N211– Sherman “Red” Yoder –Small Bowel Obstruction Rated 100 % correct

N211– Sherman “Red” Yoder –Small Bowel Obstruction Student oaded_by Sherman “Red Yoder - Hospital Student Concepts: Client Name: Yoder, Sherman “Red” Care Coordination Clinical Judgement DOB: 06/26/19XX Age: 80 Coagulation Communication MRN: Gas Exchange Glucose Regulation Oxygenation & Homeostasis Tissue Integrity Learner Objectives: 1. Demonstrate focused post-operative assessments as appropriate. 2. Use the SBAR tool to communicate with other health care providers regarding Red’s assessment findings. 3. Discuss pertinent assessment findings and what was found that was specific to the older adult client. 4. Implement appropriate interventions based on assessments. Prebrief Time: 30 minutes Simulation Time: 45 minutes Debriefing Time: 30 minutes Student Pre-Simulation Work: 1. Complete the “Post- Operative” complications care plan 2. Drug Cards: Heparin, CoumadinN211– Sherman “Red” Yoder –Small Bowel Obstruction Student oaded_by Greenfield Medical Center Provider History & Physical Patient Name: Yoder, Sherman DOB: 06/26/19XX Age: 80 years MRN: CHIEF COMPLAINT: Abdominal Pain & Diabetic Foot Ulcer HISTORIAN: Client is a reliable historian; provided medical history HISTORY OF PRESENT ILLNESS: Sherman “Red” Yoder is an 80-year-old, who presented to the Greenfield Medical Center emergency department with worsening abdominal pain, loss of appetite, nausea/vomiting. The patient recently developed a diabetic ulcer, which was being treated by home care nurses. Upon arrival, The client’s pain was 8/10. Morphine was administered. Obstruction series showed dilated small bowel loops, but no free air. Small bowel obstruction was diagnosed. Patient made NPO and NG tube was placed to low intermittent wall suction. Surgical services was consulted for possible surgical intervention. Cardiology was consulted to manage the patient’s cardiac history and for cardiac clearance in case surgery is needed. IVF with potassium chloride started; an EKG was completed; and labs sent. PAST MEDICAL HISTORY: Atrial Fibrillation Coronary Artery Disease Diabetes Type II (Recently diagnosed) Hyperlipidemia Hypertension Right great toe ulcer Benign Prostatic Hypertrophy PAST SURGICAL HISTORY: L4-5 Laminectomy MEDICATIONS (indicates patient’s HOME Meds): Cardizem SR 240 mg, PO, QD Clindamycin 300 mg, PO, 4x/day Coumadin 5 mg, PO, QD Insulin Glargine 10 units, SQ, QHS Lisinopril 5mg, PO, QD Metformin 500 mg, PO, BID Zocor 20mg, PO, QD FAMILY HISTORY: Mr. Yoder stated both his parents had high blood pressure and his father died of a heart attack. SOCIAL HISTORY: “Red” lives at home alone in a 2-story farmhouse that has 3 stairs to enter, a first-floor full bath, and 2nd floor only bedrooms. He is retired. The patient’s son, John helps with farm crops and caring for a few farm animals. The patient assists with some household/farm tasks, such as collecting eggs, etc. Daughter-in-law, Judy, assists with the patient’s medical care. Client describes his home-life as sedentary and denies following any type of special diet. The client admits to being a social drinker but denies any illicit drug use.