NUR 3330 ROGER CLINTON MED-SURG Room 306 (ALL EVALUATIONS ANSWERED CORRECTLY)
Roger Clinton Room 306
Roger Clinton, 57-year-old male construction
... [Show More] worker arrives at 0600 to be
prepared for a partial thyroidectomy to determine if he has cancer. His past
symptoms for three months have been that he noticed a slight hoarseness in
speaking, a slight dry cough not related to a cold, and upon examination had
a “pea-size lump on the center of his neck”. His Endocrinologist had a
radioiodine scan performed that showed a suspicious area. The plan is to
obtain a biopsy from several areas of the thyroid gland, and hopefully to
leave as much as possible in place. Roger knows that it will take three days
after surgery to determine if he has cancer, but does not understand the
implications resulting from a thyroidectomy. (Lifetime thyroid replacement
medication.)
You responded correctly to 4 out of 6 evaluations:
Category Your response
Educational Needs Increased acuity Patient does not understand implications of thyroidectomy
Fall Risk Increased acuity No indication at this time
Health Change Increased acuity Patient is experiencing a dry cough, and vocal Pain Level Increased acuity No indication of pain at this time.
Psychological Needs Normal acuity No indication at this time
Neurological Normal acuity No indication of increased neurological status You correctly diagnosed 8 out of 8 options:
Physiological
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Description Your Response Explanation
Acute pain False No indication at this time
Bleeding, risk for True Potential complication post operatively
Chronic pain False No indication at this time
Impaired comfort, risk for True Pre/post operatively due to dry cough Impaired mobility, risk for True As a result of surgery/anesthesia
Nausea, risk for True Potential complication of anesthesia
Safety
Description Your Response Explanation
Deficient knowledge True Patient does not understand implications Infection, risk for True As a result of surgical incision
Scenario 1
You correctly ordered 5 out of 5 actions:
Your
order
Correct
order Step
1 1 Wash hands and wear PPE as indicated Per CDC protocol
2 2 Explain to Roger that he needs to empty his bladder and ask
him to put on a patient gown and remove all jewelry
Patient will OR standards 3 3 Obtain and verify operative consent and confirm NPO status
since Mid-night
OR consent necessary 4 4 Initiate IV Required 5 5 Orient patient on what to expect as he awaits anesthesia
and the OR transport staff to take him to surgery
To reassure Scenario 2
You correctly ordered 5 out of 5 actions:
Your
order
Correct
order Step
1 1 Orient Roger back to the floor To provide comfort and promote 2 2 Take his vital signs In order to establish a baseline
3 3 Observe and mark dressing for drainage
or bleeding
To identify new onset bleeding 4 4 Assess pain level and when last To anticipate the need and This study source was downloaded by from CourseH on 09-02-2021 18:37:01 GMT -05:00
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Your
order
Correct
order Step
medicated
5 5 Fluid status and time since last voided Opioids may decrease the BP and risk for bleeding
Scenario 3
You correctly ordered 5 out of 5 actions:
Your
order
Correct
order Step
1 1 Head-to-toe assessment of patient Assessment is standard of Location of bleed 2 2 Reinforce dressing and document
amount/time of dressing pads applied
To control and assess blood 3 3 Notify Surgeon with a STAT call To determine emergent treatment 4 4 Notify Charge nurse of potential bleed
occurring
Charge nurse must notify to surgery
5 5 Instruct patient to remain in bed until HCP
arrives
To prevent further bleeding Scenario 4
You correctly ordered 5 out of 5 actions:
Your
order
Correct
order Step
1 1 Take vital signs Document current status
2 2 Keep Mr. Clinton NPO To prevent aspiration 3 3 Reinforce dressing and document amount/time of
dressing pads applied
Determines volume 4 4 Initiate secondary large bore IV site To prepare to infuse a result of potential 5 5 Witness signing of a new operative consent form
with Surgeon present
Scenario 5
You correctly ordered 1 out of 5 actions:
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