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Marg a 73-year-old lady was admitted to hospital overnight and placed into your care. She had a fall at home and was transferred by ambulance to hospital. You have just come on to the morning shift and received handover. Marg’s observatories have been within normal limits since being transferred to the unit- BP110/60, HR 78, O2 Sats: 98% and Resp: 18. Marg settled quickly and fell asleep at about 2400hrs. You would like to assist Marg to the shower but you are unsure about how safe she is on her feet and you realise that she has not had a falls risk screening/assessment completed.
Other Documentation:
Other medical history is:
Hypertension
Arthritis
Osteoporosis
Medications:
Atenolol 100 mg daily
Paracetamol 1gm QID
Question what are the three intervention and rationales to Marg situation?
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Solved in 2 steps
- A 75-year-old woman is admitted to your unit for evaluation after being found in herapartment unconscious on the floor. She is now awake but moving slowly. Her vital signs arewithin normal limits. 1. In the hospital, it is unrealistic to expect to be able to spend an uninterrupted 30 to 60 minuteswith a single client performing an admission assessment. Which three system would have toppriority for her initial assessment? Discuss why. 2. While gathering relevant history data, what should you do if the client answers with simpleone-word answer or gestures? 3. Because the client may be in significant discomfort from her fall, it is not easy for her to moveabout for the examination. How might you organize your assessment to minimize here need tochange positions frequently? 4. If the client is unable to provide a detailed recent history, what other sources of these datacould you consider?A 45-year-old woman is brought to the emergency department 45 minutes after her husband found her unconscious on the floor. She is unresponsive to painful stimuli. Her temperature is 37°C (98.6'F), pulse is 115/min, respirations are 6/min and shallow, and blood pressure is 110/60 mm Hg. Physical examination shows no other abnormalities. Arterial blood gas analysis on room air shows: pH : 7.08 Pco2: 80mmHg Po2: 45 mm Hg Which of the following is the most likely cause of this patient's hypoxemia? A) Decreased alveolar ventilation B) Decreased dead space ventilation C) Increased diffusion defect D) Increased shunt E) Increased ventilation-perfusion mismatchPressure Injuries Mr.Jones an 84 yr.old man, was admitted to the nursing homework you work as a PT Aide He has the early stages of Alzheimer's disease and suffers from diabetes. Mr.Jones wears protective briefs at night, but not during the day. He has occasional bowel and bladder accidents. He recently started falling when he walks and has started physical therapy treatment. The PT supervisor ask you to transport Mr.Jones back and forth to therapy. The facility's rules require him to ride in a wheelchair. A nurse aide will help you transfer him between the wheelchair and bed. Questions 1. What risk factors does Mr.Jones have for developing Pressure injuries (name at least four)? 2.What situations should you immediately report to the nursing staff on your PT supervisor ( name at least three)?
- Mrs Alensi returned to the ward 1 hour ago following a Left sided total knee replacement. She has a morphine infusion running at 1mg/hour for pain relief. 30 minutes ago, her BP was 115/75 and her respirations were 16. You have just checked again and now her BP is 85/55 and her respirations are 10. Describe what actions you would take and medications you anticipate administering and provide rationale.A nurse on a medical-surgical unit is caring for a client who is postoperative following an emergency appendectomy. Exhibit 1 Vital Signs Temperature 37.7° C(99.8°F) . Heart rate 82/min . Respiratory rate 16/min . Blood pressure 127/80 mm Hg . Oxygen saturation 99% on room air Exhibit 2 Assessment Height 157.5 cm (62 in) Weight 90 kg(198 lb) Bilateral lower extremities warm to touch, pedal pulses 2+ bilaterally. Spider veins noted on bilateral lower extremities. Distended veins noted on right lower extremity. Exhibit 3 Nurses' Notes Client reports pain at abdominal incision site as 4 on a 0 to 10 scale. Client also reports right lower extremity pain as 5 on a 0 to 10 scale, and itching. Reports that right lower extremity pain has been intermittent for about the last 2 months. Denies current left lower extremity pain.Measuring Height, Weight, and Vital Signs The nurse asks you to obtain a complete set of vital signs for an adult client to whom you are assigned. The measurements are as follows: temperature 38.6°C (101.5°F), heart rate 104 beats/min, respiratory rate 22 breaths/min, and blood pressure 90/60 mm Hg. Which of these vital signs are of concern? What is your first action after collecting these vital signs?
- Please answer fast A 26-year-old male was returning from a neighborhood store with a six-pack of beer. He attempted to run across a busy street but was struck by a car. He was fully conscious at the scene, complaining of pain in his abdomen and left leg. Examination by paramedics revealed an open fracture of the left tibia with moderate bleeding, left upper quadrant pain with rebound tenderness, and a fast, weak pulse. The leg was immobilized, oxygen was administered, an IV started, and he was transported to the Trauma Center, approximately 10 minutes away. About 3 minutes before arriving at the Trauma Center, he suffered cardiopulmonary arrest from which he could not be resuscitated, despite vigorous advanced life support. At autopsy, his stomach was found to be full of beer, along with 4 whole wieners (without any teeth marks!). His spleen, which is normally about the size of the patient’s fist, was grossly enlarged: it measured from just under the diaphragm to the level of the…Ben, 59 is an employee who works in a post office. He is 5ft. Tall and weighs 150 pounds. His vital signs are the following : T 36.3°C; HR 94;BP 135/85; pain level 0. At the clinic, he presents himself with a major complaint of "just not feeling well" How would you assess Ben for hypertensive risks?Mrs. Lee is a 70 yr old female admitted for dizzy spells. Her family states she has become a fall risk and are afraid she will fall and hurt herself.Your initial assessment shows an elderly female who looks younger than her stated age. She is alert and oriented, though distracted and complains of a headache. Her blood pressure is 170/98 pulse is 89 and her oxygen saturation is 97% on room air.You leave to get her a glass of water and when you return, you notice she is slurring her words slightly and face appears to be drooping on the right side. What is the most important thing impacting outcome of acute stroke?What are the 5 sudden signs of a stroke?What are some other differential diagnoses that stroke can mimic?
- SITUATION Zoran Solano, a 20-year-old man was brought into theEmergency Department (ED) after an accident whilst ridingon an electric scooter. He was stabilised and transferred tothe Orthopaedic Ward for surgery in the morning.BACKGROUND Zoran Solano was out partying with his friends, celebrating abirthday in the Valley. According to his cousin, Eyad, Zoranstarted drinking at 5pm that day and by the time they leftthe club around 2am, Zoran was very intoxicated. As theywere walking out of the club, Zoran decided to jump on anelectric scooter that was parked outside the club. Eyadstarted running after Zoran, and he saw Zoran weaving inand out of cars on the road at a high speed. Eyad saw Zoranbarely manage to avoid fully hitting the concrete column of abuilding but he jumped off the electric scooter and landed inan awkward position.ASSESSMENT GCS: 15/15, both pupils: 3 equal and reactive to light,moving both upper limbs and right leg in normal strength,left leg no movement (due to severe…A 47-year-old male driver was injured in a moderate speed lateral impact to the driver’s side of the auto. Upon examination: LOC – alert but confused and anxious Airway – patent Breathing – adequate with good chest rise SpO2 – 96% on ambient air Circulation – pulse deficit (left arm); skin – pale, cool, diaphoretic; no external bleeding noted Signs of injury found during secondary assessment: bruising over sternum, complaint of chest pain, increased chest pain upon palpation, breath sound equal bilaterally. Vital signs: unable to obtain vital signs on the left side; right side – BP – 90/60; pulse – 130, weak and regular; and respirations – 24, strong and regular Treatment? Rapid transport to level 1 trauma center. Reassessment performed every 5 minutes.A nurse is caring for a client who presented to the emergency department with an acute asthma exacerbation. The respiratory rate is 36 breaths/min, and a pulse oximeter is 85% on room air with accessory muscle use to breathe. The nurse placed the client on oxygen 4 liters nasal cannula. The arterial blood gas (ABG) is as follows: pH: 7.28, PaCO2: 50 mm Hg, PaO2: 75 mm Hg, and HCO3: 26 mEq/L. Which of the following treatments is the nurse's highest priority? A) Administer bronchodilators B) Administer sodium bicarbonate Administer methylprednisolone (D) Perform a chest x-ray