Swift River Med-Surg Questions and Answers 100% Verified

Carlos Mancia 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 - Educational Needs: Increased Fall Risk: Increased Health Change: Increased Pain Level: Normal Psychological Needs: Increased Sensorium: Normal PhysiologicalDysfunctional Gastrointestinal Motility: False Electrolyte Imbalance: False Fatigue: True Impaired Gas Exchange: True Impaired Mobility: False Ineffective Airway Clearance: True EsteemDecisional Conflict: False Noncompliance: True SafetyAnxiety: TrueDeficient Knowledge: True Fall, Risk for: True Fear: True Hypothermia: False Impaired Home Maintenance Management: False Self-ActualizationReadiness for Self-Care Enhancement: True Spiritual Distress: False Love and BelongingChronic 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 101.2Scenario 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. - 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 - Educational Needs: Increased Fall Risk: Increased Health Change: Increased Neurological: Increased Pain Level: Normal Psychological Needs: Normal PhysiologicalAcute Pain: True