Ch 14

Mary, RN

(Charge Nurse)

Mary has been an RN for 7 years and has worked in several different units throughout the hospital.

John, RN

(New grad)

John has been a nurse for only one month.

Sarah, LPN

(LPN)

Sarah has been an LPN for the past 3 years and has not done her IV certification course.

Amy, CNA

(CNA)

Amy has been an assistant for the past 5 years.

Patient #1: A 47-year-old woman admitted from the recovery room at 2:15am after an emergency open cholecystectomy. Vital signs are stable; she is experiencing postoperative nausea and vomiting. She is receiving intravenous morphine on a PCA pump and antibiotics IV every 6 hours. She is also on a maintenance IV drip. The T-tube is draining a moderate amount.

Patient #2: A 20-year-old woman admitted two days ago with abdominal pain, fever and nausea. She had a endoscopic cholecystectomy last night and is due for her first bandage change this afternoon.

Mary, RN

John, RN

Sarah, LPN

Amy, CNA

Patient #3: A 76-year-old man in respiratory isolation to rule out tuberculosis. Third morning sputum for AFB is needed. Vitals are stable; and he is independent of his iADL’s but has some physical limitations that he is appreciative of help.

Patient #4: An 60-year-old man with congestive heart failure (CHF). This patient is a DNR. Family is present with the client. Respirations are shallow; blood pressure is beginning to decline at the end of the last shift.

Patient #5: A 60-year-old woman admitted 3 days ago with left lower lobe pneumonia. She is receiving intravenous antibiotics, oxygen at 3 Liters N/C. She spiked a fever to 39.5 C. overnight; acetaminophen was administered. She receives piggyback antibiotic every 6 hours.

Patient #6: An 82-year-old man admitted 10 days ago with a urinary tract infection. The infection resolved. He is now waiting for long-term care placement. He requires assistance with ADL’s and ambulates with assistance also.

Mary, RN

John, RN

Sarah, LPN

Amy, CNA

Patient #7: A 36-year-old woman scheduled for a bowel resection at 10:00am She is NPO and has an intravenous maintenance infusion running. Bowel preparation is complete and preoperative teaching is done. The consent needs to be signed and the operating room checklist must be completed. Her pre-medications must also be administered when called by the OR.

Patient #8: A 55-year-old man in the cardiac interventional lab having an angiography done. He will be prescribed bed rest on return and will have a sandbag on his groin to prevent bleeding while his heparin level is monitored during the day. His vital signs and groin site will be checked frequently when he returns.

Mary, RN

(Charge Nurse)

Mary has been an RN for 7 years and has worked in several different units throughout the hospital.

John, RN

(New grad)

John has been a nurse for only one month.

Sarah, LPN

(LPN)

Sarah has been an LPN for the past 3 years and has not done her IV certification course.

Amy, CNA

(CNA)

Amy has been an assistant for the past 5 years.

Patient #1: A 47-year-old woman admitted from the recovery room at 2:15am after an emergency open cholecystectomy. Vital signs are stable; she is experiencing postoperative nausea and vomiting. She is receiving intravenous morphine on a PCA pump and antibiotics IV every 6 hours. She is also on a maintenance IV drip. The T-tube is draining a moderate amount.

Patient #2: A 20-year-old woman admitted two days ago with abdominal pain, fever and nausea. She had a endoscopic cholecystectomy last night and is due for her first bandage change this afternoon.

Mary, RN

John, RN

Sarah, LPN

Amy, CNA

Patient #3: A 76-year-old man in respiratory isolation to rule out tuberculosis. Third morning sputum for AFB is needed. Vitals are stable; and he is independent of his iADL’s but has some physical limitations that he is appreciative of help.

Patient #4: An 60-year-old man with congestive heart failure (CHF). This patient is a DNR. Family is present with the client. Respirations are shallow; blood pressure is beginning to decline at the end of the last shift.

Patient #5: A 60-year-old woman admitted 3 days ago with left lower lobe pneumonia. She is receiving intravenous antibiotics, oxygen at 3 Liters N/C. She spiked a fever to 39.5 C. overnight; acetaminophen was administered. She receives piggyback antibiotic every 6 hours.

Patient #6: An 82-year-old man admitted 10 days ago with a urinary tract infection. The infection resolved. He is now waiting for long-term care placement. He requires assistance with ADL’s and ambulates with assistance also.

Mary, RN

John, RN

Sarah, LPN

Amy, CNA

Patient #7: A 36-year-old woman scheduled for a bowel resection at 10:00am She is NPO and has an intravenous maintenance infusion running. Bowel preparation is complete and preoperative teaching is done. The consent needs to be signed and the operating room checklist must be completed. Her pre-medications must also be administered when called by the OR.

Patient #8: A 55-year-old man in the cardiac interventional lab having an angiography done. He will be prescribed bed rest on return and will have a sandbag on his groin to prevent bleeding while his heparin level is monitored during the day. His vital signs and groin site will be checked frequently when he returns.