Nurse

Case study: Seizure

The camp nurse has been called to the field outside the recreation centre. As the nurse arrives, a large crowd begins to separate. The nurse notes that one of the campers is lying on the ground, and the camper’s arms and legs are thrashing back and forth. The nurse also notes a small cut above the camper’s right eye. The nurse recognizes the camper because she visits the nurse every day for medication administration, and the nurse remembers that the medication the camper takes is carbamazepine (Tegretol). As the nurse moves closer, she also sees two of the counselors preparing to attempt to restrain the camper.

OTHER PERTINENT INFORMATION: Temperature – 98.5 degrees Fahrenheit
Weight – 71.5 kg Height – 5 feet & 6 inches tall
1. What should be the nurse’s initial response?

2. The camper is transferred to a local emergency department, where she is stabilized. A blood level of carbamazepine is drawn, and the result is 1.2 mcg/mL. How will the nurse interpret this finding?

3. Doctors order: 2mg of Lorazepam PO and you only have 0.5mg tablets of Lorazepam on hand. How many tablets would you administer to the patient?

4. Convert the camper’s temperature into Celsius, her weight into pounds, and her height into centimeters.

5. Give three examples of narrow-spectrum AEDs and three examples of broad-spectrum AEDs. What are the differences of these 2 spectrums AEDs? What are the side effects? What are your nursing considerations?

6. Why do we need to use a in-line filter for Dilantin IV?

Ibuprofen

1. The physician orders ibuprofen 100mg q8h for a child in pain who weighs 26kg. Recommended dose is 5-10mg/kg/day in divided doses q 6-8 h. Ibuprofen is available as 100mg/5ml. A. What is the safe daily dosage range for this child? B. Is the ordered dose safe? C. If yes how many ml will the nurse administer?

Diphenhydramine

22. A patient is experiencing hives in an allergic reaction. Which of the following reports would indicate that
diphenhydramine (benadryl) is showing its desired effect?attachment1.png

Risk of developing health problems

Some stress makes you react positively; stress can give runners the “edge” needed to make it through to the finish line. On the other hand, some stress can be harmful; it can increase the risk of developing health problems such as high blood pressure and cardiovascular disease. For this reason, stress can be divided into either eustress (good) or distress (bad). What are some positive ways you deal with stress? What are some negative ways you deal with stress? Be sure to include at least one goal that discerns a new coping skill you will utilize to decrease stress and cope healthy in the future.

 

Radiation

Why is radiation harmful to the cell yet for cancer treatment massive amounts of radiation is used?

Cystitis

What is a nursing diagnosis for Cystitis? What is an intervention for that particular nursing diagnosis?

What is the evaluation for the nursing diagnosis given?

Stress experienced

A sources of stress experienced while working as a student enrolled…

 

  • A sources of stress experienced while working as a student enrolled nurse in the clinical environment, the triggers and your response.
  • The strategies you used to manage the stress

You will then develop a stress management plan and implement the plan based on the below scenario and review your plan in response to the scenario.

 

Case Scenario 1

You are working on a busy general medical unit.  In the past week there have been four unexpected deaths and an extraordinarily busy unit resulting from larger than normal client admissions. Staffing has been a constant struggle of ensuring that there is a safe nurse-patient ratio, and a large number of shifts have been worked short-staffed. Your manager has asked you on several occasions to work extra shifts and you have agreed as your partner has just lost his job.

In the course of one shift that you worked, two clients died.  Of the clients, one was a young male, Jason Thomas, 32, who recently became a father. Jason presented to emergency for chest pain and was sent to your unit for observation.  Jason had pressed his call button for assistance and when the nursing staff arrived (yourself and Vanessa, a RN), he was found to be clutching his chest in pain, pale, diaphoretic and very short of breath.  A MET was called, and despite resuscitation, Jason died an hour later.  You were very distressed after this event as it reminded you of a personal tragedy and went to take your tea break.

Since Jason’s death, you have been sick for most of your shifts.  When you are at work you are at times abrupt and some relatives have complained about your ‘attitude’ to the Nursing Unit Manager. The staff members who have been working with you for more than 6 months and know that this is not your normal behaviour.  They have tried approaching you and asked if you are ok, but you brush their comments away or do not respond at all, and walk away from the area. 

To investigate the complaint, the Nursing Unit Manager is questioning staff members who were working alongside you on the day of the complaint as well as the patient’s family.

 

Q1) Describe a source of stress you experienced while working as a Student Enrolled Nurse in the clinical environment

Q2) What were the triggers for the event?  (To answer this question, the triggers are not only what occurred on the ward but also what was happening in your personal life at that time that may have impacted)

Q3) Describe your physical, psychosocial and behavioural response to the stressor.

Q4) Describe a minimum of three (3) strategies you used to effectively prevent, reduce and management the stressor.

Develop a plan

R2.1 Develop a personal management plan that responds to identified stressors and triggers using the following:

  • Stressors
  • Triggers
  • My response

Strategies to use

Implement stress management strategies

R3.1 Explain how the strategies in your personal management plan (developed above for R2.1), could address the personal triggers and stressors in the described scenario

R3.2 What are three (3) or more adjustments that could be made to your plan if your identified strategies are not meeting the desired outcome to prevent, reduce and manage stress

Evaluate stress reduction strategies

State 4 ways you will know that your stress management strategies are effective. (These must be different from your previous answers).

Culture unfamiliar

You are admitting a 19-year old female college student to the hospital for fevers.  Using the patient information provided, choose a culture unfamiliar to you and describe what would be important to remember while you interview this patient. Discuss the health care support systems available in your community for someone of this culture. If no support systems are available in your community, identify a national resource.

Psychiatric evaluation

At a minimum, a psychiatric evaluation in an emergency should include which of the following? Select all that
apply. I— A Is the patient psychotic? [— B Is the patient suicidal or homicidal? Is the problem organic,
functional, or a [— combination? D Is it safe for the patient to be in the l— emergency room?116914085-2933874.jpeg

Scope of nursing practice.

Scope of nursing practice. Use the Bachelor of Nursing Workplace Learning Handbook to identify two activities that would be within the scope of practice of the student Registered Nurse undertaking Workplace learning for nursing.