Swift River Med Surg Clinical Questions
& Answers(GRADED A)
Estelle Hatcher, 31yr-old, r/o appendicitis, 1st day post-op appendectomy; No known
allergies (NKA); Vital signs - Temp 101.2, BP 108/74, P 92, RR 20, SaO2 99%, alert
and cooperative. Wound site clean, dry and intact NPO, NG-tube to low continuous
suction. IV maintenance fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in left forearm.
Ambulates with minimal assistance. Family at beside. Dr. Sangerstien - ANSWER
Educational Needs Increased
Fall Risk Increased
Health Change Increased
Pain Level Increased
Psychological Needs Normal
Sensorium Normal
Ann Rails, 38 years old, c/o back pain, non-significant past medical history. No known
allergies (NKA). Vital signs -BP 124/82, Temp 98.2, P 84, RR 22, SaO2 96%. Pain and
numbness in legs for one week. Abnormal left leg weakness, gait unsteady, 5/10 on
numeric pain scale. Neuro WNL, except leg pain upon movement. Activity as tolerated
with assistance. D/C plan- decrease pain and restore normal gait. Regular diet. Dr.
Suculo - ANSWER Educational Needs Increased
Fall Risk Increased
Health Change Increased
Pain Level Increased
Psychological Needs Normal
Sensorium Normal
Virginia Smith, 57-year-old who has elected to have a total mastectomy based on
consultation with her surgeon, a total mastectomy removes all breast tissue but leaves
all or most of axillary lymph nodes and chest muscles intact. She is also to receive
radiation, chemotherapy, and hormone therapy post operatively. She is with her
physician. She is also investigating bone marrow transplantation. She has arrived in
pre-op and about to have surgery this morning. Her husband and two grown children
are also with her as she is prepared with gown and head cap awaiting transport to the
operating room. She has IV access and has received a small dose of Valium to reduce
apprehension. Temperature is 98.3, HR is 87, RR is16, BP is 121/74, PaO2 is 98%. -
ANSWER Educational Needs Increased
Health Change Increased
LOC Normal
Pain Level Normal
Psychological Needs Normal
Safety Increased
, Lithia Monson, 93 years old, c/o head injury, r/o subdural hematoma. Hx of dementia,
from nursing home, fall one day ago. No known allergies (NKA). Vital signs -Temp 97.2,
BP 96/74, P 82, RR 20, SaO2 97%. Neuro- confusion to time and place, but oriented to
self, speech clear, poor historian, did not recognize son today which is new for her;
Neuro assessment and vital signs q1 hr. Skin warm dry, bruises on forehead with small
laceration. Increased fall risk. DSD (dry sterile dressing), forehead laceration clean and
Virginia Smith
57-year-old who has elected to have a total mastectomy based on consultation with her
surgeon, a total mastectomy removes all breast tissue but leaves all or most of axillary
lymph nodes and chest muscles intact. She is also to receive radiation, chemotherapy,
and hormone therapy post operatively. She is with her physician. She is also
investigating bone marrow transplantation. She has arrived in pre-op and about to have
surgery this morning. Her husband and two grown children are also with her as she is
prepared with gown and head cap awaiting transport to the operating room. She has IV
access and has received a small dose of Valium to reduce apprehension. Temperature
is 98.3, HR is 87, RR is16, BP is 121/74, PaO2 is 98%. - ANSWER Pain, Acute
Physical Mobility, Impaired
Skin integrity, impaired
Knowledge Deficit
Disturbed Body Image
Estelle Hatcher
31yr-old, r/o appendicitis, 1st day post-op appendectomy; No known allergies (NKA);
Vital signs - Temp 101.2, BP 108/74, P 92, RR 20, SaO2 99%, alert and cooperative.
Wound site clean, dry and intact NPO, NG-tube to low continuous suction. IV
maintenance fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in left forearm. Ambulates
with minimal assistance. Family at beside. Dr. Sangerstien - ANSWER Acute Pain
Electrolyte Imbalance, Risk for
Impaired Comfort
Deficient Knowledge
Fall, Risk for
Infection, Risk for
Linda Pittmon
a 74 -year old female patient who is a noncompliant diabetic, and frequently stays at the
local homeless shelter. She has been admitted to the floor with complaints of numbness
in her right foot and ankle. Mrs. Pittmon states she has had numbness for years but
"now I can't feel it at all, and my toes don't look the right color.". - ANSWER Disturbed
body image
Ineffective health maintenance
Risk for malnutrition
Impaired tissue integrity
Risk for physical injury
Self-care deficit
