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Swift River Med-Surg Questions and answers | Updated 2024/25
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Swift River Med-Surg Questions and answers | Updated 2024/25
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Swift River Med-Surg Questions andanswers | Updated 2024/25
Carlos Mancia ii
Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical
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Hx. r/o Tuberculosis. Vital signs -Temp 99.1, BP 124/62, P 77, RR 20, SaO2 91%.
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Airborne Isolation. Neuro WNL. Skin moist, respiratory bilateral wheezes and rhonchi.
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Blood-tinged mucous, productive cough. Diet as tolerated. IV maintenance fluids with D5
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1/4 NS @ 150 ml/hr X 3 then reduce rate to 75 ml/hr. Expresses fatigue, fear, concern, and
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desire for recovery. Need frequent reminder to stay in room and maintain mask
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precautions. If family/visitors come, will need education to airborne precautions. Spanish
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interpreter available at extension 61178. Dr. Rondeau - Educational Needs: Increased
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Fall Risk: Increased
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Health Change: Increased ii ii
Pain Level: Normal
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Psychological Needs: Increased ii ii
Sensorium: Normal ii
Physiological-
Dysfunctional Gastrointestinal Motility: False ii ii ii
Electrolyte Imbalance: False ii ii
Fatigue: True ii
Impaired Gas Exchange: True ii ii ii
Impaired Mobility: False ii ii
Ineffective Airway Clearance: True ii ii ii
Esteem-
Decisional Conflict: False ii ii
Noncompliance: True ii
Safety-
Anxiety: True ii
Deficient Knowledge: True ii ii
Fall, Risk for: True
ii ii ii
Fear: True ii
Hypothermia: False ii
Impaired Home Maintenance Management: False ii ii ii ii
Self-Actualization-
Readiness for Self-Care Enhancement: True ii ii ii ii
Spiritual Distress: False ii ii
Love and Belonging- ii ii
,Chronic Sorrow: False ii ii
Social Isolation, Risk for: True ii ii ii ii
ii Jody Rush ii
Jody Rush, 20 y/o female, admitted for right femur fracture status post skiing accident. She
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is in a traction splint, and will be going for surgical repair today. Vital signs are BP 120/62 P
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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
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mcg IVP, q2 hours Fentanyl for pain. She was nauseated after her last Fentanyl dose, and
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the Dr. Ordered an additional 4mg IVP, Zofran. She has a history of exercise induced
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asthma, and uses a rescue inhaler, Albuterol. Her parents are on their way; they are flying
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in today. She was on a ski trip with some of her friends from college; her best friend has
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been camped out with her. We were able to get her on a bed pan earlier, but it took a lot of
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work. We just received an order for a foley catheter. There was some concern that she may
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have sustained a head injury as she has an abrasion to her forehead, but she denies ever
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losing - Educational Needs: Increased
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Fall Risk: Increased ii ii
Health Change: Increased ii ii
Neurological: Increased ii
Pain Level: Normal ii ii
Psychological Needs: Normal ii ii
Physiological-
Acute Pain: True ii ii
Bleeding, Risk for: True ii ii ii
Impaired Mobility, Risk for: True ii ii ii ii
Nausea: True ii
Safety-
Deficient Knowledge: True ii ii
Grieving: False ii
Peripheral Neurovascular Dysfunction: False ii ii ii
ii Mary Barkley ii
Mary Barkley, 74y/o female has been admitted to your floor with a respiratory infection and
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she has tested positive for COVID19. She resides in an assisted living facility which has
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seen four deaths related to COVID19. She is exhibiting the same initial signs and
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symptoms as the other patients and her primary care provider would like to start
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aggressively treating her. She is running a low-grade fever 99.8 and has a sore scratchy
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throat which is causing an unproductive cough. She also is complaining of chills, muscle
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pain and headache. She is an at-risk patient because of her age. She also suffers from
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Lupus and is already taking Hydroxychloroquine, a first-line lupus therapy, but there is no
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conclusive evidence of its benefits for coronavirus yet. She is very fearful and is requesting
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to see her family. She states that she does not want to die alone. - Educational Needs:
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Increased
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, Fall Risk: Normal
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Health Change: Increased ii ii
Neurological: Normal ii
Pain Level: Increased ii ii
Psychological Needs: Increased ii ii
Physiological-
Acute Pain: True ii ii
Deficient Knowledge: True ii ii
Grieving: True ii
Impaired Comfort: True ii ii
Safety:
Infection: True ii
ii Wight Goodman ii
Wight Goodman, Patient was admitted to the floor last night from the ER for an orbital
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fracture. He was hit in the left eye by a softball yesterday. Apparently he was pitching, and
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the batter hit a line drive hitting him in the right side of the face. They applied some ice to his
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face, and he decided to go to the post game keg party instead of coming to the ER. The
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patient stated that there was significant swelling, but his vision was fine, and the pain was
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controlled with beer and 800mg of Motrin. He was unable to sleep later in the evening as
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the pain became worse, and his vision became more impaired. The Maxillofacial surgeon
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was consulted, and they will see him this morning. They were not concerned as his
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intraocular pressure was normal in the ER. There is significant edema and discoloration to
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the left side of his face, and his left eye is almost completely swollen shut. His visual acuity
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is dimin - Educational Needs: Increased
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Fall Risk: Increased
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Health Change: Increased ii ii
Neurological: Normal ii
Pain Level: Increased ii ii
Psychological Needs: Normal ii ii
Physiological-
Acute Pain: True ii ii
Bleeding, Risk for: True ii ii ii
Impaired Comfort: True ii ii
Safety-
Deficient Knowledge: True ii ii
Infection, Risk for: True ii ii ii
ii Jody Rush ii
Scenario 1 ii
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