Southwestern Oklahoma State U

Introductory Scenario:

You are a nurse working the night shift on a medical
unit in a 200 bed community hospital. On a Saturday
morning at 4:00 A.M., the Emergency Department (ED)
nurse calls to notify you that you will be receiving a
patient who was brought to the ED at 2:30 A.M. by the
local ambulance service. The patient was found at a rest
area off of the interstate. At 4:10 A.M. the ED nurse and
an orderly arrive on the unit with the patient, Mr. Ed
Mason. He is intoxicated, is mumbling incoherently, and
is combative. You assist the ED nurse and orderly in
placing Mr. Mason in his bed. The ED nurse informs
you, “We’ve seen Mr. Mason in the ED before – he is an
alcoholic. We usually keep him a few hours and then
release him but, this time he is worse. He’s never been so
out of it before.” The nurse notifies you that his Blood
Alcohol Content (BAC) is 200mg% and that she forgot to
bring the patient’s chart, which includes the physician’s
orders, with them. She’ll send the chart up to the nursing
unit when they return to the ED.

Section I: Pathophysiology
Discuss the effects of chronic alcohol consumption
on physiological systems, particularly the Central
Nervous System.

Section II: Assessment
Mr. Mason has been placed in his bed. While awaiting
the chart with the physician’s medical orders you perform
a rapid baseline assessment. Which of the following
assessments should be performed by the nurse
AT THIS TIME? Select as many assessment options as desired.
Write a rationale for each assessment selected.

1. General physical assessment
2. Color of lips and nailbeds
3. Gag reflex
4. Skin color
5. Amount and color of of sputum
6. Medical history
7. Blood pressure and pulse
8. Bruises and scars
9. Medication history
10. Inspection of the abdomen

Section III: Intervention
Based on the previously assessed data, what would be the most appropriate INITIAL nursing intervention?

Choose only ONE intervention. Defend your choice of initial intervention.

1. Give magnesium sulfate injection as per standing
order protocol.
2. Place side rails up and bed in low position.
3. Order a meal tray from dietary as per the patient’s
request.
4. Encourage the patient to drink a minimum of 100
ml of fluid per hour.
5. Initiate deep breathing exercises q 1 – 2 h.
6. Write a nursing order to maintain this patient on
strict and accurate I and O.
7. Put mitts on Mr. Mason’s hands so that he will
not scratch his skin.
8. Perform an accurate baseline weight measurement.

Further Scenario
You obtain the patient’s chart on the unit. The following
brief medical history is on the chart: Mr. Mason is a 45
year old welder who has a history of heavy alcohol intake
and sporadic employment. His alcoholic binges appear
to coincide with the times he is unemployed. He has
been drinking since the age of 13 and his alcohol intake
has escalated over the past 30 years to the point that he
now consumes a fifth of whiskey every 2 days.

Section IV: Nursing Diagnosis
Based on the analysis of the data provided in the
previous section related to Mr. Mason, list THREE nursing
diagnoses, high risk diagnoses, or collaborative problems
in PRIORITY order. Give rationales for each of your
choices.

Section V:
What other information about this case would you
like to have that was not provided that would help in
making decisions regarding this patient’s care?

Southwestern Oklahoma State U

Pick one of the traits discussed in the following link. Do a little research and see if you can find more information. Do you think the information in the link is right. Present it in your own words in an original post. Then respond to two other students. All citations must be in APA format. Any source must be cited.

http://udel.edu/~mcdonald/mythintro.html

Give response to those two students.

Student one:

It is a typical misguided judgement that a specific prevailing quality that cause a window’s peak hairline. Like different attributes that impact hair development, different qualities cooperate to assist with deciding the state of our hairlines. A few specialists accept that hair designs are heritable, so a direct relation with a widow’s peak hairline might expand your shots at having this hairline, as well. Heredity markers in your DNA, alongside age and sex, impact the odds that you will have a widow’s peak hairline. Most young children have a smooth, level hairline. As they age into their teenager and adult years, their hairlines will in general, move higher up the brows. The presence or nonappearance of a widow’s peak hairline is simply one more illustration of our different highlights. Age-related retreating hairline examples can likewise look like a widow’s peak in all kinds of people. I believe this information is right as both links basically state that the widow’s peak is only a genetic feature and nothing that could be passed on in reality. I, personally, do not have widow’s peak but I am interested to know, do you? 23andMe. (n.d.). Widow’s peak hairline & genetics. 23andMe. https://www.23andme.com/topics/traits/widows-peak/.

Student two:

Like a lot of my fellow students, I was always taught that tongue rolling is genetic and that only so many people could perform the task. After doing research over the topic, it is obvious that nothing about tongue rolling is genetic; actually people can teach themselves how to do it. There was a study done on identical twins where both were asked to roll their tongues and only one twin could do it. This proves that tongue rolling is not genetic, because if it was, both twins would be able to do it. I always thought that I was special because I could do so, but now I know that is not the case!

Woods, C. (2015, August 5). Debunking the biggest genetic myth of the human tongue. PBS. https://www.pbs.org/newshour/science/genetic-myth-textbooks-get-wrong.

Southwestern Oklahoma State U

Case Study, Chapter 30, Home Health and Hospice Care

Gil W. is a 55-year-old hog farmer referred to the county health nursing service’s home health agency by the only surgeon in this rural county of 5,200 people. Gil fell several days before in his hog lot, and the deep cut on his left knee is infected. He did not seek medical care for the cut until today. Gil refuses to be hospitalized for treatment. He lives in a remote area of the county with his 55-year-old wife, Jane, a wheelchair-bound polio survivor, and Sam, his 80-year-old father-in-law, who has dementia. Gil and Jane have one son, who lives in another part of the state, several hours away.

Because the home health agency’s office is located next door to the medical clinic, the home health nurse’s initial contact with Gil is in the surgeon’s office. When the surgeon explains the situation to the nurse, the nurse tells the physician that she attempted a home visit on the family several months before at the request of a neighbor, a county commissioner, but Jane, while cordial, refused to let the nurse in the home. The surgeon tells Gil that since he refuses to be hospitalized, he will need the home health nurse to see him twice a day for at least a week, to clean and pack the wound. The number of visits may be reduced depending on how well the wound is healing and Gil’s ability to perform his own wound care. He will also have to elevate his leg and stay off of it as much as possible until it heals.

The home health nurse arranges to see Gil at 8 am and 6 pm, starting the next day, to provide the wound care and begin teaching him how to care for his wound. Gil provides her with insurance information, and the surgeon gives the medical orders for the home health service, so that prior approval for home health services can be obtained from the insurance company. The nurse also learns that Gil will ask his neighbor (the county commissioner) to help tend to his hogs and other farm work while he is recuperating (Learning objectives: 4 and 5).

  1. How can the nurse establish trust with the family, given that a previous attempt to provide assistance to the family was rejected?
  2. What would be priority assessments for the nurse to make on the initial home visit?
  3. How can the nurse teach Gil self-care for packing the wound and changing the dressing?
  4. The nurse will be changing dressings on an infected wound. What does the nurse need to consider for infection control

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Southwestern Oklahoma State U

Maternal Child Math #3

Round to the nearest tenth when appropriate. Show all work.
An infant weighs 3896 grams.
1. What is the infant’s weight in lbs. and oz.?
2. What is the infant’s weight in kilograms (kg)? (Hint: Convert partial pounds to ounces)
An infant weighs 1434 grams.
3. What is the infant’s weight in lbs. and oz.?
4. What is the infant’s weight in kilograms (kg)?
5. At the change of shift you notice 200 mL left to count in the I.V. bag. The I.V.is infusing
at 80 mL/hr. How much longer will the I.V. run? (Express your answer in hours and
minutes.)
6. The nurse has an order to give Regular insulin by continuous I.V. infusion at 20 units/hr.
The solution is 250 mL NS with 100 units of Regular insulin. What rate on the infusion
pump in mL/hr will deliver the correct dose?
7. The nurse has an order to administer heparin at 900 units/hr. The label on the I.V. bag
reads: Heparin 10,000 units in 500 mL D5W. What rate on the infusion pump in mL/hr
will deliver the correct dose?
The nurse is administering amoxicillin suspension in infant with otitis media weighing 12 lb. The
dose required is 40 mg/kg/day divided BID and the suspension comes in a concentration of 400
mg/5 mL.
8. How many milligrams will the infant receive in a 24-hour period?
9. How much medication in mL should the infant receive with each does?
10. The nurse is administering ceftriaxone to an infant weighing 10 kg. The prescribed dose
required is 100 mg/kg/day given IV once daily and the drug comes prediluted in a

concentration of 40 mg/mL. How much medication in mL should the infant receive with
each does?
11. The nurse is administering 40 grams of MgSO4 in 1000 mL N/S at 2.5 gram MgSO4 per
hour via pump. You would set the pump to run at how many mL/hour?

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