NUR 3330 ROGER CLINTON MED-SURG Room 306 (ALL EVALUATIONS ANSWERED CORRECTLY)

NUR 3330 ROGER CLINTON MED-SURG Room 306 (ALL EVALUATIONS ANSWERED CORRECTLY) Roger Clinton Room 306 Roger Clinton, 57-year-old male construction worker arrives at 0600 to be prepared for a partial thyroidectomy to determine if he has cancer. His past symptoms for three months have been that he noticed a slight hoarseness in speaking, a slight dry cough not related to a cold, and upon examination had a “pea-size lump on the center of his neck”. His Endocrinologist had a radioiodine scan performed that showed a suspicious area. The plan is to obtain a biopsy from several areas of the thyroid gland, and hopefully to leave as much as possible in place. Roger knows that it will take three days after surgery to determine if he has cancer, but does not understand the implications resulting from a thyroidectomy. (Lifetime thyroid replacement medication.) You responded correctly to 4 out of 6 evaluations: Category Your response Educational Needs Increased acuity Patient does not understand implications of thyroidectomy Fall Risk Increased acuity No indication at this time Health Change Increased acuity Patient is experiencing a dry cough, and vocal Pain Level Increased acuity No indication of pain at this time. Psychological Needs Normal acuity No indication at this time Neurological Normal acuity No indication of increased neurological status You correctly diagnosed 8 out of 8 options: Physiological This study source was downloaded by from CourseH on :37:01 GMT -05:00 This study resource was shared via CourseH Description Your Response Explanation Acute pain False No indication at this time Bleeding, risk for True Potential complication post operatively Chronic pain False No indication at this time Impaired comfort, risk for True Pre/post operatively due to dry cough Impaired mobility, risk for True As a result of surgery/anesthesia Nausea, risk for True Potential complication of anesthesia Safety Description Your Response Explanation Deficient knowledge True Patient does not understand implications Infection, risk for True As a result of surgical incision Scenario 1 You correctly ordered 5 out of 5 actions: Your order Correct order Step 1 1 Wash hands and wear PPE as indicated Per CDC protocol 2 2 Explain to Roger that he needs to empty his bladder and ask him to put on a patient gown and remove all jewelry Patient will OR standards 3 3 Obtain and verify operative consent and confirm NPO status since Mid-night OR consent necessary 4 4 Initiate IV Required 5 5 Orient patient on what to expect as he awaits anesthesia and the OR transport staff to take him to surgery To reassure Scenario 2 You correctly ordered 5 out of 5 actions: Your order Correct order Step 1 1 Orient Roger back to the floor To provide comfort and promote 2 2 Take his vital signs In order to establish a baseline 3 3 Observe and mark dressing for drainage or bleeding To identify new onset bleeding 4 4 Assess pain level and when last To anticipate the need and This study source was downloaded by from CourseH on :37:01 GMT -05:00 This study resource was shared via CourseH Your order Correct order Step medicated 5 5 Fluid status and time since last voided Opioids may decrease the BP and risk for bleeding Scenario 3 You correctly ordered 5 out of 5 actions: Your order Correct order Step 1 1 Head-to-toe assessment of patient Assessment is standard of Location of bleed 2 2 Reinforce dressing and document amount/time of dressing pads applied To control and assess blood 3 3 Notify Surgeon with a STAT call To determine emergent treatment 4 4 Notify Charge nurse of potential bleed occurring Charge nurse must notify to surgery 5 5 Instruct patient to remain in bed until HCP arrives To prevent further bleeding Scenario 4 You correctly ordered 5 out of 5 actions: Your order Correct order Step 1 1 Take vital signs Document current status 2 2 Keep Mr. Clinton NPO To prevent aspiration 3 3 Reinforce dressing and document amount/time of dressing pads applied Determines volume 4 4 Initiate secondary large bore IV site To prepare to infuse a result of potential 5 5 Witness signing of a new operative consent form with Surgeon present Scenario 5 You correctly ordered 1 out of 5 actions: This study sourc