Please help me answer the questions below. Thank you so much! Case Study #4 Romina Jackobs is a 45-year-old morbidly obe

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Please help me answer the questions below. Thank you somuch!
Case Study #4Romina Jackobs is a 45-year-old morbidly obese French woman whomoved to theUS one year ago for a job promotion. She lives alone with her twocats. She says thatshe has made a lot of friends in the apartment building that shelives in, and herneighbor has called her and let her know that she will take care ofher cats. Becauseshe has only been in her new position for a year, she is worriedthat she will get intotrouble if she has to miss too many days. As a regional publicrelations manager forDelta airlines, she has to travel a lot, she is worried she willmiss a lot of her reports.She presented in the ER this morning complaining about pain in herright calf. Onassessment her calf was red, edematous and hot to the touch. Therewas a palpablemass in the calf, so Romina was sent to ultra sound. Ultra soundrevealed that therewas an encapsulated mass in the calf, and pt was sent to CT scan.CT revealed thatthere was a large abscess in Romina's calf.The admitting doctor has put in orders for admission with adiagnosis of Abscess, aconsult for surgery, wound care nurse evaluation post surgery, homehealth careconsult on discharge, social worker consult, wound culture. Thedoctor has also ordered a transesophogeal Echocardiogram.Lab values were:WBC 17, 000RBC 4.5Hbg 13HCT 35Vital signs were:HR 115BP 165/98RR 24Temp 102.3O2 98Pain 8/10In the ER she was given morphine 2mg IV for pain that managed herpain well,however, she got very nauseous after the morphine. She is allergicto Zofran so the ER doctor ordered 12.5mg Phenergan fornausea.Romina has a medical history of :Chronic Heart Failure- Lasix 40mg qd in amHypertension- Metoprolol 25mg BIDDiabetes Type 2- Humalog sliding scale insulin qhs, acBS 100-200 4 unitsBS 200-250 6 unitsBS 251-300 8 unitsBS 301-350 10 unitsBS 351+ 12 unitsAsthma- ProAir rescue inhaler 2inh PRN q 2 hrsGERD Pepcid 20mg BIDChronic Anemia- Ferrous sulfate 1000mg/day qdThe doctor has ordered Vancomycin 1gm q8hrs IV, Zosyn 3.75gm q6hrIV and Ancef1gm 30min pre-surgery. Because her anxiety has caused her asthma tobecomerelentless, the doctor has also ordered solumedrol 40mg IV q8hr inan attempt to keepinflammation down systemically and relieve her asthma symptoms.Morphine 2mg IVq4hr for pain, Phenergan 12.5mg IV q 12hr for nausea.On entering Romina's room, there is a cane leaning against the wallacross the roomfrom Romina's bed and Romina appears frustrated. Romina reportsthat she has beenneeding to use the restroom, but can't get to her cane, so shecan't get up out of bedwithout it. Your assessment shows that she has fine crackles in herlower lungs andhas edema 2+ in BLE. Romina has her bed almost flat, and she iscomplaining ofdifficulty breathing. She states that her mattress is uncomfortableand she says she canfeel the metal frame through it, and it's hurting her tailbone andher legs, she says that she is having a hard time shifting andtrying to get comfortable, because every timeshe sits the bed up, she slides down. She said it feels like thereare rug burns on herback from the constant sliding up and down in the bed.Heart sounds are muffled and a pericardial rub is heard. Bowelsounds are present inall 4 quadrants. Pt reports last BM was this morning and was withinnormal limits. Nocomplaints of burning on urination.
1. ABNORMAL ASSESSMENT FINDINGS: RecognizeCues
Assessment: What are theidentified abnormal findings:
2. Analysis/Hypothesis: What is thecause of the patients problem that must be prioritized at thistime?
3. Planning (Patientgoals focus on resolving the problem), Mustbe SMART goals GenerateSolutions
Develops a list of actions to address the priorityhypothesis. The student nurse then selects the appropriate actionfrom the list and carries out the action.