SIM LAB ADMISSION
TICKET
Patient Name: Lou Thao
Visit #: 7
Scenario: Post op colon
resection
SLS: Medical Surgical GI # 24
Allergies: NKDA
Course Objectives (COs): By the end of the course, the student should be able to:
1. Identify competent nursing care for clients with chronic conditions, utilizing evidence-based
practice guidelines (SLO 1,2,5).
2. Differentiate care needs of the elderly adult experiencing alterations in health (SLO
2,3,5).
3. Acknowledge legal and ethical issues in healthcare (SLO 3).
4. Prioritize nursing care for patients with chronic alterations in health (SLO 1.2.4.5).
5. Develop an individualized teaching plan for the client with the goal of improving and
maintaining personal health (SLO 1,2,3,4).
6. Correctly calculate medication doses appropriate for the population (SLO 1,5).
THOROUGHLY ANSWER THE FOLLOWING COMPREHENSIVELY and submit by 0730 the
day before Simulation. Incomplete tickets will be returned for redo, and must be returned by the
following week’s simulation.
**ANSWERS MUST BE paraphrased AND CITE PROFESSIONAL source (Author, year, page).
Textbook and NANDA are preferred sources.
1. In your opinion, based on understanding (through research) Buddhism and health care,
how might Mr. Thao’s religion and culture affect health care decisions?
One way Mr. Thao’s religion and culture affects his decisions regarding his health is the way
her perceives pain. In Buddhism, they do not take anything for pain because they believe is a
normal part of life and they don’t want anything that would get in the way of how they feel
physically and mentally. Nurses need to understand this to know why maybe vials are
elevated due to pain and know why the patient may be refusing certain treatments.
2. In a fluid volume deficit, what is the overall effect on labs -- increase or decrease)?
Why?
For a patient with fluid volume deficit, everything would be within range except there
would be an increase in hemoglobin and hematocrit due to a lack of bodily fluids
(Harding et.al, 2020, p 275).
3. List 3 possible causes of fluid volume deficit in the post-operative colon resection patient.
One reason Mr. Thoa may be in a fluid volume deficit is due to his diet change. He is now
on an NPO diet and cant not have anything to eat or drink aside from a few ice cubes to
, SIM LAB ADMISSION
TICKET
keep his mouth moist. Another reason Mr. Thao may be lacking in fluids is due to
inactive bowels, this may indicate that water and nutrients are not being absorbed in the
body. Lastly, Mr. Thao has not been feeling well and has been vomiting having diarrhea,
and had an NG tub placed does not allowing fluids in his body. ( Harding et. al, 2020)
4. Paraphrase your understanding of the pathophysiology of third-spacing.
When fluid gets in places where fluid normally isn’t present is considered third spacing.
Fluid moves out of the blood and in between the cells ( Harding et. al, 2020)
5. Using evidence-based research, how long are absent bowel sounds expected throughout
in the post op GI patient? When do they return, in what order? How long is a low-grade
fever expected. When should the nurse become concerned?
A low grade fever is expected after the procedure due to the body trying to heal and fight off
inflammation from surgery( Harding et. al, 2020). Bowel sounds are expected to return
withing a few hours after surgery however it can take anywhere from 2-7 days. Ambulation
and slowing ,upgrading the patients diet after surgery can help bowel sounds return. (Harding
et. al, 2020)
6. Compare the symptoms of hemorrhage and third spacing following gastrointestinal
surgery. How are they alike and different?
7. Hemorrhaging and third spacing is different because third spacing referred to the fluid
moving to places where there is usually no fluid whereas hemorrhaging refers specifically
to blood being in places where there usually isn’t which can cause tachycardia and low
blood pressure ( Harding et. al, 2020).
Priority Problem Nursing R/T (Pathophysiology of AEB (of diagnosis) Refers
Diagnosis (NANDA diagnosis, cannot be medical to the problem/risk, NOT
approved) diagnosis) the R/T. This is assessment
data
Disturbed body image RT post op sigmoid colon AEB refusal to look at
resection stoma
Assessment Goal Nursing Rationale Outcome
Data (One goal that Interventions (Provide a Evaluation
(Include at least is patient (List three nursing reason why (How will you
three to five focused and and/or order driven each know when the
[total] SMART; interventions that intervention is goal has been
objective, Specific, relate to your goal) indicated and/or met? Provide
subjective, Measurable, therapeutic, and specific data
and/or Attainable, provide you will be
historical pieces Reasonable, and reference for assessing; what
of data that Time specific) each in APA will your
TICKET
Patient Name: Lou Thao
Visit #: 7
Scenario: Post op colon
resection
SLS: Medical Surgical GI # 24
Allergies: NKDA
Course Objectives (COs): By the end of the course, the student should be able to:
1. Identify competent nursing care for clients with chronic conditions, utilizing evidence-based
practice guidelines (SLO 1,2,5).
2. Differentiate care needs of the elderly adult experiencing alterations in health (SLO
2,3,5).
3. Acknowledge legal and ethical issues in healthcare (SLO 3).
4. Prioritize nursing care for patients with chronic alterations in health (SLO 1.2.4.5).
5. Develop an individualized teaching plan for the client with the goal of improving and
maintaining personal health (SLO 1,2,3,4).
6. Correctly calculate medication doses appropriate for the population (SLO 1,5).
THOROUGHLY ANSWER THE FOLLOWING COMPREHENSIVELY and submit by 0730 the
day before Simulation. Incomplete tickets will be returned for redo, and must be returned by the
following week’s simulation.
**ANSWERS MUST BE paraphrased AND CITE PROFESSIONAL source (Author, year, page).
Textbook and NANDA are preferred sources.
1. In your opinion, based on understanding (through research) Buddhism and health care,
how might Mr. Thao’s religion and culture affect health care decisions?
One way Mr. Thao’s religion and culture affects his decisions regarding his health is the way
her perceives pain. In Buddhism, they do not take anything for pain because they believe is a
normal part of life and they don’t want anything that would get in the way of how they feel
physically and mentally. Nurses need to understand this to know why maybe vials are
elevated due to pain and know why the patient may be refusing certain treatments.
2. In a fluid volume deficit, what is the overall effect on labs -- increase or decrease)?
Why?
For a patient with fluid volume deficit, everything would be within range except there
would be an increase in hemoglobin and hematocrit due to a lack of bodily fluids
(Harding et.al, 2020, p 275).
3. List 3 possible causes of fluid volume deficit in the post-operative colon resection patient.
One reason Mr. Thoa may be in a fluid volume deficit is due to his diet change. He is now
on an NPO diet and cant not have anything to eat or drink aside from a few ice cubes to
, SIM LAB ADMISSION
TICKET
keep his mouth moist. Another reason Mr. Thao may be lacking in fluids is due to
inactive bowels, this may indicate that water and nutrients are not being absorbed in the
body. Lastly, Mr. Thao has not been feeling well and has been vomiting having diarrhea,
and had an NG tub placed does not allowing fluids in his body. ( Harding et. al, 2020)
4. Paraphrase your understanding of the pathophysiology of third-spacing.
When fluid gets in places where fluid normally isn’t present is considered third spacing.
Fluid moves out of the blood and in between the cells ( Harding et. al, 2020)
5. Using evidence-based research, how long are absent bowel sounds expected throughout
in the post op GI patient? When do they return, in what order? How long is a low-grade
fever expected. When should the nurse become concerned?
A low grade fever is expected after the procedure due to the body trying to heal and fight off
inflammation from surgery( Harding et. al, 2020). Bowel sounds are expected to return
withing a few hours after surgery however it can take anywhere from 2-7 days. Ambulation
and slowing ,upgrading the patients diet after surgery can help bowel sounds return. (Harding
et. al, 2020)
6. Compare the symptoms of hemorrhage and third spacing following gastrointestinal
surgery. How are they alike and different?
7. Hemorrhaging and third spacing is different because third spacing referred to the fluid
moving to places where there is usually no fluid whereas hemorrhaging refers specifically
to blood being in places where there usually isn’t which can cause tachycardia and low
blood pressure ( Harding et. al, 2020).
Priority Problem Nursing R/T (Pathophysiology of AEB (of diagnosis) Refers
Diagnosis (NANDA diagnosis, cannot be medical to the problem/risk, NOT
approved) diagnosis) the R/T. This is assessment
data
Disturbed body image RT post op sigmoid colon AEB refusal to look at
resection stoma
Assessment Goal Nursing Rationale Outcome
Data (One goal that Interventions (Provide a Evaluation
(Include at least is patient (List three nursing reason why (How will you
three to five focused and and/or order driven each know when the
[total] SMART; interventions that intervention is goal has been
objective, Specific, relate to your goal) indicated and/or met? Provide
subjective, Measurable, therapeutic, and specific data
and/or Attainable, provide you will be
historical pieces Reasonable, and reference for assessing; what
of data that Time specific) each in APA will your
