Swift River Med-Surg Solved100%
Correct (Verified)
Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical
Hx. r/o Tuberculosis. Vital signs -Temp 99.1, BP 124/62, P 77, RR 20, SaO2 91%.
Airborne Isolation. Neuro WNL. Skin moist, respiratory bilateral wheezes and rhonchi.
Blood-tinged mucous, productive cough. Diet as tolerated. IV maintenance fluids with
D5 1/4 NS @ 150 ml/hr X 3 then reduce rate to 75 ml/hr. Expresses fatigue, fear,
concern, and desire for recovery. Need frequent reminder to stay in room and maintain
mask precautions. If family/visitors come, will need education to airborne precautions.
Spanish interpreter available at extension 61178. Dr. Rondeau - ANSWER-Educational
Needs: Increased
Fall Risk: Increased
Health Change: Increased
Pain Level: Normal
Psychological Needs: Increased
Sensorium: Normal
Physiological-
Dysfunctional Gastrointestinal Motility: False
Electrolyte Imbalance: False
Fatigue: True
Impaired Gas Exchange: True
Impaired Mobility: False
Ineffective Airway Clearance: True
Esteem-
Decisional Conflict: False
Noncompliance: True
Safety-
Anxiety: True
Deficient Knowledge: True
Fall, Risk for: True
Fear: True
Hypothermia: False
Impaired Home Maintenance Management: False
Self-Actualization-
Readiness for Self-Care Enhancement: True
Spiritual Distress: False
Love and Belonging-
Chronic Sorrow: False
,Social Isolation, Risk for: True
Carlos Mancia
Scenario 1
Mr. Mancia is a non-English speaking patient and is fearful of being discovered as an
illegal immigrant. Upon entering the room with a translator to admit him to the hospital,
he is asked for address and phone number but refuses to comply.
Scenario 2
Upon entering the room, you wash/glove hands. Following isolation precautions, you
notice several family members are by his bedside and none of them are wearing face
masks as requested by the sign on the door.
Scenario 3
Before entering Carlos Mancia room to administer his antipyretic medication for his
recent temp of 101.2
Scenario 4
The sister of Mr. Mancia calls from home to speak with you. She shares her concerns
about the patient's wife who is now coughing and having night sweats.
Scenario 5
Mr. Mancia is holding a Catholic Rosary in his hand and is crying as you enter the room.
- ANSWER-Scenario 1
-Don Personal Protective Equipment
-Allow for non-compliance of request
-Do not probe further
-Verify call Light/bed safety precautions
-Document results
Scenario 2
-Obtain translator
-Offer masks to visitors
-Educate patient
-Evaluate understanding
-Obtain Spanish signs & brochure
Scenario 3
-Obtain translator
-Wash Hands
-Put on gown and mask
-Don Gloves
-Administer antipyretic medication
Scenario 4
, -Educate caller regarding HIPAA
-Evaluate caller understanding
-Refer caller to contact health department
-Notify doctor
-Document conversation
Scenario 5
-Obtain translator
-Use therapeutic communication/Active Listening
-Educate patient
-Evaluate learning
-Document teaching moment
Jody Rush
Jody Rush, 20 y/o female, admitted for right femur fracture status post skiing accident.
She is in a traction splint, and will be going for surgical repair today. Vital signs are BP
120/62 P 88 R 20 T 98.9 F, 37.2 C, PaO2 99. She has been in a lot of pain, and has
been receiving 25 mcg IVP, q2 hours Fentanyl for pain. She was nauseated after her
last Fentanyl dose, and the Dr. Ordered an additional 4mg IVP, Zofran. She has a
history of exercise induced asthma, and uses a rescue inhaler, Albuterol. Her parents
are on their way; they are flying in today. She was on a ski trip with some of her friends
from college; her best friend has been camped out with her. We were able to get her on
a bed pan earlier, but it took a lot of work. We just received an order for a foley catheter.
There was some concern that she may have sustained a head injury as she has an
abrasion to her forehead, but she denies ever losing - ANSWER-Educational Needs:
Increased
Fall Risk: Increased
Health Change: Increased
Neurological: Increased
Pain Level: Normal
Psychological Needs: Normal
Physiological-
Acute Pain: True
Bleeding, Risk for: True
Impaired Mobility, Risk for: True
Nausea: True
Safety-
Deficient Knowledge: True
Grieving: False
Peripheral Neurovascular Dysfunction: False
Jody Rush
Correct (Verified)
Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical
Hx. r/o Tuberculosis. Vital signs -Temp 99.1, BP 124/62, P 77, RR 20, SaO2 91%.
Airborne Isolation. Neuro WNL. Skin moist, respiratory bilateral wheezes and rhonchi.
Blood-tinged mucous, productive cough. Diet as tolerated. IV maintenance fluids with
D5 1/4 NS @ 150 ml/hr X 3 then reduce rate to 75 ml/hr. Expresses fatigue, fear,
concern, and desire for recovery. Need frequent reminder to stay in room and maintain
mask precautions. If family/visitors come, will need education to airborne precautions.
Spanish interpreter available at extension 61178. Dr. Rondeau - ANSWER-Educational
Needs: Increased
Fall Risk: Increased
Health Change: Increased
Pain Level: Normal
Psychological Needs: Increased
Sensorium: Normal
Physiological-
Dysfunctional Gastrointestinal Motility: False
Electrolyte Imbalance: False
Fatigue: True
Impaired Gas Exchange: True
Impaired Mobility: False
Ineffective Airway Clearance: True
Esteem-
Decisional Conflict: False
Noncompliance: True
Safety-
Anxiety: True
Deficient Knowledge: True
Fall, Risk for: True
Fear: True
Hypothermia: False
Impaired Home Maintenance Management: False
Self-Actualization-
Readiness for Self-Care Enhancement: True
Spiritual Distress: False
Love and Belonging-
Chronic Sorrow: False
,Social Isolation, Risk for: True
Carlos Mancia
Scenario 1
Mr. Mancia is a non-English speaking patient and is fearful of being discovered as an
illegal immigrant. Upon entering the room with a translator to admit him to the hospital,
he is asked for address and phone number but refuses to comply.
Scenario 2
Upon entering the room, you wash/glove hands. Following isolation precautions, you
notice several family members are by his bedside and none of them are wearing face
masks as requested by the sign on the door.
Scenario 3
Before entering Carlos Mancia room to administer his antipyretic medication for his
recent temp of 101.2
Scenario 4
The sister of Mr. Mancia calls from home to speak with you. She shares her concerns
about the patient's wife who is now coughing and having night sweats.
Scenario 5
Mr. Mancia is holding a Catholic Rosary in his hand and is crying as you enter the room.
- ANSWER-Scenario 1
-Don Personal Protective Equipment
-Allow for non-compliance of request
-Do not probe further
-Verify call Light/bed safety precautions
-Document results
Scenario 2
-Obtain translator
-Offer masks to visitors
-Educate patient
-Evaluate understanding
-Obtain Spanish signs & brochure
Scenario 3
-Obtain translator
-Wash Hands
-Put on gown and mask
-Don Gloves
-Administer antipyretic medication
Scenario 4
, -Educate caller regarding HIPAA
-Evaluate caller understanding
-Refer caller to contact health department
-Notify doctor
-Document conversation
Scenario 5
-Obtain translator
-Use therapeutic communication/Active Listening
-Educate patient
-Evaluate learning
-Document teaching moment
Jody Rush
Jody Rush, 20 y/o female, admitted for right femur fracture status post skiing accident.
She is in a traction splint, and will be going for surgical repair today. Vital signs are BP
120/62 P 88 R 20 T 98.9 F, 37.2 C, PaO2 99. She has been in a lot of pain, and has
been receiving 25 mcg IVP, q2 hours Fentanyl for pain. She was nauseated after her
last Fentanyl dose, and the Dr. Ordered an additional 4mg IVP, Zofran. She has a
history of exercise induced asthma, and uses a rescue inhaler, Albuterol. Her parents
are on their way; they are flying in today. She was on a ski trip with some of her friends
from college; her best friend has been camped out with her. We were able to get her on
a bed pan earlier, but it took a lot of work. We just received an order for a foley catheter.
There was some concern that she may have sustained a head injury as she has an
abrasion to her forehead, but she denies ever losing - ANSWER-Educational Needs:
Increased
Fall Risk: Increased
Health Change: Increased
Neurological: Increased
Pain Level: Normal
Psychological Needs: Normal
Physiological-
Acute Pain: True
Bleeding, Risk for: True
Impaired Mobility, Risk for: True
Nausea: True
Safety-
Deficient Knowledge: True
Grieving: False
Peripheral Neurovascular Dysfunction: False
Jody Rush
