Swift River Assignment 1 Exam Guide Graded A 2024

Charlie Raymond, 65-year-old male who was admitted to a negative pressure room on Med-Surg for COVID precautions.. He has a history of COPD, hypertension, diabetes type II, and a recent myocardial infarction. He is a retired postal worker who lives at home with his wife. He is on Claforan (cefotaxime) 2 g IV q4hr and sliding scale insulin. Initially this cardiologist was concerned about congestive heart failure and Mr. Raymond is receiving Furosemide (Lasix) 20 mg IV twice a day for pulmonary edema. Vital Signs: BP is 145/78, Pulse 89 Respirations 24 and slightly labored, Temperature 100.2 SaO2 94% on 2L nasal cannula. The patient/family is fearing the worst due to COVID-19 Pandemic. Scene 2: Select Nursing Concerns: Scene 3 The next day, he tests positive for COVID 19 and his condition has deteriorated as he is now in respiratory distress. Mr. Raymond weighs 260 lbs. Vital Signs: BP is 92/58, Pulse 102, Respiratio - Educational need increased fall risk increased Health change increased neuro normal pain level normal patient needs increased Scene 2: Nursing concerns: Physiological FALSE Bleeding False Death anxiety TRUE Disturbed Body Image FALSE Esteem FALSE Impaired Acute Confusion FALSE Impaired Gas Exchange TRUE Ineffective breathing pattern TRUE Knowledge deficit TRUE Pain, Acute FALSE Physical Mobility, Impaired Skin Integrity FALSE Scene 3 Don appropriate PPE. Change to simple O2 face mask per Healthcare provider Perform focused respiratory assessment. Notify respiratory therapist to begin treatment. Notify family to self-isolate for 14 days Scene 4 Reorient patient to setting using therapeutic communication. Obtain a sitter/UAP. Restart the IV. Begin strict I&O. Obtain an order to insert a foley catheter. Scene 5 Use therapeutic communication to explain necessary procedure. Position the patient properly. Create sterile field with foley kit on the bedside table and don sterile gloves. Instruct Lucy to assist in maintaining patient position and field sterility Insert foley catheter according to hospital recommended guidelines,to ensure sterility of catheter. Scene 6 Make sure O2 mask is secure and free of sputum. Ensure patient is in fowlers position. Check the foley catheter to make sure it is not obstructed. Notify Rapid Response team (RRT). Provide initial report and assist RRT. Scene 7 Mr. Raymond, COVID-19 positive, in severe respiratory distress, rapid response called. Patient has a history of COPD, hypertension, diabetes type II, and a recent myocardial infarction. Patient received Furosemide Lasix 20mg, IVP x2, on Claforan Q4, and on sliding scale Insulin. Intubated by RRT, BP: 88/58, P: 110, T: 101.2, SaO2: 94%, ABG's are pending. Foley catheter in place. Recommend patient be transferred to ICU. Accompany your 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 SCENE 2: RN CONSIDERATIONS Scene 3