Concept explainers
To identify:
The essential information that should be available in Ms. A’s electronic record to support safe patient care and coordination of care.
Case summary:
Ms. A is a 55-year-old female patient, who had undergone abdominal surgery and had a sigmoid colostomy. A student nurse is assigned to care for her along a staff nurse, the nurse observes that she drains semisoft brown stool and her stoma is bright red color. After many observations of changing colostomy bag, the student nurses attempts to change the colostomy bag for the first time.
To discuss:
The information that should be documented in the electronic health record regarding the student’s assessment and interventions.
Case summary:
Ms. A is a 55-year-old female patient, who had undergone abdominal surgery and had a sigmoid colostomy. A student nurse is assigned to care for her along a staff nurse, the nurse observes that she drains semisoft brown stool and her stoma is bright red color. After many observations of changing colostomy bag, the student nurses attempts to change the colostomy bag for the first time.
To discuss:
Any other available ways to respond to or approach the situation.
Case summary:
Ms. A is a 55-year-old female patient, who had undergone abdominal surgery and had a sigmoid colostomy. A student nurse is assigned to care for her along a staff nurse, the nurse observes that she drains semisoft brown stool and her stoma is bright red color. After many observations of changing colostomy bag, the student nurses attempts to change the colostomy bag for the first time.
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FUNDAMENTALS OF NURSING-PACKAGE
- Need: What labs are high Nutrition Intervention (what to educate her on, like you're talking to her) Nutrition Monitoring and Evaluationarrow_forwardA 65 year old male with a small bowel obstruction is to be started on TPN. He is 5’ 9” and weighs 70 kg. 3.1 What is his kcal requirements using Mifflin St Jeor equation? Assume an activity factor of 1.2. 1770 kcal 1980 kcal 2020 kcal 2080 kcal 3.2 What is his fluid requirements (ml)? 2000 ml 2100 ml 2200 ml 2300 ml 3.3 The patient has just undergone a small bowel resection. His albumin dropped to 2.2. He has no significant past medical history except for a minor bicycle accident when he was 10 years old. How many grams of protein will this patient require based on your assessment? 105 – 126 g/day 110 – 130 g/day 84 – 105 g/day 110 – 180 g/dayarrow_forwardTwo kind verbarrow_forward
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- You are seeing a 68 year-old male patient admitted to the ICU. He is sedated on the ventilator with propofol at 20ml/hr, D51⁄2NS running at 75ml/hr. and a past medical history of DM2, obesity, CAD, HTN, and Pneumonia. Ht 172cm, Wt 72kg, Alb 2.3, VE=7.9 L/min, Tmax =38.4 C 4.1 What is the total kcal this patient is receiving before the initiation of TF (Hint: include propofol and D51⁄2 NS in calculation)? 306 kcal 528 kcal 678 kcal 834 kcal Which estimated prediction equation will you recommend to calculate the kcal need for this patient? Penn State Equation (2003b): Mifflin(0.96)+ VE (31) + Tmax (167)-6212 MifflinStJeor =(10xW)+(6.25xHt)–(5xAge)+5 Harris-Benedict equation: kcal/day (male) = 66 +13.8 (W) + 5.0(H) – (6.8 x A) Ireton-Jones equations (1992)(ventilator-dependent): 1925 – 10 (A) + 5 (W) + 281 (S) + 292 (T) + 851 (B) What is the estimated kcal goal for this patient? 1787 kcal 1847 kcal 1927 kcal 2317 kcal What is the…arrow_forwardYou are seeing a 68 year-old male patient admitted to the ICU. He is sedated on the ventilator with propofol at 20ml/hr, D51⁄2NS running at 75ml/hr. and a past medical history of DM2, obesity, CAD, HTN, and Pneumonia. Ht 172cm, Wt 72kg, Alb 2.3, VE=7.9 L/min, Tmax =38.4 C 4.1 What is the total kcal this patient is receiving before the initiation of TF (Hint: include propofol and D51⁄2 NS in calculation)? 306 kcal 528 kcal 678 kcal 834 kcal Which estimated prediction equation will you recommend to calculate the kcal need for this patient? Penn State Equation (2003b): Mifflin(0.96)+ VE (31) + Tmax (167)-6212 MifflinStJeor =(10xW)+(6.25xHt)–(5xAge)+5 Harris-Benedict equation: kcal/day (male) = 66 +13.8 (W) + 5.0(H) – (6.8 x A) Ireton-Jones equations (1992)(ventilator-dependent): 1925 – 10 (A) + 5 (W) + 281 (S) + 292 (T) + 851 (B) What is the estimated kcal goal for this patient? 1787 kcal 1847 kcal 1927 kcal 2317 kcal What is the…arrow_forwardHealth education is central to nursing practice. Discuss.arrow_forward
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