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x is a 28-year-old male who presents to the Emergency Department with severe fatigue and dehydration secondary to a four-day history of vomiting. During the interview, he describes attending a family reunion and states that perhaps he "ate something bad." Upon admission his vital signs are a temperature of 102.7, pulse of 116, respirations 18, and blood pressure of 86/54. The nurse also notes the patient has dry mucous membranes and tenting of skin. The physician orders an IV to be started with 0.45% normal saline, and orders a serum electrolytes and an arterial blood gas. The following results are returned from the laboratory: Sodium (Na+) 150 Potassium (K+) 5.5 Chloride (Cl-) 110 BUN 42 Creatinine 0.8 Glucose 86 pH 7.32 PaCO2 35 HCO3- 20 PaO2 90 O2 Sat 98% 1. What is your interpretation of this arterial blood gas sample? 2. Explain the high potassium in this patient. 3. What are your priority nursing diagnoses for this patient? (Name 3) 4. Name three nursing interventions based on one of your nursing diagnoses. y- has undergone treatment for renal stones three times in the last year. Today he calls this primary healthcare provider with complaints of acute, excruciating, colicky, pain that radiates down the thigh toward the genitalia. The pain started last night, and has become progressively more severe. He also complains of the urge to void but has little urine output, and it is blood tinged. Due to the pain, he has not taken any fluids or food in 24 hours. Mr. Lyons has the following orders: Morphine sulfate 2 mg IVP every 2 hours as needed for severe pain Ibuprofen 600 mg every 6 hours Normal saline at 200 cc/hr 5. What are the rationales for the above orders? 6. Mr. Lyons' symptoms are most indicative of stones in what area of the renal system? 7. What potential complications can you see in Mr. Lyon's condition? 8. Describe nursing collaborative functions that may help determine the type of stone Mr. Lyons has. 9. Name 3 priority nursing interventions for Mr. Lyons. 10. Describe priority nursing interventions for the priority nursing diagnosis. The nurse working in the Cardiac Procedures area receives a patient who has undergone a cardiac catheterization via the right femoral artery for evaluation of unstable angina. Prior to the procedure, the patient was NPO for 12 hours, and received a sedative. An IV catheter was placed for administration of the contract agents and to have access in case of an emergency situation. 37.What is the rationale for assessing distal pulses immediately after the catheterization? 38. What other assessments should the nurse perform to check for arterial insufficiency? 39. The patient asks why he needs to stay in bed with the leg extended for 2 - 6 hours. How should the nurse respond? 40. After the procedure, why is it important to assess the patient's BUN and creatinine, and fluid volume status? 41. List the 3 common waveforms found on the ECG. Explain what each waveform of the ECG indicates in NSR. 42.Describe the relevance of the following abnormal waveforms a) P-waveform in atrial fibrillation. b) QRS waveform in ventricular fibrillation c) T waveform -that has been identified a "peaked" T wave d) U wave Alfred Jamison, age 74, is admitted to the neurology medical unit for a possible stroke. His daughter says he has been living independently and has no problems with memory or taking care of himself. She also says he has a "heart problem" and takes a blood thinner. He is very confused, has right-sided weakness, and fluent speech. 43.What are risk factors for stroke? Name at least 5. 44.What questions do you have for Alfred's daughter? List at least 6 priority questions. 45.What are the possible explanations for the change in mental status? 46.The stroke is determined to be hemorrhagic. Would thrombolytic therapy be an appropriate consideration? Why or Why not. Please be detailed in your explanation.

i have to write a care plan for one of my patients. this is my first time and i really don't know what to look for. i have to go to the medical record department of the hospital to look at their medical record history. i am not really sure what i am to look for. the things needed on my lists are: part i a. summary of impressions (2) b. client variables (overall depth and breath of information) 1. physical (complete and attached (1) 2. psychological (1) 3. sociocultural (1) 4. developmental (2) 5. spiritual c. client stressors (3) (multiple stressors i.d. and discussed) d. medications (3) complete info. (classification/rationale/nursing implications/effects on labs. includes references. e. diagnostic tests (3) complete info with references. i.d. reason that pt. lab results are abnormal by underlining cause. i.d. labs that should be ordered and states rationale. f. medical diagnosis/surgical procedures (3) must be referenced. includes pathophysiologic template. part ii focus sheets a. nursing diagnosis (5) appropriateness of diagnosis. all s&s and r/f somewhere in care plan. b. stg/oc (5) are oc measurable, specific, observable. c. interventions (5) treating the etiology each oc addressed. i.d. primary, secondary, tertiary interventions. d. rational (5) each intervention has a related rational and each rational is referenced. e. evaluation (5) part iii references (3) part iv overall quality of paper (2) spelling, punctuation, attention to detail, organization, apa format. i know this is alot but can you offer any advice? thanks soooo much!!

Hi Allnurses! I can't tell you how happy I am to join you. Beause I just started going to nursing school I have a lot of things I don't understand anyway I have questins and I need help. I was asked to submit an assignment on patient teaching plan.I am a student my self and don't know enough about nursing...I mean this is my first semester and our instructor is full of surprises.I don't know what to do so please Help me understand what a patient teaching plan (if there is any standard...) is and explain what the plan constitute ...or what issues I need to adress. Thank you

Chevyv Thank you Very much for your advise.Please post the Packet.that will be very helpful to me thank you again . Have agreat day Apolojo

daytonite !! yee thank you so much .the web sites,the report and critical thinking sheet are really helpfull.keep up the good work. thank you again. have a pleasant day!

Hi allnurses ! I am a student and Yesterday was my first clinical experience.My patient was diagnosed with CVA / or multi infract deventia as my instructor said ... what should be my patients care plan.just for your info though Her vital signs were: bp=171/82, rr= 64, temp=98.5, pain=0/10. age 81,and she was on 2000cc/day (??) fluid restriction.please help me figure out this:bowingpur . Thank you. apolojo Go nurses:yeah: