute discomfort
Alteration in comfort
Potential for bleeding
Knowledge deficit
Potential for infection
Wight Goodman Scenario 1
,Swift River: Medical-Surgical Exam
Questions & Answers (Grade A+)
Wight GoodmanMr. Goodman has been scheduled for surgery to
repair a supraorbital rim fracture, but he is very concerned about
any scaring that may affect his appearance. He is alert and oriented
and has signed the surgical consent. The nurse notices a small
amount of blood coming from the patient's nose. He does not
remember his nose bleeding initially or in the ER. VS BP140/82 P74
R 20 T 98.7 F, 37.1 C. -
correct answer ✅1- Wash hands and assess
2- Complete Neurological assessment
3- Check the blood from his nose for CSF
4- Pre-op education
5- Ask Surgeon to discuss with patient the potential facial scarring
Wight Goodman Scenario 2
Wight GoodmanThe blood from the nose was positive for CSF. An
MRI is ordered, and reveals a small Orbital roof fracture. The
neurosurgeon is consulted. The maxillofacial surgeon will repair the
suborbital rim fracture first, and the neurosurgeon will monitor the
patient postoperatively as well as be available to assist if the orbital
roof fracture becomes unstable. IV antibiotics are ordered to be
administered ASAP. The patient will need to sign another surgical
consent for potential neurosurgery. The surgeon also orders Neuro
, Swift River: Medical-Surgical Exam
Questions & Answers (Grade A+)
checks q2 hours, his Glasgow Coma Score is 15. -
correct answer ✅1- Complete Neurological assessment
2- Educate patient of plan of care
3- Evaluate patients understanding of care
4- Administer IV antibiotics
5- Sign additional surgical consent
Wight Goodman Scenario 3
Mr. Goodman is first day post-op from his suborbital rim fracture
repair, and his orbital edema has been greatly reduced. His CSF with
rhinorrhea has subsided. The neurosurgeon has decided to
continue to observe his recovery, instead of surgical intervention to
repair the orbital roof fracture. The patients VS are stable, and he is
afebrile. Patient does not have medical insurance, so he is wanting
to leave today. The patient is emotionally distraught, and angry as
face appears to have drooping of his eyelid and his visual acuities
have not improved. While the swelling has decreased there is still
periorbital edema (Ptosis). -
correct answer ✅1- Complete Neurological Assessment
2- Educate patient and family of necessity for q2 hour neuro checks
and visual acuities
3- Inform Healthcare Provider that patient is medically indigent,
and wanting to go home today
Questions & Answers (Grade A+)
Wight Goodman | Room 301
Patient Overview
wight_goodman.jpgWight GoodmanPatient was admitted to the
floor last night from the ER for an orbital fracture. He was hit in the
left eye by a softball yesterday. Apparently, he was pitching, and the
batter hit a line drive hitting him in the right side of the face. They
applied some ice to his face, and he decided to go to the post game
keg party instead of coming to the ER. The patient stated that there
was significant swelling, but his vision was fine, and the pain was
controlled with beer and 800mg of Motrin. He was unable to sleep
later in the evening as the pain became worse, and his vision
became more impaired. Patient states, "I'm afraid I will be
permanently scarred"! The Maxillofacial surgeon was consulted,
and they will see him this morning. They were not concerned as his
intraocular pressure was normal in the ER. There is significant
edema and discoloration to th -
correct answer ✅Educational Needs- Increased
Fall Risk- Increased
Health Change- Increased
Neurological- Increased
Pain Level- Increased
Psychological Needs- Increased
,Swift River: Medical-Surgical Exam
Questions & Answers (Grade A+)
Wight Goodman
Wight Goodman Patient was admitted to the floor last night from
the ER for an orbital fracture. He was hit in the left eye by a softball
yesterday. Apparently, he was pitching, and the batter hit a line
drive hitting him in the right side of the face. They applied some ice
to his face, and he decided to go to the post game keg party instead
of coming to the ER. The patient stated that there was significant
swelling, but his vision was fine, and the pain was controlled with
beer and 800mg of Motrin. He was unable to sleep later in the
evening as the pain became worse, and his vision became more
impaired. Patient states, "I'm afraid I will be permanently scarred"!
The Maxillofacial surgeon was consulted, and they will see him this
morning. They were not concerned as his intraocular pressure was
normal in the ER. There is significant edema and discoloration to
the left side of his face, and his left eye is -
correct answer ✅Acute discomfort
Alteration in comfort
Potential for bleeding
Knowledge deficit
Potential for infection
Wight Goodman Scenario 1
,Swift River: Medical-Surgical Exam
Questions & Answers (Grade A+)
Wight GoodmanMr. Goodman has been scheduled for surgery to
repair a supraorbital rim fracture, but he is very concerned about
any scaring that may affect his appearance. He is alert and oriented
and has signed the surgical consent. The nurse notices a small
amount of blood coming from the patient's nose. He does not
remember his nose bleeding initially or in the ER. VS BP140/82 P74
R 20 T 98.7 F, 37.1 C. -
correct answer ✅1- Wash hands and assess
2- Complete Neurological assessment
3- Check the blood from his nose for CSF
4- Pre-op education
5- Ask Surgeon to discuss with patient the potential facial scarring
Wight Goodman Scenario 2
Wight GoodmanThe blood from the nose was positive for CSF. An
MRI is ordered, and reveals a small Orbital roof fracture. The
neurosurgeon is consulted. The maxillofacial surgeon will repair the
suborbital rim fracture first, and the neurosurgeon will monitor the
patient postoperatively as well as be available to assist if the orbital
roof fracture becomes unstable. IV antibiotics are ordered to be
administered ASAP. The patient will need to sign another surgical
consent for potential neurosurgery. The surgeon also orders Neuro
, Swift River: Medical-Surgical Exam
Questions & Answers (Grade A+)
checks q2 hours, his Glasgow Coma Score is 15. -
correct answer ✅1- Complete Neurological assessment
2- Educate patient of plan of care
3- Evaluate patients understanding of care
4- Administer IV antibiotics
5- Sign additional surgical consent
Wight Goodman Scenario 3
Mr. Goodman is first day post-op from his suborbital rim fracture
repair, and his orbital edema has been greatly reduced. His CSF with
rhinorrhea has subsided. The neurosurgeon has decided to
continue to observe his recovery, instead of surgical intervention to
repair the orbital roof fracture. The patients VS are stable, and he is
afebrile. Patient does not have medical insurance, so he is wanting
to leave today. The patient is emotionally distraught, and angry as
face appears to have drooping of his eyelid and his visual acuities
have not improved. While the swelling has decreased there is still
periorbital edema (Ptosis). -
correct answer ✅1- Complete Neurological Assessment
2- Educate patient and family of necessity for q2 hour neuro checks
and visual acuities
3- Inform Healthcare Provider that patient is medically indigent,
and wanting to go home today
