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Donald Lyles, 52-year old male, was admitted yesterday evening for stabilization of his
uncontrolled type II diabetes. His HbgA1c is 10.6%. He has a history of a Myocardial
Infarction, MI, one year ago, and has refused all cardiac rehab, and has not had another
cardiac event. He refuses to comply with dietary recommendations. His BMI is 37. Vital
signs are BP: 146/94, P: 88, R: 22, T: 99.2, PaO2: 94% Blood glucose upon admission is 340
mg/dl - - Glucose regulation
Nutrition
safety
1Engage Safety
Dispose syringe in sharps container
2Use unexpired glucometer strips
Verify patient identity
3Assist patient in leaving the room
Activate fire alarm
Contain the fire
4Assess for obvious injury
Notify HCP of fall
Obtain vital signs
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5Complete an incident report and submit to risk management
Document in nurses' notes fall event and patient status
Kenny Barrett, 64 years old, was admitted for observation of initial administering of BP his
treatment with blood pressure of 220/124 after visiting his doctor for a routine physical.
ECG was unremarkable. No past history of HTN. Past medical history includes
hyperlipidemia, current elevated triglycerides, and a history of 1 pack a day smoker for the
past 20 years. Vital signs are Temp 98.9F, BP 178/90, P 88, RR 18 SaO2 95% on Room air. IV
with NS @ 125 mL/ hr. Patient has been complaining of a headache and dizziness. He is a
patient of Dr. Adams. - - Addiction
perfusion
Linda Yu, was admitted to your unit after surgery on her left hip due to a fall. She is 2 days
post-op. She is 85 years old and has a history of osteoarthritis and cataracts. PT has been
getting the patient up with a walker and she is able to take a few steps. She is aware of
herself and the situation, but no time or day. She is also anxious as a result of recent
surgery. Her family lives out of state, but the daughter was here for the surgery, she left
yesterday. The plan is to discharge Ms. Yu back to her assisted living facility. Her daily
medications at home include: Prednisone 5 mg, Furosemide 20 mg, and ASA 81 mg daily.
The surgeon added oxycodone 5mg q 4-6 hours prn pain. NKDA. - - Anxiety
care coordination
stress and coping
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Preston Wright, 73-year-old male patient of Dr. Greene, status post CVA 4 weeks ago. He
has been readmitted for a red spot on his sacrum of 1 cm and a 2 cm blister on his right
heel. IV fluids of D5 1/2 NS are infusing at 100 mL/hour to his right forearm. Mr. Wright is
pleasant and cooperative but needs to be reminded to avoid pressure on his heel and
sacrum. Post CVA, he has developed some aphasia and is having difficulty with verbal
communication. He has orders for dressing changes q daily and pain medications before
the dressing change. - - Cognition
communication
mobility
sensory perception
Donald Lyles Scenario 1
You are administering Insulin for Mr. Lyles. What do you do with the needle immediately
after injecting the patient? - - Scenario 1
Dispose syringe in sharps container
Engage Safety
Scenario 2
Use unexpired glucometer strips
Verify patient identity
Scenario 3
Assist patient in leaving the room
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