painhctz 25 mg po dailylipitor 20 mg po daily2 gm low sodium dietnpo H e a l t h M e d i c a l

PART I – Code Blue Scenario

Read the following scenario.

SCENARIO:

Admission Date: 2/1/21

Today’s Date: 2/2/21

Name: John Bower

DOB 4/1/1991

Gender: Male Age: 30

Race: Caucasian

Weight: 133 kg Height 178 cm

Religion: catholic Major Support: Wife

Phone: xxxxxxx

Allergies: NKA

Immunizations: Flu last September

Attending Physician: Hospitalist

Past Medical History: HTN; Hyperlipidemia; past fractures of ribs, left arm and right ankle MVA accident 2 years ago

Medications:

• HCTZ 25 mg QD
• Lipitor 20 mg QD

Social History: 15 year heavy smoker, drinks alcohol a few times a week. Works for IT department remotely; sedentary lifestyle lives with wife and their cat

Primary medical Diagnosis: Closed Fracture of R femur from MVA. Surgery scheduled for this morning; admitted 2000 on the previous day.

Scenario Overview:

Patient admitted to your unit at 2000; for scheduled surgery r/t to an MVA yesterday when he obtained a closed R femur fracture.

Physician’s Orders:

VS Q 4H

Start IV

0.9% NSS IV at 50 ml/hr

Telemetry monitor

IV morphine 1 mg Q2H for pain

HCTZ 25 mg PO daily

Lipitor 20 mg PO daily

2 gm low sodium diet

NPO after midnight for surgery in a.m.

Electrolytes, CBC, Type and Screen 2 units PRBC in a.m.

Activity as tolerated

Nursing notes:

VS on admission: BP 145/89; HR 80; RR 20; Temp 98.7; pain 6/10; A&O x 3

PIV in L AC; 0.9% NSS infusing at 50 mL/hr

1 mg morphine given at 2000, 2300, 0100, 0400

2348: VS 148/90; HR 84; RR 26; Temp. 99.0; pain 6/10 A&O x 3 patient resting

0400: VS 146/88; HR 90; RR 30; Temp. 100.4; pain 6/10; patient sleeping

You are the charge nurse coming on at 0700. After receiving report from the night nurse, you go in to assess Mr. Bower:

0730: VS 146/88; HR 120; RR 38; Temp. 102.2; restless, lethargic, A&O x 2; petechial rash on trunk, bilateral crackles ULL

Your critical thinking skills tells you that here is a concern.

First part of your assignment:

Submit your answers for this part in APA paragraph form. Use scholarly references.

• Identify the disease process that may have occurred to this patient.
• Identify the risk factors associated with this.
• Identify the nursing interventions that could have been implemented earlier and those that will be implemented for this disease process