Swift River Medical Surgical Exam Latest Update With Complete
Answers
1. Ann Rails 38 years old, c/o back pain, non-
Fall risk
significant past medical history. No known
Health
allergies (NKA). Vital signs -BP 124/82, Temp
change Pain
98.2, P 84, RR 22, SaO2 96%.
level
Pain and numbness in legs for one week.
Educational Needs Psy-
Abnormal
left leg weakness, gait unsteady, 5/10 on numeric pain chological
Needs
scale. Neuro WNL, except leg pain upon
movement. Activity as tolerated with
assistance. D/C plan- de- crease pain and
restore normal gait. Regular diet. Dr. Suculo
2. Arthur Thomason 56-year-old MVA victim, Educational
fourth day post op with a splenectomy and needs Health
femur repair. He is experiencing new onset of change LOC
shortness of breath and has a nasal cannula Pain level
with 2L of Oxygen in place. He is restless with Psychological needs
slight confusion but is easily orientated
with attempts from nurse. Temperature spiked during
Safety 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. Skin cool
to touch and appears pale. His coughing, to
clear his airway, appears ineffective. Recent
chest X-ray shows diffuse bilateral interstitial
infiltrates in all lobes. Re- cent blood gases
demonstrate falling PaO2 (hypox- emia) and
increasing CO2 (Hypercapnia). Mr. Thoma- son
is anxious and is obviously worsened from the
shift before in overall condition.
, Swift River Medical Surgical Exam Latest Update With Complete
Answers
3. Calvin Umbyuma Mr. Umbyuma is a 42 y/o male Educational
who has been admitted for complaints of needs Health
shortness of breath with pleuritic chest change Pain
pain. He was diagnosed with HIV positive level
antibodies over a year ago. He has recently
been traveling back to his home country of
, Swift River Medical Surgical Exam Latest Update With Complete
Answers
Kenya to visit his sick mother. He received
traditional medical treatment at his village. His
temp is 100.9 F,
38.3 C, R 22, P92, BP 152/89 PaO2 91%.
Inflammatory markers - Erythrocyte
Sedimentation Rate (ESR) and
C-Reactive Protein (CRP) are elevated at 78.9
mm/h and
67.2 mg/L. He has been placed in a room at the Educationa
end of the hall. l Health
change
4. Cameron Daniels just turned 18 y/o. She is
being ad- mitted from the ER with a diagnosis
of pelvic inflam-
matory disease (PID). She has heavy vaginal discharge Pain
level with an unpleasant odor. She is complaining of
abdom- Fall risk inal pain and looks pale. She was seen
by OBGYN in the
ER and a culture was sent to the lab for
Chlamydia and Neisseria Gonorrhea. She was a
very difficult IV start and has a 23g saline lock
(SL) in her right hand. They have ordered a liter
bolus of LR, but it is running very slowly and the
IV is positional. VS BP 96/58, P 116, R 18, T 101.2
PaO2 98%.
5. Higher numbered acuities are at most
risk. Cameron Daniels, acuity 3, 6. Higher
room 304 numbered
acuities are
at most risk.
Arthur
Thomaston,
, Swift River Medical Surgical Exam Latest Update With Complete
Answers
acuity 3, room 302 Acute discomfort
Alteration in mobility
Knowledge deficit
Potential falls
Potential for infection
Nausea
Alteration in
comfort Alteration
in gas ex-
change
Inettectual airway
clear- ance
Answers
1. Ann Rails 38 years old, c/o back pain, non-
Fall risk
significant past medical history. No known
Health
allergies (NKA). Vital signs -BP 124/82, Temp
change Pain
98.2, P 84, RR 22, SaO2 96%.
level
Pain and numbness in legs for one week.
Educational Needs Psy-
Abnormal
left leg weakness, gait unsteady, 5/10 on numeric pain chological
Needs
scale. Neuro WNL, except leg pain upon
movement. Activity as tolerated with
assistance. D/C plan- de- crease pain and
restore normal gait. Regular diet. Dr. Suculo
2. Arthur Thomason 56-year-old MVA victim, Educational
fourth day post op with a splenectomy and needs Health
femur repair. He is experiencing new onset of change LOC
shortness of breath and has a nasal cannula Pain level
with 2L of Oxygen in place. He is restless with Psychological needs
slight confusion but is easily orientated
with attempts from nurse. Temperature spiked during
Safety 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. Skin cool
to touch and appears pale. His coughing, to
clear his airway, appears ineffective. Recent
chest X-ray shows diffuse bilateral interstitial
infiltrates in all lobes. Re- cent blood gases
demonstrate falling PaO2 (hypox- emia) and
increasing CO2 (Hypercapnia). Mr. Thoma- son
is anxious and is obviously worsened from the
shift before in overall condition.
, Swift River Medical Surgical Exam Latest Update With Complete
Answers
3. Calvin Umbyuma Mr. Umbyuma is a 42 y/o male Educational
who has been admitted for complaints of needs Health
shortness of breath with pleuritic chest change Pain
pain. He was diagnosed with HIV positive level
antibodies over a year ago. He has recently
been traveling back to his home country of
, Swift River Medical Surgical Exam Latest Update With Complete
Answers
Kenya to visit his sick mother. He received
traditional medical treatment at his village. His
temp is 100.9 F,
38.3 C, R 22, P92, BP 152/89 PaO2 91%.
Inflammatory markers - Erythrocyte
Sedimentation Rate (ESR) and
C-Reactive Protein (CRP) are elevated at 78.9
mm/h and
67.2 mg/L. He has been placed in a room at the Educationa
end of the hall. l Health
change
4. Cameron Daniels just turned 18 y/o. She is
being ad- mitted from the ER with a diagnosis
of pelvic inflam-
matory disease (PID). She has heavy vaginal discharge Pain
level with an unpleasant odor. She is complaining of
abdom- Fall risk inal pain and looks pale. She was seen
by OBGYN in the
ER and a culture was sent to the lab for
Chlamydia and Neisseria Gonorrhea. She was a
very difficult IV start and has a 23g saline lock
(SL) in her right hand. They have ordered a liter
bolus of LR, but it is running very slowly and the
IV is positional. VS BP 96/58, P 116, R 18, T 101.2
PaO2 98%.
5. Higher numbered acuities are at most
risk. Cameron Daniels, acuity 3, 6. Higher
room 304 numbered
acuities are
at most risk.
Arthur
Thomaston,
, Swift River Medical Surgical Exam Latest Update With Complete
Answers
acuity 3, room 302 Acute discomfort
Alteration in mobility
Knowledge deficit
Potential falls
Potential for infection
Nausea
Alteration in
comfort Alteration
in gas ex-
change
Inettectual airway
clear- ance
