Medical<\/p>\n
Fundamentals Case Study
\nReview the case study and complete the questions to increase your knowledge of Fundamentals content. Copy and paste the questions into a document to type your answers. Copy and paste the questions and answers back into messaging to your coach. You coach will provide you with feedback on your answers.
\nA 70-year-old female has been admitted to the hospital. The client has had nausea and vomiting for the past three days. Upon admission the client is slightly confused and weak. Her vital signs are: 99 F (37.2 C), respirations 20 breaths\/minute, pulse 102 beats\/minute, BP 96\/66 mm Hg, and her pain level is an \u201c8\u201don a scale of 0-10. Breath sounds are clear bilaterally upon auscultation. Pulse oximetry is 95% on room air. Bowel sounds are absent in the right and left lower quadrants and in the left upper quadrant. Abdomen is hard and distended. When questioned as to her last bowel movement, the client responds, \u201cI have not moved my bowels in over one week.\u201d Mucous membranes dry; skin turgor poor. The abdomen is hard and swollen. When asked when she had her last bowel movement, the client says, “I haven’t moved my bowels in over a week.” Mucous membranes are dry, and skin turgor is low.
\nThe health care provider (HCP) orders the following:
\nIV of Lactated Ringers (LR). Infuse 1 Liter of LR over 6 hours by infusion pump now. When completed infuse LR at 100 mL\/h
\nInsert indwelling urinary catheter to straight drainage
\nObtain urine analysis (UA) and urine culture and sensitivity (C& S)
\nInsert nasogastric (NG) tube to intermittent suction
\nDiet: NPO
\nVitals signs every 4 hours
\nLabs: CBC and electrolytes stat
\nMonitor I & O every shift
\nQuestions:
\nThe HCP ordered 1 Liter of LR to infuse over 6 hours. Calculate the flow rate you will program the infusion pump. _____________________mL\/h (round to the nearest whole number).
\nThe client states she has pain to her left forearm four (4) hours after the start of the infusion. Upon inspection and palpation of her forearm, the nurse notes redness and swelling at the IV site and the forearm is warm to touch. What is the initial action the nurse should take?
\nWhat are the recommended nursing interventions when an IV becomes infiltrated? What are the recommended nursing interventions when phlebitis is noted?
\nA urine culture C& S is ordered. How would the nurse obtain a urine C& S from a indwelling urinary catheter?
\nTo whom can the nurse delegate the task of taking the urine sample to the labatory? How should the specimen be transported?
\nAfter an X-ray has confirmed placement of the NG tube, how would the nurse check for placement prior to the administration of medication(s) and\/or feeding(s) through the NG tube?
\nThe nurse is checking placement of the NG tube, what would a gastric pH of 4 or lower indicate? What would a pH of 6 or higher indicate?
\nName two complications that can occur with an NG tube? List nursing actions to prevent these complications.
\nThe client asks the nurse if she could have a glass of water because she is extremely thirsty. What is the best response for the nurse to make?
\nThe client\u2019s lab results have returned. What findings (urine and serum) would indicate dehydration?
\nWhat would be a priority nursing diagnosis for this client? List one short-term goal. List three interventions for your priority nursing diagnosis.<\/p>\n","protected":false},"excerpt":{"rendered":"
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