#1 Nursing Community for Nurses: 313,314 Members

Log in   Sign up   Why join?   | Layout: Switch to narrow layout Color: gold style blue style rose style
Nursing Community for Nurses
Home Forums Articles Specialty Students Region Career Resources

Advanced Search Site Help Site Map

Patient Assessment - Deep trouble



Currently Online
Members: 528
Guests: 3,499
4,027

Job Spotlight
ER & L&D RN
Houston, Texas
Administrator
Lagos, Lagos, Nigeria
Forum Spotlight
Distance Learning for Nursing

Nursing Degrees

Nursing Articles

Misadventure in The Hospital of Infectious Diseases
The Case Of The Missing Dentures
Misadventure in the Psychiatric Disease Department
Misadventure in a Maternity Hospital
Misadventures in Nursing
Be Kind to Co-workers, Or Else
Fixodent or Forget it!
Me and Mr. Smith and Waffles
How quickly we forget.
It is my X-ray
Submit An Article

Nursing Jobs

Job Seeker: Employer:

Scrubs & Gear

Newsletter

Interested in the hottest topics of the week? Subscribe to the free allnurses.com Nurse-zine Newsletter.

Enter email address:


Read current:
Nursing Newsletter

How-To allnurses

allnurses videos

Welcome to allnurses: A Nursing Community for Nurses

The largest most active online nursing community. Join 313,314 nurses from around the world to learn, communicate, and network. For full allnurses.com access, register today - it's free! Problems during registration? Please don't hesitate to contact support.

Would you like to comment?
Join or Login if already a member.
 
Thread Tools Search this Thread
  #1  
Old Jun 08, 2003, 08:55 AM
gwenith's Avatar
Aussie Mod
Join Date: Jul 2002
Patient Assessment - Deep trouble

The aim of this "game" is to look at critical indicators in assessment.

Some of the patients in the following scenario are in "deep trouble" but some may not be. Can you identify the ones in trouble? If you can write what you think on a piece of paper.

If you feel happy to post about one of the patients please do so but don't let the cat out of the bag on all of them!!!

If you want to add another "deep trouble" patient scenario please do so - I do not have the corner on these!!!

Patient A)

A forty year old man with a 25 year history of heavy cigarette smoking compalining of central chest pain. Pain score 10/10. Colour - normal not pale. Sao2 98% on 4 Lpm O2. Monitor sinus rhythm with occasional PVCS - Bp 160/80. He is very restless, moving around the bed loudly complaining and demanding immediate attention and threatening to walk out. ECG is normal.

Patient B

8 year old child came in with Mother who is distraught and keep s telling everyone that "young Jimmy" was alright when she checked on him only an hour previously. Jimmy is sitting upright, with his head forward and jaw protruding. There is saliva dripping form his mouth and it is obvious he cannot swallow. He looks sick - florridly pink cheeks. Resps and sats normal but temp 38.5C. Tachycardic.

Patient C

Oversdose Vital signs within normal parameters. Monitor - sinus rhythm. Sao2 99% on 100% O2 GCS 6/14 eye opening to painful stimuli.verbal respons - nil and Motor response 3 - flexing. When you see the patient tehy are in a lateral position with a guedel airway in place (oropharyngeal airway)



I am getting tired so I might limit it to three patients for tonight but I will be back to post some more with the answers to these!

Top
  #2  
Old Jun 08, 2003, 05:40 PM
nowplayingEDRN's Avatar
Senior Member
Join Date: Apr 2003

More info on the child please.

Top
  #3  
Old Jun 08, 2003, 05:57 PM
Nurse Ratched's Avatar
Premium Member
Join Date: Jun 2002

Patient C sounds not in too horrible a distress - what did the pt OD on and how long ago?

Top
  #4  
Old Jun 08, 2003, 06:05 PM
Registered User
Join Date: Aug 2001

I would say patient B is in deep trouble and about to experience an occluded airway.

Top
  #5  
Old Jun 08, 2003, 06:32 PM
Registered User
Join Date: Oct 2001

I'm also looking at patient "B".

Top
  #6  
Old Jun 08, 2003, 06:32 PM
Registered User
Join Date: Mar 2002

Is the child experiencing epiglottis? With the sudden onset and protruding jaw and difficulty swallowing it sounds like it could be this to me

Top
  #7  
Old Jun 08, 2003, 06:42 PM
Registered User
Join Date: Sep 2002

B sounds like croup to me even though no cough was mentioned.

Top
  #8  
Old Jun 08, 2003, 06:46 PM
Registered User
Join Date: Jul 2002

Does the child have all his immunizations? Pertussis??? not sure but this is what it sounds like.
Patient c may be stable at the moment and I think that patient A needs a closer look too. Restlessness is always a sign of distress. maybe Unstable angina and some panic thrown in for good measure.



Gwenith, please don't wait too long to give the answers, OK. PM if ya have to.

Gator

Top
  #9  
Old Jun 08, 2003, 06:49 PM
Registered User
Join Date: Jul 2002

oops. I meant diptheria, not pertussis

Top
  #10  
Old Jun 08, 2003, 07:01 PM
Registered User
Join Date: Oct 2001

Patient "A" threatening to walk out but pain scale 10/10..

I'm still concerned with patient "B" and I had thought of epiglottitis. Still sticking with "B".

Top
Sponsored Links
 
Would you like to comment?
Join or Login if already a member.


Similar Threads
Thread Thread Starter Forum Replies Last Post
Assessment of the Critically Ill Patient RRTsoontobeRN General Nursing Discussion 2 Sep 25, 2007 11:40 PM


Currently Active Users Viewing: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search



New To Site?
Need Help?

All times are GMT -5. The time now is 08:11 PM.

Patient Assessment - Deep trouble

Copyright © 1996-2008, allnurses.com. All rights reserved.  allnurses.com, Inc. Advertising Information