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Raihana Ding is a 65-year-old woman who has been admitted to your ward with cellulitis to her right leg, past history of stable angina

Raihana Ding is a 65-year-old woman who has been admitted to your ward with cellulitis to her right leg, past history of stable angina & asthma.  She has an IVT left forearm, 8/24 Normal Saline, daily Ceftriaxone 1gm.  The cellulitis has been marked.

Q1. What is cellulitis & why is it necessary for it to be marked?

Q2. You perform vital signs which are BP 92/61, HR 133, RR 22, Sao2 95%RA, Temp 40.7°C. What will your immediate actions be?

Q3. Why might she be displaying these values on her vital signs?

Q4. What are four (4) clinical manifestations you would expect to see regarding this type of shock?

Q5. Raihana needs IV medications & IV therapy to replace the fluid being lost through her skin.  A PICC line is inserted.

a.What is a PICC line?

b) Why is a PICC line the preferred option for Raihana?

c. You have been asked to change the PICC dressing but have not completed your employers PICC course.  The RN insists that you must perform the dressing because everyone else is too busy, what will you do?

Q6.

a.Insert the clinical signs & symptoms of Stable Angina and Unstable Angina below

b.Insert  7 clinical symptoms of Myocardial Infarction in the space provided below:

Stable Angina:

Onset:

Duration:

Pressure:

Related to:

Relieved by:

Unstable Angina:

Onset:

Duration:

Pressure:

Related to:

Relieved by:

  1. Give seven (7) clinical symptoms of Myocardial Infarction.

7-

Q7. Why are PQRST assessments performed?

Q8. During your assessment she becomes unresponsive, what are your actions as Nurse 1 at this time?

Q9. What are the roles of the following nurses during cardiac arrest?

Nurse 2

Nurse 3

Nurse 4

Q10. What equipment is available on the emergency trolley?

Q11. Who is responsible for checking that all equipment is available on the emergency trolley?

Case study 2 – scenario 

Balun is a 52-year-old indigenous man who suffers from Type 1 Diabetes Mellitus. He presented to hospital with severe flank pain, dysuria, glycosuria, ketonuria and haematuria.

Q1. 1Name, briefly describe and give one (1) example for each of the three classifications of Acute Kidney Injury (AKI) listed below.

  1. Prerenal
  2. Intrarenal

c)Postrenal

Q2. Name the classification of AKI Balun is most likely experiencing?

Q3. List six (6) clinical signs & symptoms that Balun may present with, associated with his acute renal failure.

Q4. Describe the nursing management for Balun relating to his acute kidney injury?

Q5. What is Short Term Haemofiltration?

Case study three (3) – scenario 

Stella is a 65-year-old woman who has been transferred to your ward following L) lower lobectomy two (2) days ago for Ca, she also suffers from asthma. She has had an uneventful post-op period although she states she has pain when coughing. She has an intercostal catheter insitu attached to an underwater seal drainage unit with minimal drainage.

Q1. Identify three (3) reasons why post-op pain management is so important?

Q2. Why does Stella have and intercostal catheter insitu?

Q3. Why is it important to keep the UWSD below chest level at all times?

Q4. What might you see in the UWSD if Stella is bleeding post-operatively?

Q5. Explain what you would do if this occurs?

Q6. Identify four (4) signs that indicate Stella may be experiencing respiratory distress?

Q7. Stella is ordered CPAP; how will this help a patient suffering respiratory distress?

Q8. What is the nursing care of ICC & UWSD?

Q9. Stella has developed an audible wheeze, what do you think is happening?

Q10. Explain the pathophysiology of asthma.

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