Case study

[Magy peter]

Mrs. A. D., the 50-year-old school nurse who went to primary healthcare center, complaining of feeling dizzy and nauseated. The nurse immediately noted that she looks to be having some difficulty catching her breath during coughing. A new graduate nurse takes Mrs. A.D admitting vital signs as:pulse 122, RR 14, BP 88/50 mmHg, tympanic temperature 39 degrees Celsius, SpO2 92%. As the nurse enters Mrs. A.D.'s room she noticed that Mrs. A.D. turned on her right side, and her eyes are closed.  Mrs. A. D’s respirations appear labored and forceful. While the nurse is inside the patient’s room the electronic BP machine alarm is sounding. The nurse noticed that the electronic machine is flashing "72 systolic" with no diastolic reading. Mrs. A.D.

 

Answer the following questions:

1. List in order of priority your first three nursing interventions.

a.

b.

c.

2. Which vital signs should you reassess and which methods should you use? (5 points)

 

3. Which hourly vital signs should you delegate to a UAP?

 

 

I thought that my first intervention is to change her position and put ventilator 

then reducing her fever

 

and I will reassess her BP because it may have false reading

and I will let the UAP to check her temp and pulse and spo2

 

is my solve to this case study logical or not?

[JKL33]

Can you tell us what class/level this is for?

When you say ventilator I will assume you mean oxygen.

Provide more information about what you think is going on/what concerns you. List them out. What all is wrong here?

[Magy peter]

5 hours ago, JKL33 said:

Can you tell us what class/level this is for?

When you say ventilator I will assume you mean oxygen.

Provide more information about what you think is going on/what concerns you. List them out. What all is wrong here?

 Thank you for sharing your thoughts
This is Nursing skills / level 2 

I proveded more information in my notes about consciousness level ,and making bed in fowler’s position, using mercury sphyngomonamometer for accuracy and some other things
I think I got the right steps by doing these things

[JKL33]

Hi @Magy peter,

I don’t have time for a detailed post right now, and also it’s hard for us to know exactly what your instructor is looking for.  Maybe they just want you to take immediate steps to clarify this patient’s situation. (?) such as assess level of consciousness and obtain a manual blood pressure as you mentioned. 
 

Otherwise, briefly, your patient is not well at all. There is some evidence that they could been in an emergent situation and you need to take some immediate steps to clarify this and/or intervene. 
 

I will check back tonight or maybe others will chime in!