Swift River ATI with Complete Solutions
Mr. Thomason appears better oriented and MD arrives unexpectedly to examine him.
Drag the following actions into the correct order. (The first item should be on top.) -
ANSWER-1Remind physician to wash his hands before examining the patient
2Explain to physician what interventions you have recently initiated
3Assist physician in physical exam of patient
4Obtain recent chest X-ray reports and recent ABG's for physician to review
5Reassure patient and help explain any new orders from physician to patient
Arthur Thomason 56-year-old MVA victim, fourth day post op with a splenectomy and
femur repair. He is experiencing new onset of shortness of breath and has a nasal
cannula with 2L of Oxygen in place. He is restless with slight confusion but is easily
orientated with attempts from nurse. Temperature spiked during 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. Recent blood gases demonstrate falling PaO2
(hypoxemia) and increasing CO2 (Hypercapnia). Mr. Thomason is anxious and is
obviously worsened from the shift before in overall condition. - ANSWER-Alteration in
comfort: True
Alteration in gas exchange: True
Ineffectual airway clearance: True
Potential for shock: True
Prolonged confusion: True
Anxiety/fear: True
Potential for failure to thrive: True
Arthur Thomason Scenario 4
Rapid Response team arrived including anesthesia. The MD on site makes the decision
to intubate the patient and start ventilatory assistance and move the patient to
Respiratory Intensive Care.
Drag the following actions into the correct order. (The first item should be on top.) -
ANSWER-1Provide verbal report to team members who respond to rapid response
2Emergency intubation and assisted breathing is provided for Mr. Thomason
3Assume role in response team of documenter
,4Obtain patient record and follow patient as he is transferred to ICU
5Provide information for MD to call family at home and explain what has just happened
Arthur Thomason Scenario 5
The family arrives one hour after the event to his prior room and find Mr. Thomason's
room is empty and have no idea of the events that have just occurred. You, his prior
nurse, notice the family and respond to them. - ANSWER-1You explain that his
condition has worsened and now he has been taken to ICU.SBAR communicates
Situation, Background, Assessment, Recommendation.
2You explain that he is receiving a higher level of care and was he was sedated before
leaving the floor to make him more comfortable.
3You have them remain with you, seated in comfortable place, while you call ICU and
attempt to locate physician for them.
4You escort them with you to the ICU.
5You call his doctor to inform him the family has arrived.
ARTHUR THOMASON SCENARIO1
You enter his room and recognize that Mr. Thomason appears to be talking to himself
and appears confused. - ANSWER-1AssessAssessment is the first step of nursing
process.
2Replace oxygen nasal cannula that had become disconnectedABC's are priority in
patient care
3Use therapeutic communicationActive listening allows patient to express herself and is
first step to understanding patient condition.
4Notify doctor and charge nurseCommunicate change in condition.
ARTHUR THOMASON SCENIOR 3
You enter room one hour after the physician has left the patient. Your notice Mr.
Thomason is lying supine, appears slightly cyanotic in his lips, is exhibiting more effort
to breathe, and is increasingly restless. Lung sounds are worse.
Drag the following actions into the correct order. (The first item should be on top.) -
ANSWER-1Tap patient and ask, "Are you okay?"
2Elevate head of bed
, 3Call Rapid Response team
4Start secondary large bore IV line
5Remain with patient and reassure
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. - ANSWER-Acute discomfort False
Alteration in body image False
Alteration in gas exchange True
Alteration in physical mobility True
Alteration in skin integrity False
.Bleeding False
Death anxiety True
Esteem False
.Ineffectual breathing pattern True
Knowledge deficit True
Sudden confusion False
Charlie Raymond Scenario 1
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 125/78,
Pulse 102, Respirations 30 and labored, Temperature 101.3, SaO2 91% . He has
bilateral lower lobe atelectasis with bronchial/vesicular wheezing. - ANSWER-1Don
appropriate PPE.Per CDC guidelines.
2Change to simple O2 face mask per Healthcare provider.
Mr. Thomason appears better oriented and MD arrives unexpectedly to examine him.
Drag the following actions into the correct order. (The first item should be on top.) -
ANSWER-1Remind physician to wash his hands before examining the patient
2Explain to physician what interventions you have recently initiated
3Assist physician in physical exam of patient
4Obtain recent chest X-ray reports and recent ABG's for physician to review
5Reassure patient and help explain any new orders from physician to patient
Arthur Thomason 56-year-old MVA victim, fourth day post op with a splenectomy and
femur repair. He is experiencing new onset of shortness of breath and has a nasal
cannula with 2L of Oxygen in place. He is restless with slight confusion but is easily
orientated with attempts from nurse. Temperature spiked during 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. Recent blood gases demonstrate falling PaO2
(hypoxemia) and increasing CO2 (Hypercapnia). Mr. Thomason is anxious and is
obviously worsened from the shift before in overall condition. - ANSWER-Alteration in
comfort: True
Alteration in gas exchange: True
Ineffectual airway clearance: True
Potential for shock: True
Prolonged confusion: True
Anxiety/fear: True
Potential for failure to thrive: True
Arthur Thomason Scenario 4
Rapid Response team arrived including anesthesia. The MD on site makes the decision
to intubate the patient and start ventilatory assistance and move the patient to
Respiratory Intensive Care.
Drag the following actions into the correct order. (The first item should be on top.) -
ANSWER-1Provide verbal report to team members who respond to rapid response
2Emergency intubation and assisted breathing is provided for Mr. Thomason
3Assume role in response team of documenter
,4Obtain patient record and follow patient as he is transferred to ICU
5Provide information for MD to call family at home and explain what has just happened
Arthur Thomason Scenario 5
The family arrives one hour after the event to his prior room and find Mr. Thomason's
room is empty and have no idea of the events that have just occurred. You, his prior
nurse, notice the family and respond to them. - ANSWER-1You explain that his
condition has worsened and now he has been taken to ICU.SBAR communicates
Situation, Background, Assessment, Recommendation.
2You explain that he is receiving a higher level of care and was he was sedated before
leaving the floor to make him more comfortable.
3You have them remain with you, seated in comfortable place, while you call ICU and
attempt to locate physician for them.
4You escort them with you to the ICU.
5You call his doctor to inform him the family has arrived.
ARTHUR THOMASON SCENARIO1
You enter his room and recognize that Mr. Thomason appears to be talking to himself
and appears confused. - ANSWER-1AssessAssessment is the first step of nursing
process.
2Replace oxygen nasal cannula that had become disconnectedABC's are priority in
patient care
3Use therapeutic communicationActive listening allows patient to express herself and is
first step to understanding patient condition.
4Notify doctor and charge nurseCommunicate change in condition.
ARTHUR THOMASON SCENIOR 3
You enter room one hour after the physician has left the patient. Your notice Mr.
Thomason is lying supine, appears slightly cyanotic in his lips, is exhibiting more effort
to breathe, and is increasingly restless. Lung sounds are worse.
Drag the following actions into the correct order. (The first item should be on top.) -
ANSWER-1Tap patient and ask, "Are you okay?"
2Elevate head of bed
, 3Call Rapid Response team
4Start secondary large bore IV line
5Remain with patient and reassure
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. - ANSWER-Acute discomfort False
Alteration in body image False
Alteration in gas exchange True
Alteration in physical mobility True
Alteration in skin integrity False
.Bleeding False
Death anxiety True
Esteem False
.Ineffectual breathing pattern True
Knowledge deficit True
Sudden confusion False
Charlie Raymond Scenario 1
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 125/78,
Pulse 102, Respirations 30 and labored, Temperature 101.3, SaO2 91% . He has
bilateral lower lobe atelectasis with bronchial/vesicular wheezing. - ANSWER-1Don
appropriate PPE.Per CDC guidelines.
2Change to simple O2 face mask per Healthcare provider.
