Ms. P, 23 years old, had an emergency appendectomy yesterday. She has Down syndrome. She has gotten
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Ms. P, 23 years old, had an emergency appendectomy yesterday. She has Down syndrome. She has gotten up to the chair twice today. Surgical dressing is clean, dry, and intact. Bowel sounds are hypoactive. Her IV is infusing well; you have 200 mL left. Oral intake is 100 mL and output is 400 mL. I gave her morphine sulfate 8 mg IVP at noon for pain. Her noon vital signs are T 100° F, P 80, R 20, BP 110/78, pulse ox 98%.” Ms. P’s current flow charts contain the following information: Nursing Care Kardex VS: q4h Diet: Clear liquid Ambulate -c assistance IV: IL D5/0.9% NS @ 125 mL/hr LFA #22 g angiocath Routine Medications: Cefoxitin 1 g IVPB q8h 1000 – 1800 – 0200 PRN Medications: Morphine sulfate 8 mg IVP q4h prn pain Droperidol 1.25 mg IVP q4h prn N/V Diet: Clear fluid 7 – 3 shift Intake and Output Record Oral: 100 Void:8:00 AM 50 9:00 50 11:00 75 12:00 50 1:00 PM 75 2:00 100 IV: 900 IVPB: 50 . . Emesis: 12:00 PM 100 Total: 500 Total: 1050 Integrated Learning Activity: With a partner, use the clinical situation and the flowcharts to: 1. Identify the pertinent patient information made known to you in the report. 2. Identify the pertinent patient information made known to you in the flowcharts. 3. Review the data in columns 1 and 2 and identify information •It is 3:30 PM; prioritize your plan of care for the next hour: Time Plan of Nursing Care •8:00 PM: Ms. P’s mother and family are at the bedside. They tell you that Ms. P is increasingly restless and is pulling at her surgical dressing. You note the following entries in the nursing notes: Has voided a total of 100 mL since 4:00 PM. Emesis 100 mL greenish fluid at 6:00 PM, refused dinner. Morphine sulfate 8 mg and droperidol 1.25 mg given IVP at 6:00 PM. 1. Identify the nursing interventions that require immediate follow-up. 2. Identify a rationale for each nursing intervention that you plan to implement. Critical reflection: To provide patient-centered care, identify nursing intervention
SCIENCE
HEALTH SCIENCE
NURSING
NURS 235
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