22 year old nursing student went to a friend’s Birthday party on Tuesday night. At the party, alcohol, pizza, ice cream and cake was served. When she left the party, she realized that she was out of cigarettes and coffee, and texted her roommate that she was stopping by the grocery store. As she was texting (while driving), she drove off the road and hit a tree!. She suffered a broken leg (L tibia and fibula). She called her roommate and family crying, in pain and very stressed: She has a Pharmacology test on Friday! The surgeon has scheduled her surgery for Friday noon.   Her assessment findings include: Vital signs WNL, SaO2 – 96%, pain at a level 8 prior to medication with morphine 20 minutes ago, her broken L leg is wrapped and immobile with toes visible, pink and with strong and equal bilateral pedal pulses. She vomited upon arrival and still feels nauseous. She is requesting a cigarette break to “soothe her nerves”. Medications she takes include: oral hormonal contraceptives (“The Pill”), daily ibuprofen for headaches, CBD gummies for stress and relaxation Alcohol: 1-2 drink a few times per week Her Orders include: -Morphine 3mg IV every 4 hours PRN pain -Morphine 5 mg IV every 4 hours PRN pain -Ibuprofen 800mg po every 6 hours      -ondansetron (Zofran) 4mg IV every 6 hours PRN nausea/vomiting. -ondansetron (Zofran) 4 mg PO every 6 hours PRN nausea/vomiting -MRI of the L leg, chest xray, CBC, CMP, blood alcohol level     Based on the information given about this patient, write a problem list for her: actual and potential               Which of the assessment data above is relevant for the nurse when she is concerned about peptic ulcer development? (risk factors)         Are there other medications or treatments you think would benefit this patient? If so, what medications are they? What is your rationale? (include this in your SBAR below)

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
Problem 1SRQ
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Case Study B:

  1. 22 year old nursing student went to a friend’s Birthday party on Tuesday night. At the party, alcohol, pizza, ice cream and cake was served. When she left the party, she realized that she was out of cigarettes and coffee, and texted her roommate that she was stopping by the grocery store. As she was texting (while driving), she drove off the road and hit a tree!. She suffered a broken leg (L tibia and fibula). She called her roommate and family crying, in pain and very stressed: She has a Pharmacology test on Friday! The surgeon has scheduled her surgery for Friday noon.

 

  1. Her assessment findings include:
  1. Vital signs WNL, SaO2 – 96%, pain at a level 8 prior to medication with morphine 20 minutes ago, her broken L leg is wrapped and immobile with toes visible, pink and with strong and equal bilateral pedal pulses. She vomited upon arrival and still feels nauseous. She is requesting a cigarette break to “soothe her nerves”.
  2. Medications she takes include: oral hormonal contraceptives (“The Pill”), daily ibuprofen for headaches, CBD gummies for stress and relaxation
  3. Alcohol: 1-2 drink a few times per week
  1. Her Orders include:

-Morphine 3mg IV every 4 hours PRN pain

-Morphine 5 mg IV every 4 hours PRN pain

-Ibuprofen 800mg po every 6 hours     

-ondansetron (Zofran) 4mg IV every 6 hours PRN nausea/vomiting.

-ondansetron (Zofran) 4 mg PO every 6 hours PRN nausea/vomiting

-MRI of the L leg, chest xray, CBC, CMP, blood alcohol level

 

 

  1. Based on the information given about this patient, write a problem list for her: actual and potential

 

 

 

 

 

 

 

  1. Which of the assessment data above is relevant for the nurse when she is concerned about peptic ulcer development? (risk factors)

 

 

 

 

  1. Are there other medications or treatments you think would benefit this patient? If so, what medications are they? What is your rationale? (include this in your SBAR below)

 

 

 

 

  1. Are there medications or treatments that are ordered that you think might not be appropriate for this patient? What are they and what is your rationale? (Include this in your SBAR below)

 

 

 

 

  1. Write an “SBAR” for the medications and/or treatments that you would ask the physician to add to this Nursing Student’s treatment plan.

 

  1. S – Situation

 

  1. B = Background history

 

  1. A = Assessment findings to support your request

 

  1. R = Request and/or recommendation

 

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