Delegation in Nursing Discussions

Critical Thinking Week 4 Please answer the following 5 questions using the scenario. You do not need to write paragraphs for this Critical Thinking- copy and paste below, and answer the questions. Scenario: A 72-year-old client, with a history of heart failure HF and allergy to peanuts, has been in the surgical critical care unit for past 3 days following abdominal surgery for stomach cancer. The client’s central line has become thrombosed and was successfully replaced.

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1. Highlight the assessment findings that require immediate follow-up by the nurse: Approximately 10 minutes after the insertion, the client reports feeling flushed and states, “my heart is just racing.” The client is visibly flushed and clammy to the touch. Vital signs include blood pressure (BP), 60/Doppler; heart rate (HR), 160; respiratory rate (RR), 30; and temperature (T), 99°F. Scenario: After the initial sudden appearance of signs and symptoms, the client continues to become more flushed and reports, “a lump in my throat.” Audible wheezing can be heard at the bedside as the client exhales. The client appears apprehensive and is moving restlessly in the bed. 2. (Fill in the blank) Choose the most likely options for the information missing from the statement below by selecting from the list of options provided. Based upon the demonstration of ___1 ___, ___1___, ___1___, ___1___ and __1___ the diagnosis of _____2____ is made. Option 1 Option 2 Audible wheezing Cardiogenic Shock Generalized flushing Anaphylactic Shock Cardiac diagnosis Hypovolemic Shock Known allergy Pulmonary Embolism Recent surgery Acute Congestive Heart Failure Restlessness Tachycardia Hypotension Client’s age Scenario: It has been decided that the client’s anaphylactic shock reaction was due to an allergy to latex. Supplemental oxygen was provided via nonrebreather mask. Intravenous (IV) vasopressor was administered and lactated Ringer (LR) was hung. 3. Choose the most likely options for the information missing from the statements below by selecting from the lists of options provided. 2 Based on the treatment goals and interventions already initiated, the client’s priority need will be to ______________1____________. This will be best accomplished by initially administrating ____________2____________ followed by ______3 ______ and _____3____. Option 1 Option 2 Reverse biochemical mediators IV epinephrine Option 3 IV epinephrine Stabilize blood pressure IV diphenhydramineIV diphenhydramine Stabilize respiratory rate IV hydrocortisone IV hydrocortisone Scenario: The interventions have resulted in the stabilization of the client’s breathing, heart rate and blood pressure. The client is now resting quietly. It is at this time that the nurse begins to revise the client’s plan of care to minimize the client risk for injury while maximizing client safety. 4. Which actions would the nurse include in the plan of care at this time? Select all that apply. 1. Monitor mental status daily to note changes in cognition and/or behavior indicative of anoxic injury. 2. Remove all products containing latex from the client’s immediate environment. 3. Clearly post notice of client’s latex allergy in view of staff and visitors. 4. Place automatic epinephrine injector for ease of rapid access. 5. Include existence of latex allergy into client medical record. 6. Place properly identified allergy bracelet on client. 7. Monitor electrocardiogram for ischemic changes. Scenario: It has been 3 days since the client experienced the anaphylactic reaction to latex and 2 days since being transferred out of the surgical critical care unit to a postsurgical unit. In this period the client has had no contact with any latex products during direct care or treatment interventions. There has been no reoccurrence of allergic signs or symptoms and no indication of resulting organ damage related to the original allergic episode. Delegation in Nursing Discussions

The client has recovered sufficiently from the partial gastrectomy and discharge is planned for the am. 5. Use an X to indicate which information listed in the left column would be included in the client’s discharge instructions to avoid future episodes of latex induced anaphylaxis. Information Common products containing latex Common cross-sensitivities to a latex allergy Ways to minimize contact with latex containing products 3 Recognition and response to the early signs and symptoms of an allergic reaction Effective self-administration of epinephrine Cost of various forms of epinephrine injectors 4 1 Critical Thinking Week 4 Please answer the following 5 questions using the scenario. You do not need to write paragraphs for this Critical Thinking- copy and paste below, and answer the questions. Scenario: A 72-year-old client, with a history of heart failure HF and allergy to peanuts, has been in the surgical critical care unit for past 3 days following abdominal surgery for stomach cancer. The client’s central line has become thrombosed and was successfully replaced. 1. Highlight the assessment findings that require immediate follow-up by the nurse: Approximately 10 minutes after the insertion, the client reports feeling flushed and states, “my heart is just racing.” Delegation in Nursing Discussions

The client is visibly flushed and clammy to the touch. Vital signs include blood pressure (BP), 60/Doppler; heart rate (HR), 160; respiratory rate (RR), 30; and temperature (T), 99°F. Scenario: After the initial sudden appearance of signs and symptoms, the client continues to become more flushed and reports, “a lump in my throat.” Audible wheezing can be heard at the bedside as the client exhales. The client appears apprehensive and is moving restlessly in the bed. 2. (Fill in the blank) Choose the most likely options for the information missing from the statement below by selecting from the list of options provided. Based upon the demonstration of ___1 ___, ___1___, ___1___, ___1___ and __1___ the diagnosis of _____2____ is made. Option 1 Option 2 Audible wheezing Cardiogenic Shock Generalized flushing Anaphylactic Shock Cardiac diagnosis Hypovolemic Shock Known allergy Pulmonary Embolism Recent surgery Acute Congestive Heart Failure Restlessness Tachycardia Hypotension Client’s age Scenario: It has been decided that the client’s anaphylactic shock reaction was due to an allergy to latex.

Supplemental oxygen was provided via nonrebreather mask. Intravenous (IV) vasopressor was administered and lactated Ringer (LR) was hung. 3. \ Delegation in Nursing Discussions

Choose the most likely options for the information missing from the statements below by selecting from the lists of options provided. 2 Based on the treatment goals and interventions already initiated, the client’s priority need will be to ______________1____________. This will be best accomplished by initially administrating ____________2____________ followed by ______3 ______ and _____3____. Option 1 Option 2 Reverse biochemical mediators IV epinephrine Option 3 IV epinephrine Stabilize blood pressure IV diphenhydramineIV diphenhydramine Stabilize respiratory rate IV hydrocortisone IV hydrocortisone Scenario: The interventions have resulted in the stabilization of the client’s breathing, heart rate and blood pressure. The client is now resting quietly. It is at this time that the nurse begins to revise the client’s plan of care to minimize the client risk for injury while maximizing client safety. 4.

Which actions would the nurse include in the plan of care at this time? Select all that apply. 1. Monitor mental status daily to note changes in cognition and/or behavior indicative of anoxic injury. 2. Remove all products containing latex from the client’s immediate environment. 3. Clearly post notice of client’s latex allergy in view of staff and visitors. 4. Place automatic epinephrine injector for ease of rapid access. 5. Include existence of latex allergy into client medical record. 6. Place properly identified allergy bracelet on client. 7. Monitor electrocardiogram for ischemic changes. Scenario: It has been 3 days since the client experienced the anaphylactic reaction to latex and 2 days since being transferred out of the surgical critical care unit to a postsurgical unit. In this period the client has had no contact with any latex products during direct care or treatment interventions.

There has been no reoccurrence of allergic signs or symptoms and no indication of resulting organ damage related to the original allergic episode. The client has recovered sufficiently from the partial gastrectomy and discharge is planned for the am. 5. Use an X to indicate which information listed in the left column would be included in the client’s discharge instructions to avoid future episodes of latex induced anaphylaxis. Information Common products containing latex Common cross-sensitivities to a latex allergy Ways to minimize contact with latex containing products 3 Recognition and response to the early signs and symptoms of an allergic reaction Effective self-administration of epinephrine Cost of various forms of epinephrine injectors 4 1 Critical Thinking Week 4 Please answer the following 5 questions using the scenario. You do not need to write paragraphs for this Critical Thinking- copy and paste below, and answer the questions. Scenario: A 72-year-old client, with a history of heart failure HF and allergy to peanuts, has been in the surgical critical care unit for past 3 days following abdominal surgery for stomach cancer. The client’s central line has become thrombosed and was successfully replaced. 1.

Highlight the assessment findings that require immediate follow-up by the nurse: Approximately 10 minutes after the insertion, the client reports feeling flushed and states, “my heart is just racing.” The client is visibly flushed and clammy to the touch. Vital signs include blood pressure (BP), 60/Doppler; heart rate (HR), 160; respiratory rate (RR), 30; and temperature (T), 99°F. Scenario: After the initial sudden appearance of signs and symptoms, the client continues to become more flushed and reports, “a lump in my throat.” Audible wheezing can be heard at the bedside as the client exhales.

The client appears apprehensive and is moving restlessly in the bed. 2. (Fill in the blank) Choose the most likely options for the information missing from the statement below by selecting from the list of options provided. Based upon the demonstration of ___1 ___, ___1___, ___1___, ___1___ and __1___ the diagnosis of _____2____ is made. Option 1 Option 2 Audible wheezing Cardiogenic Shock Generalized flushing Anaphylactic Shock Cardiac diagnosis Hypovolemic Shock Known allergy Pulmonary Embolism Recent surgery Acute Congestive Heart Failure Restlessness Tachycardia 2 Hypotension Client’s age Scenario: It has been decided that the client’s anaphylactic shock reaction was due to an allergy to latex. Supplemental oxygen was provided via nonrebreather mask. Intravenous (IV) vasopressor was administered and lactated Ringer (LR) was hung. 3. Delegation in Nursing Discussions

Choose the most likely options for the information missing from the statements below by selecting from the lists of options provided. Based on the treatment goals and interventions already initiated, the client’s priority need will be to ______________1____________. This will be best accomplished by initially administrating ____________2____________ followed by ______3 ______ and _____3____. Option 1 Option 2 Reverse biochemical mediators IV epinephrine Option 3 IV epinephrine Stabilize blood pressure IV diphenhydramineIV diphenhydramine Stabilize respiratory rate IV hydrocortisone IV hydrocortisone Scenario: The interventions have resulted in the stabilization of the client’s breathing, heart rate and blood pressure. The client is now resting quietly. It is at this time that the nurse begins to revise the client’s plan of care to minimize the client risk for injury while maximizing client safety. 4. Which actions would the nurse include in the plan of care at this time? Select all that apply. 1. Monitor mental status daily to note changes in cognition and/or behavior indicative of anoxic injury. 2. Remove all products containing latex from the client’s immediate environment. 3. Clearly post notice of client’s latex allergy in view of staff and visitors. 4. Place automatic epinephrine injector for ease of rapid access. 5. Include existence of latex allergy into client medical record. 6. Place properly identified allergy bracelet on client. 3 7. Monitor electrocardiogram for ischemic changes. Scenario: It has been 3 days since the client experienced the anaphylactic reaction to latex and 2 days since being transferred out of the surgical critical care unit to a postsurgical unit. In this period the client has had no contact with any latex products during direct care or treatment interventions. There has been no reoccurrence of allergic signs or symptoms and no indication of resulting organ damage related to the original allergic episode.

The client has recovered sufficiently from the partial gastrectomy and discharge is planned for the am. 5. Use an X to indicate which information listed in the left column would be included in the client’s discharge instructions to avoid future episodes of latex induced anaphylaxis. Information Common products containing latex Common cross-sensitivities to a latex allergy Ways to minimize contact with latex containing products Recognition and response to the early signs and symptoms of an allergic reaction Effective self-administration of epinephrine Cost of various forms of epinephrine injectors Included in discharge instructions 1 Melong Nelly Doungmene NSG: 430 Professor: Sandra Gallegos Critical Thinking Assignment 2 Question One The patient’s systolic blood pressure is significantly low at less than 90, meaning the patient is likely dealing with hypotension and is at risk of several life-threatening conditions. A significant decrease in systolic blood pressure is usually associated with heart problems, which the patient is currently dealing with (Li et al., 2021). They can, however, also be caused by an allergic reaction, which is why it is important for the nurse to follow up, as the patient has been noted to have a peanut allergy. The heart rate of the patient is also significantly high at 160. A heart rate that is higher than 100 usually indicates tachycardia, which can be used by excessive bleeding, reactions to medication, or high blood pressure (Welzel et al., 2018). Due to the surgery recently performed on the patient, bleeding or high blood pressure are the most likely causes of the high heart rate. The patient also states they believe the y have a lump in their throat, which can be the result of a stress response or the loss of muscle coordination. Delegation in Nursing Discussions

The respiratory rate of the patient is also significantly high at 30, which is higher than the normal 20 for adults. A higher than normal respiratory rate is usually associated with heart complications, which is a condition that the patient is currently dealing with (Rossi et al., 2021). It can, however, be caused by a number of other conditions, which is why it is important for the nurse to follow up to confirm the primary cause for the patient. The audible wheezing that has been noted also indicates the presence of respiratory complications that can be related to the heart complications currently being experienced by the patient. Body temperature is within the normal range of 97.9 to 99F, meaning the patient is not experiencing any fever. 3 Question Two Based upon the demonstration of Audible wheezing Known allergy Cardiac diagnosis Recent surgery Tachycardia Hypotension Client’s age The diagnosis of Anaphylactic Shock Question Three 1.

Client’s priority: Reverse biochemical mediators 2. This will be best accomplished by initially administrating: Epinephrine followed by:Diphenhydramine and Hydrocortisone Question Four Selected Care Plan: 2. The removal of all items containing latex that may be anywhere near the client 3. Create and post notice of the client’s allergy to latex that can be seen by all visitors and staff. 4 4. Create ease of accessibility to epinephrine injector by placing one near the patient. 5. Update the patient’s medical records with latex allergy. 6. Use an allergy bracelet that correctly identifies the condition of the patient. Question Five Information Included in discharge instructions Common products containing latex X Common cross-sensitivities to a latex allergy X Ways to minimize contact with latex-containing products X Recognition and response to the early signs and symptoms of an X allergic reaction Effective self-administration of epinephrine X Cost of various forms of epinephrine injectors X 5 References Li, E. W., Di Ciaccio, P., Fan, K., Taper, J., & Dennington, P. (2021). Atypical presentation of IgA-related immediate reaction with back pain and relative hypotension–anaphylaxis or not?. Pathology, 53, S45. Welzel, T., Ziesenitz, V. C., Seitz, S., Donner, B., & van den Anker, J. N. (2018). Management of anaphylaxis and allergies in patients with long QT syndrome: A review of the current evidence. Annals of Allergy, Asthma & Immunology, 121(5), 545-551. Rossi, C. M., Lenti, M. V., & Di Sabatino, A. (2022). Adult anaphylaxis: A state-of-the-art review. European Journal of Internal Medicine. 1 Melong Nelly Doungmene NSG: 430: Comples Care Nursing Professor: Sandra Gallegos Critical Thinking Assignment 2 Scenario: A 72-year-old client, with a history of heart failure HF and allergy to peanuts, has been in the surgical critical care unit for past 3 days following abdominal surgery for stomach cancer. The client’s central line has become thrombosed and was successfully replaced. 1. Highlight the assessment findings that require immediate follow-up by the nurse: Approximately 10 minutes after the insertion, the client reports feeling flushed and states, “my heart is just racing.” The client is visibly flushed and clammy to the touch. Vital signs include blood pressure (BP), 60/Doppler; heart rate (HR), 160; respiratory rate (RR), 30; and temperature (T), 99°F. Scenario: After the initial sudden appearance of signs and symptoms, the client continues to become more flushed and reports, “a lump in my throat.” Audible wheezing can be heard at the bedside as the client exhales. The client appears apprehensive and is moving restlessly in the bed. 2.

(Fill in the blank) Choose the most likely options for the information missing from the statement below by selecting from the list of options provided. Based upon the demonstration of ___1 _audible wheezing__, ___1 restlessness___, ___1_hypotension__,1 _tachycardia__ and generalized __1__flushing_ the diagnosis of _anaphylatic ____2___schock_ is made. Option 1 Option 2 Audible wheezing Cardiogenic Shock Generalized flushing Anaphylactic Shock Cardiac diagnosis Hypovolemic Shock Known allergy Pulmonary Embolism Recent surgery Acute Congestive Heart Failure Restlessness Tachycardia Hypotension Client’s age Scenario: It has been decided that the client’s anaphylactic shock reaction was due to an allergy to latex. Supplemental oxygen was provided via nonrebreather mask. Intravenous (IV) vasopressor was administered and lactated Ringer (LR) was hung. 3 3. Choose the most likely options for the information missing from the statements below by selecting from the lists of options provided. Based on the treatment goals and interventions already initiated, the client’s priority need will be to ___ Reverse biochemical mediators. ___This would be best accomplished by initially ___administrating ___IV _epinephrine followed by___ IV diphenhydramine ___ and ___IV hydrocortisone. Option 1 Option 2 Reverse biochemical mediators IV epinephrine Option 3 IV epinephrine Stabilize blood pressure IV diphenhydramineIV diphenhydramine Stabilize respiratory rate IV hydrocortisone IV hydrocortisone Scenario: The interventions have resulted in the stabilization of the client’s breathing, heart rate and blood pressure. The client is now resting quietly. It is at this time that the nurse begins to revise the client’s plan of care to minimize the client risk for injury while maximizing client safety. 4. Which actions would the nurse include in the plan of care at this time? Select all that apply. ➢ 1. Monitor mental status daily to note changes in cognition and/or behavior indicative of anoxic injury. ➢ 2. Remove all products containing latex from the client’s immediate environment. ➢ 3. Clearly post notice of client’s latex allergy in view of staff and visitors. ➢ 4.

Place automatic epinephrine injector for ease of rapid access. ➢ 5. Include existence of latex allergy into client medical record. ➢ 6. Place properly identified allergy bracelet on client. ➢ 7. Monitor electrocardiogram for ischemic changes. Scenario: It has been 3 days since the client experienced the anaphylactic reaction to latex and 2 days since being transferred out of the surgical critical care unit to a postsurgical unit. In this period the client has had no contact with any latex products during direct care or treatment interventions. There has been no reoccurrence of allergic signs or symptoms and no indication of resulting organ damage related to the original allergic episode. Delegation in Nursing Discussions

Delegation in Nursing Discussions