*NURSING > CASE STUDY > ROGER CLINTON MED-SURG/Room 306 (ALL EVALUATIONS ANSWERED CORRECTLY) (All)

ROGER CLINTON MED-SURG/Room 306 (ALL EVALUATIONS ANSWERED CORRECTLY)

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Roger Clinton Room 306 Roger Clinton, 57-year-old male construction worker arrives at 0600 to be prepared for a partial thyroidectomy to determine if he has cancer. His past symptoms for three mo ... nths have been that he noticed a slight hoarseness in speaking, a slight dry cough not related to a cold, and upon examination had a “pea-size lump on the center of his neck”. His Endocrinologist had a radioiodine scan performed that showed a suspicious area. The plan is to obtain a biopsy from several areas of the thyroid gland, and hopefully to leave as much as possible in place. Roger knows that it will take three days after surgery to determine if he has cancer, but does not understand the implications resulting from a thyroidectomy. (Lifetime thyroid replacement medication.) You responded correctly to 4 out of 6 evaluations: Category Your response Educational Needs Increased acuity Patient does not understand implications of thyroidectomy Fall Risk Increased acuity No indication at this time Health Change Increased acuity Patient is experiencing a dry cough, and vocal changes Pain Level Increased acuity No indication of pain at this time. Psychological Needs Normal acuity No indication at this time Neurological Normal acuity No indication of increased neurological status at this time You correctly diagnosed 8 out of 8 options: Physiological Description Your Response Explanation Acute pain False No indication at this time Bleeding, risk for True Potential complication post operatively Chronic pain False No indication at this time Impaired comfort, risk for True Pre/post operatively due to dry cough and effects of surgical incision Impaired mobility, risk for True As a result of surgery/anesthesia Nausea, risk for True Potential complication of anesthesia Safety Description Your Response Explanation Deficient knowledge True Patient does not understand implications of thyroidectomy Infection, risk for True As a result of surgical incision Scenario 1 You correctly ordered 5 out of 5 actions: Your order Correct order Step 1 1 Wash hands and wear PPE as indicated Per CDC protocol 2 2 Explain to Roger that he needs to empty his bladder and ask him to put on a patient gown and remove all jewelry Patient will be receiving IV fluids in the OR, and to ensure OR standards are met to prevent infection 3 3 Obtain and verify operative consent and confirm NPO status since Mid-night OR consent is required prior to surgery. 8-hour NPO is necessary to prevent aspiration during anesthesia 4 4 Initiate IV Required for the induction of anesthesia 5 5 Orient patient on what to expect as he awaits anesthesia and the OR transport staff to take him to surgery To reassure patient and reduce anxiety Scenario 2 You correctly ordered 5 out of 5 actions: Your order Correct order Step 1 1 Orient Roger back to the floor To provide comfort and promote a therapeutic environment 2 2 Take his vital signs In order to establish a baseline 3 3 Observe and mark dressing for drainage or bleeding To identify new onset bleeding should it occur 4 4 Assess pain level and when last To anticipate the need and [Show More]

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