Fictitious Elderly Patient with MRSA

Published

Handoff report at 11:00 PM:

"Mrs. J, 88 years old, was admitted this evening from a skilled nursing facility. The family says the patient was lethargic and confused during their visit. Her admitting vital signs were T 101° F, P 92 and irregular, R 28 and short and shallow, BP 110/70, pulse ox 94%. Her physician was called for admitting orders and was informed of the UA report from the skilled nursing facility. He will come in tomorrow morning to see her. She was given acetaminophen at 8:30 PM and her current temperature is 100.6° F; she is still slightly confused. She has an IV infusing. She is in a private room."

Mrs. J's flowcharts contain the following information:

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Nursing Care Kardex

VS q4h Diet: DAT

LBM: On admission

IV: 0.9% NS at 75 mL/hr

#24 angiocath RFA

Lab: CBC, chem. panel, UA

PRN Medication:

Acetaminophen 325 mg tabs ii q4h prn temp greater than 101° F

[/TD]

[TD]

Nurse's Notes from Skilled Nursing Facility

Documentation of latest nurse's notes:

1600 Turned, incontinent of urine, strong urine odor, incontinent pad applied............A. Cann LVN

1700 Family in to visit. Upset, called physician...............................................A. Cann LVN

1830 Transferred to hospital per order. Recent UA culture reports show + MRSA. Unable to contact physician to inform. Copy of report included with transfer. .....................T. Gage RN

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[/TR]

[/TABLE]

It is now 11:30 how would Iprioritize my plan of care of the next hour

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Is this your homework assignment?

One of the more important things that you can do is to learn what is priority.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

We are happy to hep with homework......but we need for you to tell us what you think first. Our goal is to help you be the best nurse you can be...and that starts with you telling us what you think.

Start the dialog and we will jump right in

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You should, by now, have a way to look up in your med/surg book the beginnings of the answers to this scenario. That should give you some idea of the "why" as well ad the "what," and that's the most important thing. So when you give us your ideas, say what your rationales are for them.

Why are we not giving you the answer to your question? Because you don't need to know that we know; your faculty needs to know that you know, or know how to start to find out. We're on their side on that one. :)

So.... what do you know?

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Specializes in ICU, Geriatrics, Float Pool.

Why do people think it's okay to post their homework on here and ask for answers? You're trying to become a nurse, taking the easy way out won't get you very far in your career.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Why do people think it's okay to post their homework on here and ask for answers? You're trying to become a nurse, taking the easy way out won't get you very far in your career.

They think this is ok because it is the nursing student assistance forum. Here we do help with homework, care plans, care maps, math or any other aspects of nursing school theories, pathophysiology, concept that students don't understand.....we do however make the student work for the correct answers, and tell us what they think first before we jump in, for that is what will help them learn to think like a nurse.

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Why do people think it's okay to post their homework on here and ask for answers? You're trying to become a nurse, taking the easy way out won't get you very far in your career.

I think it's also because a lot of people assume that going to the internet and pushing "send" is the same thing as "research," and it's not. We are often the first ones to disabuse them of this notion, but we do try to tell them what to do in its stead, something that they apparently never had the occasion to learn. We care enough to send the very best. :)

:flwrhrts:

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Specializes in retired LTC.

To OP - I really hope that the names you used for the responsible nurses in your scenario are fictitious. Otherwise, you may have violated some privacy issues - theirs and the pt who maybe can then be traced with some investigation.

Also, your screen name could be real and easy to further trace all parties. Be careful.

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Specializes in ICU, Geriatrics, Float Pool.

Yeah, assistance is one thing. Expecting other people to do the legwork is something else. Not that I see anyone doing that here, which is good. The fact that the OP has 1 post and it is asking for an answer is why I have my suspicions.

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As a pre nursing student this is so intriguing to me! I'm really curious as to what the answer is. I'm guessing you must give her something that helps get rid of the MRSA?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

This was a question about prioritizing care for the next hour of this patient....yes there are antibiotics that are given for MRSA infections.

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