What meaning did you make from the patient monologue

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Reference no: EM133777149

Assignment

Sirius Dell Monologue Script

Hi I'm Sirius. Although I'm getting older, I continue to run my 30 acre farm located in New Windsor by myself. Since the death of my wife Esther, the farm is what helps to keep me moving and to help pass the time by. My son Charlie still lives in Iowa with his wife. He checks in frequently and still visits in the summer and holidays.

Last year, I had a scare and ended up going to the ER. I passed out in the grocery store. Come to find out, I had been taking magnesium supplements and drinking a hibiscus tea to help me sleep and never told my doctor. The doctors told me that both supplements interacted with my blood pressure medication causing my blood pressure to be too low which caused my fainting spell. Since the ER visit last year, I haven't had any more dizzy or faint spells. I still smoke and although I tried to decrease my cigarettes from 2 packs per day to 1 pack per day, I have not been successful in quitting. I still feel stress. Running a 30 acre farm all by myself is really tiring, making for long days. I'm getting too old to do this but I can't seem to let the farm go. Smoking and drinking my glass of bourbon each night helps to relax me in the evenings.

Patient Report:

Time: 08:00

Person providing report: Off-going PACU RN

Situation: Sirius Dell is a 74 year old male who fell and fractured his left femur while working on his farm. Patient had an ORIF 2 hours ago with Dr. Barley.

Background: Client fell in ditch while working on his farm. He has NKDA with a past medical history of smoking (1ppd), social drinking, hypertension, hyperlipidemia, and gout.

Assessment: VS: HR 84; BP 120/80; RR 20; SaO2 96% on 2 LPM via NC. Patient is awake and tolerating clear liquids. Vital signs are now Q1 hour. PIV in right antecub infusing D5 ½ with 20 meq KCL/L @ 75 ml/hr with PCA Morphine with basal rate of 1 mg.hour and a demand dose of 0.5 mg, lockout 10 minutes. Foley draining clear yellow urine. Patient educated on incentive spirometer at bedside. Bowel sounds hypoactive in all 4 quads. Left leg elevated on 1 pillow. Left thigh dressing dry and intact. Bilateral anti-embolism stockings and SCDs. Non-weight bearing. Neurovascular assessments WNL. Patient refusing lovenox at this time. MD notified.

Recommendation:

• Educate patient on Lovenox and the importance of the medication
• PT consult
• Encourage incentive spirometry
• Pain management with goal less than 3/10
• Assure patient is ready to move to floor once bed is available

Required

I. What meaning did you make from the patient monologue that you felt was important to note from a nursing perspective? Why do you feel it is important? How will you use this information during your care of this patient? What other information regarding this client would you like to have? How will you obtain it? How will it help you to plan care? What do you remember about Sirius Dell from NURS133? How can this help you?

II. If you had 30 minutes to care for a PACU client (assume you are the primary RN), outline of your top assessments, interventions, and evaluations. Provide your rationale/evidence so that you can defend these positions in pre and debrief.

III. Identify the safety assessments and interventions the RN needs to consider when caring for a patient on a PCA pump? What risks can occur if you fail to do these assessments and interventions?

IV. Identify potential complications of S/P ORIF for which you will monitor. How will you do so? How often? How would you intervene if they should arise?

Reference no: EM133777149

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