case studyCasey is a 17-year-old high school student admitted to the ER with a compound fracture of the left leg obtained when falling at the local skateboard park while practicing for a national competition. He has never been hospitalized before.

Nursing questions

1. Casey is a 17-year-old high school student admitted to the ER with a compound fracture of the left leg obtained when falling at the local skateboard park while practicing for a national competition. He has never been hospitalized before. His mother has been notified and is on her way. The EMTs gave him morphine and he reports his pain level as “okay.”

  • What part of the interview and examination can be done prior to his mother’s arrival?
  • As you enter the room for the first time, what should you observe as part of the general survey?
  • As you complete his history, what areas are especially important?
  • What are the important developmental considerations for Casey?

 

 

 

2. As you recall, our older patient, Red Yoder, with whom you met in Week 2, is preparing for discharge from the hospital since his wound required intravenous antibiotics and wound care. Jon (Red’s son) thinks that Red should move in with him for now, but Red is sure he is able to care for himself and insists that his confusion was due to the fact that he did not have his glasses or hearing aids for the last week. You have identified discharge teaching needs for him. This morning, however, in report the night nurse has shared “Patient is alert and oriented; vital signs stable. Fasting blood sugar this morning is 118. Red had his usual night of sleep. He was up several times to go to the bathroom. Since his catheter was removed yesterday, he has urgency incontinence. He is able to ambulate to the bathroom, but he is weak.” You administer his AM medications and note that he has some difficulty grasping the water cup and needs assistance holding it. Mr. Yoder states he needs to go to the bathroom and when you assist him up to his feet, he seems a bit unsteady. He takes several steps and tells you he needs to sit down.

  • How much, if any, functional decline has occurred while Red was hospitalized and how will this affect his recovery?
  • What are the risks and benefits of Red living with Jon and Judy?
  • What are the risks or benefits of Red living at home after discharge? If services are in place, would it be considered a safe discharge?
  • Considering all aspects of aging, what are the best and appropriate options for Red at this time?

 

 

 

3. William Smaile is a 65-year-old man who presents to his general practitioner’s office with complaint of right forearm swelling, redness, and pain. He was recently discharged from the hospital where he had been receiving intravenous antibiotics for a respiratory infection.

Subjective Data

  • Pain level is a 5/10 location = right forearm, aching
  • Retired foreman at a local industrial plant

Objective Data

  • Vital signs: BP 150/68, T 37 degrees Centigrade, P 80, R 16
  • Swelling and reddened right forearm, warm to touch
  • + pulses, brachial and radial (R)
  • +2 capillary refill fingers right hand
  1. What other assessments should be included for this patient?
  2. From your readings, what is the most probable cause of the swelling?
  3. What is your nursing diagnosis?
  4. What would be included in the nursing care plan?
  5. What interventions might be included in the plan of care for this patient?

 

 

 

4. Describe the characteristics of the lymph nodes associated with the disease states listed below: (Choose one.)

 

  • Acute infection
  • Chronic inflammation
  • Cancer

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