To use critical thinking and data collection to recognize and report complications that may impact the morbidity and mortality of clients who have sustained a traumatic insult to the urinary tract while functioning within the LPN scope of practice
Select appropriate nursing interventions for clients with disorders of the urinary system.
Read the scenario below and answer the questions. When you see a that means a clue.
It is Friday the 13th and a full moon. You are an LPN that normally works on a medical-surgical unit, but your unit is overstaffed, and the emergency department is short staffed. The nursing supervisor asks for a volunteer to go down to be an extra pair of hands. You volunteer as tribute. When you get to the ER, you are asked to do vitals on a client in the trauma room. The client is a 24-year-old male who was stabbed multiple times to the abdomen.
The wounds appear superficial, and the client has been stable thus far. He will be going to CAT scan as soon as they can fit him in. You approach the client, who appears slightly pale with cool, clammy but is alert and talkative. The vital signs are:
97.3 (PO) P= 115 BP= 95/54 Resp rate= 24 Pain= 6/10. You notice the client voided 100 mL tea-colored urine in his urinal.
One hour later, the client becomes unconscious. His pulse is now 144, and blood pressure is 70/50. The client is taken to the OR and has a nephrectomy for a very damaged and bleeding right kidney.
Answer the following questions:
1. What were the clues in the data collection that should have alerted you and the staff that there might be a problem? (5-10 sentences)
2. Why is the urine â€œtea-colored?â€ (one sentence)
3. What are some other interventions that could have been done? (2-5 sentences)
4. Was the LPN in this scenario working within the scope of practice for an LPN? Why or why not? (5-10 sentences)
5. How did the environment of care (busy ER) contribute to the clientâ€™s deterioration? (5-10 sentences)
. Standard American English (correct grammar, punctuation, etc.)
. Logical, original and insightful
. Professional organization, style, and mechanics in APA format
. Submit document throughÂ GrammarlyÂ to correct errors before submission
Module 03Â Content
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To identify maladaptive breathing patterns and intervene as necessary
Explain care for the client with upper respiratory disorders.
Read the scenarios and answer the questions that follow each. Please cite any sources using APA format.
Scenario # 1
A 45-year-old male comes to the ER unconscious. A co-worker went to check on him when he did not show up for work and found him unconscious. The client is a type one diabetic. His respirations are 36, and his breath has a â€œfruityâ€ scent. His respirations are both deep and rapid. Labs are drawn, and his glucose is 1024.
Â· Why does this client have rapid, deep respirations and â€œfruityâ€ smelling breath? (5-10 sentences)
Scenario # 2
A 94-year-old in long-term-care is terminally ill and has been placed on hospice care. Her family summons you because her breathing has become erratic. You observe periods of rapid, deep respirations followed by periods of apnea.
Â· What should the nurse do next? (5-10 sentences)
Scenario # 3
A 64-year-old male comes via car to the clinic where you are working. His wife reports he has been having â€œtrouble breathingâ€ for the past several days, but today it is much worse. The client is unable to speak and appears very anxious. His respiratory rate is 48.
Â· What is the priority nursing intervention? (5-10 sentences)
Scenario # 4
A 22-year-old female arrives to urgent care. Her mother reports she thinks the client is having trouble breathing and that it started after she broke up with her boyfriend. The client is crying. Her respiratory rate is 36.
Â· What is the most appropriate nursing intervention? (5-10 sentences)
Scenario # 5
You are the medication nurse on a medical-surgical unit. You arrive to the room of a 28- year-old female who was admitted for opiate overdose and substance abuse disorder. You find the client in bed, unresponsive with a respiratory rate of 4.
Â· What is the priority nursing intervention? (5-10 seconds)
Â· Standard American English (correct grammar, punctuation, etc.)
Â· Logical, original and insightful
Â· Professional organization, style, and mechanics in APA format
Â· Submit document throughÂ GrammarlyÂ to correct errors before submission
Module 05Â Content
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To recognize risk factors for pulmonary edema/fluid overload.
Explain care for the client with lower respiratory disorders.
Read the scenarios below and answer the questions. If you use sources, site them using APA format.
Case # 1
An elderly woman comes into the ER with severe dehydration after spending the day at the beach. The client is weak and feels like she is going to faint. An IV is started, and the RN hangs 0.9% Normal Saline. There are no IV pumps available. The client begins to feel better after 500 mLâ€™s are infused, and the rest of the IV bag is infused. The client begins to have difficulty breathing. Auscultation of the lungs reveals crackles to Â½ of the lower lung fields. The provider diagnoses pulmonary edema, and the client is treated with Lasix. She is stabilized but needs to be admitted to the ICU.
Question # 1: What nursing action could have prevented the client from having pulmonary edema? (5-10 sentences)
Question # 2: What makes this client at risk for pulmonary edema? (5-10 sentences)
Case # 2
A 22-year-old special-needs client comes to the ER with fever and difficulty breathing. The client weighs 66 LBS. The client is admitted with pneumonia and IV fluids, antibiotics, and respiratory treatments are started. The client is dehydrated, so she receives several bags of IV fluids over three days. On the third day, the client has worsening shortness of breath, and an X-ray is ordered which shows pulmonary edema. An echocardiogram is ordered. It shows normal cardiac function. The client is given Lasix, and the shortness of breath resolves.
Question # 3: How did the clientâ€™s size (body weight) put her at risk for pulmonary edema? (5-10 sentences)
Question # 4: How could pulmonary edema have been prevented in this client? (5-10 sentences)
Case # 3
A 32-year-old male with a history of cardiomyopathy is admitted to the medical-surgical floor with a diagnosis of flu. The client has a high fever and receives multiple bags of 0.9%NS. One day into the admission the client develops severe shortness of breath. An X-ray shows pulmonary edema.
Question # 5: What puts this client at risk for pulmonary edema? (5-10 sentences)
Â· Standard American English (correct grammar, punctuation, etc.)
Â· Logical, original, and insightful
Â· Professional organization, style, and mechanics in APA format
Â· Submit document throughÂ GrammarlyÂ Â to correct errors before submission.
Â· APA citation
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Module 06Â Content
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