Patient Scenarios/Critical Thinking - page 3
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Sep 10, '11Quote from Hospice Nurse LPNGeez! I came back to see what he/she was thinking. What the heck, I'm got my own homework to do. Hey! Any of you interested in doing mine?
What are you studying? I am actually kind of bored tonight.
Sep 10, '11Quote from Nascar nurseI'm reviewing for a patho/pharm test on Monday. I've been working toward my BSN for several years pt time. I figure as long as I graduate before I collect social security I'm golden. Actually, I think bed sounds like a much better idea. Too bad we scared the kid off.What are you studying? I am actually kind of bored tonight.
Sep 10, '11To make a better informed decision I would want to know if he looks any good with his gown off. I'm kidding of course; what I really would need to know is if he's married ... no, no, still kidding. Does he think the IV pole is a stripper pole . I'm leaving now ... hopefully this will inspire you not to take everything so seriously. You could drop to your left knee and threaten to fall on your sword but no ones going to start it for you.
Come on ...
Sep 11, '11Quote from xtxrnWell at least they are letting you know what you are up for as an RN! The stress and difficulties of dealing with so many altered mental status patients!I smell homework......
Sep 11, '11Assuming I have not gone into the patient's room I would check the chart and see what has been done to the gentleman so far that day. I would look for problems other nurses have noted and whether there has been new information on the patient. Upon walking into the room I would assess the patient. "What is happening to this patient?" I would carefully observe the patient and see whether the patient was conscious. If so, I would try to figure out why he's taking off his gown. I would talk to the patient and see if he was hot or itchy, feeling uncomfortable or having any pain. I would also ask whether the treatment or medication was helping and if there was anything I could do to make him feel more comfortable then note whatever he tells me. Then, I would try to check all the equipment in the room like making sure the intravenous line is open and the correct solution is flowing at the correct rate. Next, I would make sure the patient's environment is clean and safe. Then I would take their vital signs and make sure the patient is comfortable. My solution after this would be ???? Record the patient's status and nursing care and lastly evaluate the care given.
Sep 11, '11Real world answer:
Leave the gown off of him b/c there's just not enough linene available to waste any more on him, and obviously he wants to be naked. Put the new IV in somewhere he's going to have a harder time accidentally pulling it out, and secure with as much paper tape as possible. Make sure the bed alarm is on before you leave the room.
Likely what your instructor wants to hear:
Is this behavior the pt's baseline? If not, check new meds, lab results, etc. Could be a UTI, could be constipation, could be Na level is out of whack, could be desatting, etc.
Address the environment...is he just hot?
If it is a change in mental status, call MD with the data you collected from assessing the pt...list out what orders you'd like to get.
We've got no problems helping students out, but you've got to meet us halfway...from now on let us know what you're thinking from the get go and I can almost guarantee you'll find someone willing to take the time to evaluate and make sure you're pointed in the right direction.