NURSING ASSESSMENT

CLINICAL-
You are caring for a male patient who suffered a fractured shaft of femur 5 days ago. He develops chest pain and shortness of breath. What would your immediate actions be? Explain your answer in detail including your assessment, hypotheses and rationales for actions.- (500 WORDS)

PRIORITIZATION –
After morning handover of your 4 patients you have reviewed the charts and have entered the room to greet your patients. It is 0730 and breakfast is usually delivered at 0740. Before you can introduce yourself, the following demands on your time occur concurrently:

Patient 1 – Mrs Peterson is asking for help to the ensuite to use her bowels. You know Mrs Peterson had a stroke 2 weeks ago and has a moderate left hemiplegia and needs assistance to move. She is classified as a high falls risk.
Registered Nurse An Nguyen in the adjacent bed unit enters the room and asks you to check some Endone for her patient.

Patient 2 – Mrs Walters requires a blood glucose assessment. You noted it was not done at 0600 when you reviewed the chart. She may require sliding scale insulin prior to eating.

Patient 3 – Mr Young is nil by mouth and has IV therapy running at 167mls per hour. The infusion pump alarm is sounding and the IV flask appears to be close to empty.

Patient 4 – Mr Stavropoulous has been admitted for acute asthma. He is due to have Ventolin and Seretide at 0800 but as you look at him you note he appears short of breath and he is sitting upright with increased work of breathing.
In what order would you address these requests? Describe your rationale for each decision. – (500 WORDS)

PROFESSIONAL-
You are working in the Day procedure unit. Your postoperative patient requires Morphine 2.5mg IV. The order prescribes 2.5 mg every 10 minutes up to a maximum of 3 doses. This is the first dose. Your colleague comes to the medication room and checks the drug from the schedule 8 storage cupboard with you. You prepare a syringe of 10mg of Morphine diluted to 10ml with Normal Saline according to the local protocol. You both check the order and drug and all is correct. Your colleague says she is happy for you to go and administer the drug alone. “Just remember only give 2.5 ml” she says and she leaves the medication room. How will you manage this situation? Describe in detail your response to your chosen scenario drawing upon your knowledge and research of professional regulations and requirements, professional behavior, conflict resolution techniques, education and provision of feedback.

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