Kevin is a 28-year-old male who recently

Kevin is a 28-year-old male who recently underwent surgery for the diagnosis of small cell carcinoma of the left, lower lob. He had a left, lower lobectomy to remove the cancerous mass. Kevin’s medical history includes an allergy to pineapple and amoxicillin. Kevin is a self-employed, graphic designer. He is single and has no children. The recovery room nurse reports that the surgery was uncomplicated. Kevin’s condition is stable and he will be returning to your unit soon. He has IV infusing into his right forearm and a dressing over the left side of his chest which is connected to a chest tube. He is alert and comfortable at this time. Kevin’s post-operative orders include: Continue IV Ringer’s Lactate x 24 hours, then to Normal Saline; Diet: Clear fluids to DAT; Bedrest until no longer requiring chest tube; Morphine 10-20mg IV q4-h PRN; Gravol 25-50mg IV or IM q4-6h PRN; Cefazolin 1g IV q-8h x 4 doses. The porter has returned Kevin to his room at 10:00hrs. Please answer the following questions using point form. 1 (4 points) What priority assessment would you make at this time? (4 marks – 1 mark each) First, I will assess Kevin’s vital signs upon receiving him from recovery room. I will also make sure to assess Kevin’s level of consciousness. I will perform a head-to-toe assessment. I will check Kevin’s chest tube if it’s draining well and it should not be kinked or clamped. I will also document the amount of drainage. Kevin is risk for infection, I will monitor his chest tube and surgery wound for any signs of infection such as unexpected drainage color and foul-smelling drainage. 3 (3 points) It has been determined that Kevin has a tension pneumothorax. Define what that is and list four signs and symptoms (3 marks – 1mark for definition, 0.5 marks for each sign/symptom) Tension pneumothorax is a condition that happens when there is an air leakage outside of the lung into the plural cavity which causes the air to become trapped between the lung and pleura. Sign and symptoms: Shortness of breath Rapid breathing Chest pain Tachycardia —————————————————————————————————————- 6 (2 points) Kevin is experiencing pain in his chest and requests morphine (refer to the order provided). How many mL can you give (lowest and highest) based on the order and vial information provided here: Morphine Sulfate Injection, USP 5mg/mL Lowest dose: 10 mg/5mg x 1 mL = 2mL Highest dose: 20mg / 5 mg x 1 mL = 4mL ——————————————————————————————————————- Kevin’s vital signs are: BP 125/80, Pulse 105 BPM, RR 8 RPM, Temp 37.1C. Based on the findings staed and how the patient presents, what additional assessments would you make and why? (2 marks – 0.5 marks each for two assessments, 1 mark for rationale) I will check Kevin’s Oxygen Saturation. Rationale: Kevin’s O2 Sat is not checked, I need to checked it to monitor his oxygen level. Based on the vital sign provided (respiration), Kevin is having abnormal slow breathing rate which could lead him to get not enough amount of oxygen. Rationale: Administering oxygen is necessary for human life. It helps to increase the amount of oxygen in Kevin’s blood and to prevent further complications. ————————————————————————————————————– 8-hours post-op, Kevin has a CBC blood test. The results show his hemoglobin to be at 92g/L, which is abnormally low. Physician has been informed and has ordered one unit of packed red blood cells to be administered. The need for the blood has been explained to Kevin and he has provided consent for the procedure. You are now getting ready to administer the blood transfusion. a) What size IV catheter must used for this transfusion? b) The blood bank has sent O-positive blood for the transfusion. Kevin’s blood type is B-negative. Explain why this blood type can or cannot be used. SCIENCE HEALTH SCIENCE NURSING

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