How to Answer Hello Dear Writer Questions (Complete Guide)

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hello dear writer I’m going to share case scenario and questions related to it please answer each question from case scenario You are assigned to Mr. M. a 79-year-old man who was admitted today to your unit for a urinary tract infection and urosepsis .For this week’s discussion board think back to Mr. M from the case scenario. Based on what you have learned this week about management of clients with renal and urologic disorders answer the following questions: What else would you do in this situation with Mr. M? What other options or alternatives would you explore and why for Mr. M? What referrals might you make for Mr. M at this time? Who else on the interprofessional team would you involve in Mr. M’s care? Now i am sharing whole case scenario Nursing Care Kardex You should have also read the handoff nursing report and reviewed Mr. M health history. In order to plan your care you need to check the Nursing Care Kardex to obtain additional information and the medical orders. Now click here for the nursing care Kardex for Mr. M. Name: Mr. M Age: 79 Diagnosis: Urinary Tract Infection and Urosepsis VS q4h Ambulate with assistance prn I&O q8h IV Lactated Ringers 100 ml/hr Bathroom privileges with assistance Diet: soft as tolerated Routine meds: Acetamenophen 500 mg tabs i po q4h for temperature greater than 38 degrees celcius; Ceftriaxone 1 g IVPB qAM as ordered – Alternative Formats It is now 0730. As you enter his room you notice he is restless and seems disoriented. You are planning your initial care activities for Mr. M. Using the list below, think about how you would prioritize the five nursing interventions as you would do them to initially take care of Mr. M. INSERT A NUMBER BOX FOR THIS ACTIVITY Assess for call bell and bed safety features Take vital signs Gather urinary output data Assess mental status Perform a body systmes physical assessment NEED FEEDBACK/ANSWERS WITH RATIONALES – TO DOWNLOAD FROM PUBLISHER WEBSITE As you provide morning care to Mr. M you note the following signs and symptoms: VS: T 38.5 C, P 98, R 22, BP 120/76, pulse oximetry 94% Fine crackles audible on auscultation in the bilateral lower lung fields Crackles audible throughout the bilateral lung fields He is sleepy, lethargic He is incontinent of a scant (small) amount of urine Based on your nursing assessment and critical thinking select the nursing diagnosis that is a high priority at this time. You should have a rationale for your selection. Note: all of the following nursing diagnosis may apply to Mr. M. The key is to select the nursing diagnosis that is the highest priority at this time. Using the following list, check only the one you think is the highest priority. Nursing Diagnoses Click the option Ineffective breathing pattern Impaired urinary elimination Risk for injury Risk for infection Anxiety Impaired gas exhange Acute confusion Imbalanced nutrition: less than body requirements Risk for imparied skin integrity Hyperthermia Deficient fluid volume Fatigue Risk for shock Impaired comfort Answers – Week 8 Week 8 – Mr M Nursing Assessment It is now 0730. As you enter his room you notice he is restless and seems disoriented. You are planning your initial care activities for Ms. M. Using the list below, think about how you would prioritize the five nursing interventions as you would do them to initially take care of Mr. M. 5 – Assess for call bell and bed safety features Minimize fall or injury to patient 1 – Take vital signs Reassess, especially temperature 4 – Gather urinary output data Assess amount, color and voiding pattern 3 – Assess mental status Assess delirium and manage confusion 2 – Perform a body systems physical assessment Establish baseline; assess bladder; patient may have a full bladder; which may contribute to his restlessness Follow-up Action Plan As you take his 12:00 noon vital signs you note the following signs and symptoms: lethargic, skin very warm and flushed, VS T 39.1 C, P 130, R 28, BP 90/5484, pulse oximetry 88%. Based on this new information what are your next steps? What do you think is going on with Mr. M? What would you identify as the PRIORITY PROBLEM? Now prioritize the following nursing interventions for this situation and identify your follow up action plan for Mr. M. 1. Check pulse oximetry: attach probe to ear, nose or forehead preferably 4. Take vital signs q5min 6. Notify physician 2. Prepare to start oxygen 5. Document findings 3. Prepare to insert indwelling urinary catheter Priority Problem: Signs and symptoms of septic shock New action plan: Monitor vital signs and oxygenation; prepare to transfer to intensive care unitFeedback – Week 8 Points to consider for Mr M: At 0600 Temp was 38 There is no documentation that Tylenol was given Restlessness Agitated and restless all night – why? What are your thoughts about why this is happening? Sepsis Urinary retention Fever Dehydration What should you be considering? Geriatric patient What should you be assessing? Initiate neuro checks At 0730 Temp was 38.5 Did you give Tylenol? P has gone from 78 to 98 BP has dropped from 146/88 to 120/76 Fine crackles audible Sleepy and lethargic All night was agitated and restless Scant amount of urine Complete a physical assessment as baseline has been deviated from What should you be considering as this is an elderly patient? You should be concerned for this patient Notify physician of change in status At 1200 Temp was 39.1 P – 130 R – 28 BP – 90/54 Lethargic, skin warm and flushed Oximetry 88% What is happening? If Tylenol had been given would this situation have developed? Prepare for transfer to ICU The required (necessary) readings for this week are: these are the books use to get information regarding disease condition Lewis , S., Heitkemper, M., Dirksen, S., Barry, M., Goldsworthy, S., & Goodridge, D. (2014) Medical-Surgical Nursing in Canada: Assessment and Management of Clinical Problems, (3rd Edition). Reed Elsevier Canada, Ltd. Toronto, Canada. Chapters: 47-49

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