mainegirl

I have been given three scenarios for patients and asked what order I would see them after arriving on a shift at 7pm. This assignment is just a discussion but I would like to be better informed. Any ideas would be very helpful. Here are the patients: a) 2 yr old w/ asthma who arrived earlier in the day in resp. distress, 10% dehydration, and fever. He's in high top crib- no parental supervision/ visitors. He's been getting q2h vaponephrine nebulizer treatment with some positive effect. b) 13 yr old Female w/ ruptured appendix who had lap appendectomy in morning. Presented to ER night before w/ abd pain, fever, nausea, vomiting. Fecolith found upon surgery. After PACU, returned to floor at 5pm groggy, in pain 8/10, Temp-39.7 po with firmly distended abdomen, no bowel sounds. Parents at bedside, concerned. c) 18 yr old Male in accident last night, killing his date. On suicide precautions, extensive chest and head injuries where he impacted steering wheel and windshield. Parents at bedside, afebrile, foley, no bowel sounds. Has multiple abrasions and contusions all over, complaining loudly of pain. I know this is a lot and still there are questions you might have regarding their conditions but this is all I have. I can make guesses based on looking in the books but experience really counts here. Appreciate anyone who has the time and hope it stimulates some thought!

I am a nursing student with a couple of questions...1) when might a new nurse approach the charge nurse for assistance ? 2) are there things that a night shift can do at the end of the shift to make the day shift's workload a bit easier? Thanks.