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Asked by BrigadierSnow12924

 

Client 1: Room 4570

 

June Jones is a 64-year-old female who runs a dairy farm operation with her husband, who also drives truck for a local fresh food supplier. June presents to the emergency department after being referred by her home care nurse following a nurse visit. June has homecare services for follow up of her right total hip replacement -attention to wound and for home physical therapy. June is post-op day 5. Vital signs in the home, at the recent nurse visit, were 38.7 (0), 112 regular, 174/96, 28-30 slightly labored. The homecare nurse assessed June to be “not feeling so good.” She has pressure injuries and that right hip has a lot of infectious looking drainage. She is positive for MRSA. She has isolation precautions.

 

Client 2: Room 4571

 

A 26-year-old female, is a law student who has been struggling in school after ending a long term relationship with her boyfriend and comes in today for severe abdominal pain and bloody diarrhea. She has a history of IBD and she reports that this flare has been the worst one she has experienced yet. She reports between five to fifteen loose stools per day with intermittent blood that started a week ago, but over the last day or two, she has noticed blood in her stool consistently. She reports diffuse, crampy abdominal pain that she rates at a 7/10, fevers and generalized malaise. She has lost 10 lbs. over the last few weeks, and she has only been able to drink Gatorade and eat Nabisco wafers for a week. She has denied any vomiting but states that she has been nauseated. She has been on oral antibiotics for something. She has pending labs for C.Diff. She has isolation precautions.

 

Client 3: Room 4572

 

Mr. Gene Thompson is a 53 y/o obese gentleman, patient of Dr. Smith, who has been in the hospital two days with acute Klebsiella pneumonia. He received a tracheostomy 5 weeks ago, and he was home for only a few days before having to come back to the hospital with symptoms of SOB, mucous plugging, fever and general malaise – Chest x-ray  and blood cultures confirmed that he has klebsiella pneumonia.

 

Shift report:

 

“Gene is a 53 year old male, with klebsiella pneumonia.  His COVID screen was negative.I had to suction him 3 times last night. His trach site looks OK, but he needs a dressing change and trach cares because he coughed up a nasty one…sorry I didn’t have time to fix it. He has been coughing a lot.  

He has isolation precautions.

 

 

4. Debrief: For each of the clients you are caring for, be prepared to discuss your answers to the following questions.

 

1. What do you notice – what elements of your clients history contribute to your interpretation that you would respond with setting precautions?

 

Chronic (past) History?

 

Acute (now) history?

 

2.  What type of isolation did you employ?  Why? 

 

3. Correlatively what equipment- supplies would you-did you use for care of each of your clients?

 

SCIENCE
HEALTH SCIENCE
NURSING
SAC 116