What to do for this patient simulation????

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i have a simulation tomorrow where myself and another student nurse will have to take care of this patient and we have no clue on what we will have to do. Here is the patient information.

64 yrs old had left modified radial mastectomy

-allergic to ink

-Meds- lantus 10 units at night, humilin R sliding scale with meal and at night

- Dilaudid 2 mgs iv push q 3 hrs

-O2 2L nasal to keep O2 above 92%

-Vitals- HR 84, BP 142/84, RR 20, O2 98%, Temp 37.7C

-Clear breath sounds

-Hypoactive Bowels

-800 mL clear urinevoided overnight

-C/O pain in calf 10/10

-

Pt feels achy, refused to get out of bed since surgery 2 days ago

HELP!

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Specializes in Critical Care.

What do you have so far? Any of those findings concern you?

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Specializes in Oncology, radiology, ICU.

Have you looked up the causes for what is abnormal? That's where you should start then do a plan of care from that.

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Specializes in Emergency.

So I think they want you to do some critical thinking here... just to get you started: the pt has been in bed for days. post surgery. what should you be thinking here. no movement.... post surgery.... pain in calf.......

also pt is diabetic...

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Specializes in Med/Surg, Ortho, ASC.

Have you had any in-class preparation for this scenario? What does your textbook guide you to prepare for?

I would find it very odd if you have not had any preparation whatsoever for this scenario.

Just think: what would you do if Allnurses.com didn't exist? Then do that!

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Specializes in Med surg, LTC, Administration.

Simple, basic, read your chapter. Peace!

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ADPIE baby, ADPIE

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Specializes in Med/Surg.

There should be one major red flag standing out for you, mainly regarding the fact that she had, I'm assuming you mean a "radical" mastectomy and is complaining of pain in her leg. There is a reason we make our post-ops get up day of surgery and its not because we are mean and like to see our pts in pain. Does she have SCDs/TEDs on? Has she been getting Lovenox/Heparin for DVT prophylaxis? And FYI most of our radical masts go home the day following surgery, being in bed for 2 days is absolutely unacceptable. Also, as an aside, feeling achy she probably doesn't need 2mg iv dilaudid, maybe some motrin would allow her to be weaned off the oxygen and get out of bed.

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First, identify what are the greatest needs for the patient.

ex. pain, insulin, decrease bowel sounds etc

Then, in your med/surg text book read up on a care plan for pt with mastectomy.

this will allow you to further prioritize your nursing care plans

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
i have a simulation tomorrow where myself and another student nurse will have to take care of this patient and we have no clue on what we will have to do. Here is the patient information.

64 yrs old had left modified radial mastectomy

-allergic to ink

-Meds- lantus 10 units at night, humilin R sliding scale with meal and at night

- Dilaudid 2 mgs iv push q 3 hrs

-O2 2L nasal to keep O2 above 92%

-Vitals- HR 84, BP 142/84, RR 20, O2 98%, Temp 37.7C

-Clear breath sounds

-Hypoactive Bowels

-800 mL clear urinevoided overnight

-C/O pain in calf 10/10

-

Pt feels achy, refused to get out of bed since surgery 2 days ago

HELP![/quote

What does your care plan say? What does your care plan say for post op patients? What should be your prioritiy? What does a pain in the calf mean?

http://lmgtfy.com/?q=care+of+post+op+masectomy+patient

I think you need to sit down and develop a plan of care....take a deep breath and concentrate. There is a reason for care plans other than to be a pain in your bum!! That's to develop a plan to care for your patient......think ABC's and what is important after surgery whether the patient likes it or not....

I know shcool is over whelming at times......but there is a method behind your instructors madness...

Good Luck!

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Specializes in Med/Surg, Ortho, ASC.
There should be one major red flag standing out for you, mainly regarding the fact that she had, I'm assuming you mean a "radical" mastectomy and is complaining of pain in her leg. There is a reason we make our post-ops get up day of surgery and its not because we are mean and like to see our pts in pain. Does she have SCDs/TEDs on? Has she been getting Lovenox/Heparin for DVT prophylaxis? And FYI most of our radical masts go home the day following surgery, being in bed for 2 days is absolutely unacceptable. Also, as an aside, feeling achy she probably doesn't need 2mg iv dilaudid, maybe some motrin would allow her to be weaned off the oxygen and get out of bed.

Think of how educational it would have been for the OP and his/her partner to have figured this out for themselves. Critical thinking skills, etc., etc.

What a shame if we at allnurses.com contribute to the deprivation of a learning experience, just because we can.

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Just prepare for your simulation as much as you can

1. research your meds

2. research your surgery

3. possible complications

4. create a list of foci you think you may have before seeing the patient (revise your foci after meeting patient)

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