- Directions Please Respond To The Questions After Reading The Clinical Case Scenario Below As A Nurse Working The Night 1 (217.06 KiB) Viewed 20 times
1. Prior to disconnecting the cake with ER nurse, is there any additional information you may need?
2.upon your assesment you recover that she has a wound on the bottom of her rt foot. she says "I had it for weeks now" what are the next steps I'm addressing this matter?
3.In anticipation of the nutrition consult, what type of diet would Ms Ruiz prescribed? what nutrients would be restricted?
Directions: Please respond to the questions after reading the clinical case scenario below. As a nurse working the night shift on an inpatient medical-surgical unit, you receive hand off communication from the ED nurse on a patient being admitted to your floor: Anita Ruiz is a 77-year-old Hispanic woman being admitted with a diagnosis of Chest Pain.She came to the ER early this moming c/o crushing chest pain that started in epigastric area radiating to left shoulder and arm. Her medical history includes HTN, CAD, Hyperlipidemia, Diabetes Type 2, and CKD stage 2; surgical history includes CABG with three grafts x 2 months ago, Cholecystectomy in 2015, and TAH in 2013. The following workup was completed: CXR, ECG, Echocardiogram, and lab work of cardiac enzymes series, CBC, Chem 7, and a Lipid panel. She is scheduled for a stress test in AM. She was downgraded from Telemetry to M/S when her third enzymes and the latest ECG came back normal. She is on 02 2L/min via NC. The meds she received in the ER include, Morphine 2 mg IVP x 2, Metoprolol 5 mg IVP followed by 50 mg pox 1, and Aspirin 81 mg po x 1. The latest vitals are, BP 134/76, HR 72, RR 17, T37.2 C, 02 Sat 98% and is pain free. A 21g IV with a saline lock was inserted to the left forearm. She is A+Ox3 and will be accompanied by her daughter. Physician orders include: NPO P MN for Stress Test, IV fluids Dextrose 5% +0.45%NS 1L @ 60ml/hr p MN, POC Glucose AC + HS with Hypoglycemia protocol, AM Lab work: CBC, Chem 7, PT/PTT, Cardiac enzymes x 1 with Troponin, Repeat ECG in AM, BRP as tolerated, Nutrition consult, Social Work consult, Cardiology consult. X Medications as ordered: Digoxin 0.25mg po daily, Simvastatin 20 mg po QHS, Furosemide 20 mg po 2x daily, Metoprolol Succinate 25 mg po daily, Sitagliptin 100mg po daily, Glyburide/Metformin HCL 5/500 po 2x a day AC, and NTG 1/150 gr SL x 3 q 5min PRN for chest pain Questions: Reflecting on the above case scenario, respond to the following questions.