NURSING RN 101 Part I: Small Bowel Obstruction NextGen Unfolding Reasoning Mary O’Reilly, 55 years old Case Study
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Course
NURSING RN 101
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NURSING RN 101
Book
Clinical Reasoning
NURSING RN 101 Part I: Small Bowel Obstruction NextGen Unfolding Reasoning Mary O’Reilly, 55 years old
Mary O’Reilly is a 55-year-old woman with a prior history of partial colectomy w/colostomy and small bowel obstruction
three months ago that resolved with bowel rest and required no surgical...
part i small bowel obstruction nextgen unfolding reasoning
mary o’reilly is a 55 year old woman with a prior history of partial colectomy wcolostomy and small bowel obstr
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Part I: Small Bowel Obstruction
NextGen Unfolding Reasoning
.
Mary O’Reilly, 55 years old
Primary Concept
Elimination
Interrelated Concepts (In order of emphasis)
∙ Patient Education
∙ Clinical judgment
NCLEX Client Need Categories Covered in NCSBN Clinical Covered in
Case Study Judgment Model Case Study
Safe and Effective Care Environment Step 1: Recognize Cues ✔
∙ Management of Care ✔ Step 2: Analyze Cues ✔
∙ Safety and Infection Control Step 3: Prioritize Hypotheses ✔
Health Promotion and Maintenance ✔ Step 4: Generate Solutions ✔
What data from the history are RELEVANT and must be NOTICED as clinically significant by the
nurse? (NCSBN: Step 1 Recognize cues/NCLEX Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
- CT of her abdomen/pelvis revealed - High-grade bowel obstruction would be the admitting
high-grade small bowel obstruction. diagnosis and priority for plan of care for this patient.
- Abd. is firm, slightly distended, with - Abd. Assessment abnormal, should not be distended.
tympanic bowel sounds. - If there’s no change in input and decrease in output,
- Pt. reports decreased output in concerning.
colostomy - sign of infection.
- WBC: 14.7 - Signs of sepsis.
- Lactate: 2.8 - Higher risk of recurrent obstruction.
- History of bowel obstruction - Slightly elevated; monitor for trends.
- T: 99.8 - High; dehydration, risk for AKA
- Creatinine: 1.35 - Low end of normal; vomiting = at risk for hypokalemia
- Potassium: 3.7
After receiving report, you quickly review this patient’s past medical
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