Urinary system | client centered | Rasmussen College System

 

You are an LPN working on a medical-surgical floor in a team that consists of an RN and a medical assistant. Read through some of the chart entries over a 48-hour period and answer the questions at the end. Please make sure you cite any sources using APA format. You will find when there is a major clue.

0130: Admission nurses note (RN): Client arrived via EMS from long-term-care for evaluation of “low blood sugar.” Pt. arrived confused (alert and oriented X 1) and is a known diabetic. Finger stick was 45. Orange juice and crackers, given repeat finger stick 104. Pt now alert and oriented X 4. Report from the charge nurse at the long-term-care facility indicates that the client has been having frequent bouts of hypoglycemia.

0530: (RN) Foley catheter inserted for incontinence–pt. “too weak” to get up to the bathroom and is experiencing bouts of incontinence.

600 mL clear yellow urine noted. The nurse indicates that the ER is “very busy” and “short-staffed.” 0545 (Admitting Physician) See history and physical. Pt. admitted to the medical-surgical service for evaluation of recurrent hypoglycemia.

View the ER chart before the pt. is transferred to the floor:

0730: (RN) Report is given to RN on 3 North.

Emergency Department Chart

Client: Mabel Simpson

DOB: 4/23/1941

Admission Date 8/16/2019

Medical Diagnosis: recurrent hypoglycemia

Allergies: None

Vitals/ Data Collection: Temp.- 97.3 PO

History: Diabetes (insulin dependent)  

Medications: Insulin R titrated to finger sticks

Allergies: None

Vitals/ Data Collection: Pulse- 68

History: Hypertension

Medications: Furosemide 20 MG twice per day

Allergies: None

Vitals/ Data Collection: Respirations- 18

History: Atrial Fibrillation

Medications: Warfarin 5 Mg Mon, Wed, Fri 2 Mg Tues, Thurs

Allergies: None

Vitals/ Data Collection: Blood Pressure- 122/86

History: Rheumatoid Arthritis   

Medications: Enalapril 5 Mg once per day

Allergies: None

Vitals/ Data Collection: No C/O pain

History: Mild Heart Failure (class 1)

Medications: Proventil inhaler as needed for wheezing

Allergies: None

Vitals/ Data Collection: Alert and oriented X 4

History: Former Smoker- smoked 1 pack per day X 40 years- last smoked 10 years ago

Medications: Methotrexate 2.5 Mg per day

Allergies: None

Vitals/ Data Collection: Lungs: No adventitious sounds

History: Appendectomy as a child

Medications: Tylenol 650 Mg as needed for pain or fever

Allergies: None

Vitals/ Data Collection: + Bowel sounds

History: Mobility (baseline): able to ambulate slowly with minimal assist

Clear yellow urine draining from Foley catheter in adequate amts.

Medications: 

Allergies: None

Vitals/ Data Collection: Clear yellow urine draining from Foley catheter in adequate amts.

History: 

Medications: 

Allergies: None

8/16/2019

10:00: (RN) Pt received on 3 North. Alert and oriented X 4. Fingerstick 81. Eating breakfast. Offering no complaints.

8/17/2019 (Medical Assistant)

0130: Sleeping Soundly

0700: (LPN) alert and oriented Finger stick 124. Offering no complaints. Medications given as ordered. Foley catheter draining cloudy yellow urine- RN notified.

1100: (Case Manager note): Pt. alert and oriented. Blood sugar stable. Will speak to the physician about discharge tomorrow morning.

1300: (Physical Therapy): Ambulated to the hallway 200 feet. Ambulates slowly- baseline as per long-term-care facility charge nurse. Recommend physical therapy after discharge, however, ambulated well enough for discharge.

1600: (LPN) Pt found to be confused (alert and oriented X 1). RN notified. Fingerstick 130. Vitals 97.5 (axillary), 110, 24, 98/64

1800: (Medical assistant) 400 cc’s emptied from catheter bag.

0100: (RN) Pt confused and combative. Attempting to pull out her IV and repeatedly removing her gown. Pt’s physician was paged- ordered Lorazepam 1 MG IM. Medicated as ordered and slept the remainder of the night with no incident.

0700: (RN) Pt awake and alert but combative. Finger stick-124. Vitals: 98.9 (axillary), 116, 28, 90/55

1730: (LPN) Unable to administer medication. Pt appears extremely confused. RN notified.

1200: (LPN) Pt’s daughter at bedside. Daughter indicates that her mother is not normally confused and is concerned that she may have had a stroke and notes that her mom feels “very warm.” RN notified. Foley catheter draining cloudy urine.

1230: (Medical Assistant) Vital signs: T 103.6 (rectal), P=130, BP=84/43, resp rate=28

1300: (RN) Rapid response called (because of the change in condition) and client transferred to the ICU.

Update: The client spent 3 days in the ICU but unfortunately did not recover.

Please answer the following questions:

  1. Why did this client become confused and combative? (5-10 sentences)
  2. What pivotal decision made in the ER directly caused this client’s worsening condition? (1-2 sentences)
  3. What type of incontinence did this client have? Explain your answer. (5-10 sentences)
  4. What factors in the client’s medical history contributed to the client’s change in condition? (5-10 sentences)
  5. How did communication (or lack thereof) contribute to the poor outcome for this client? (5-10 sentences)
Order a unique copy of this paper
(550 words)

Approximate price: $22

Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

Our customer is the center of what we do and thus we offer 100% original essays..
By ordering our essays, you are guaranteed the best quality through our qualified experts.All your information and everything that you do on our website is kept completely confidential.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism guarantee

The paper ordered is very original. Orders are checked by the most advanced anti-plagiarism software in the industry which ensures that the the essay written is 100% original. In that regard,we have a zero tolerance policy for plagiarism.

Read more

Free-revision policy

Our Company thrives on excellence and thus we help ensure the Customer’s total satisfaction with the completed Order.To do so, we provide a Free Revision policy as a courtesy service. To receive free revision the Company requires that the Customer provides the request within Fifteen (15) days from the first completion date and within a period of thirty (30) days for dissertations and research papers.

Read more

Privacy policy

The Company is committed to protect the privacy of the Customer and it will never resell or share any of Customer’s personal information, including credit card data, with any third party. All the online transactions are processed through the secure and reliable online payment systems.

Read more

Fair-cooperation guarantee

By placing an order with us, you agree to the service we provide. We will endeavor to do all that it takes to deliver a comprehensive paper as per your requirements. We also count on your cooperation to ensure that we deliver on this mandate.

Read more

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
$26
The price is based on these factors:
Academic level
Number of pages
Urgency