Concept Map Christopher Parrish PDF

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clinical worksheets for virtual clinical on Christopher Parrish...

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CONCEPT MAP WORKSHEET [Christopher Parrish] [Student] [11/1/20]

DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) He has cystic fibrosis and cystic fibrosis causes thick mucus in the lungs and pancreas. The thick mucus in the lungs will make it hard for him to breathe and cause wheezing. The thick mucus in the pancreas restricts the digestive enzymes to go to the intestine to break down food and absorb nutrients.

DIAGNOSTIC TESTS (REASON FOR TEST AND RESULTS) A fecal lipid test can identify fat malabsorption and the need for pancreatic enzyme supplementation. His results would show fat malabsorption and the need for pancreatic enzyme supplementation. Liver enzyme test results may show hepatic insufficiency. His result would show hepatic insufficiency. An albumin level test would test the level of albumin in his system and it would be decreased.

PATIENT INFORMATION

Christopher Parrish Age: 18 years old Gender: Male Race: white History of cystic fibrosis

ANTICIPATED PHYSICAL FINDINGS Wheezy respirations Dyspnea Tachypnea Barrel chest Cyanosis Clubbing of the fingers and toes Thin extremiti4es Sallow skin with poor turgor Rectal prolapse Pancreatitis Failure to thrive Hyperresonance or percussion

ANTICIPATED NURSING INTERVENTIONS Perform vital signs and assessments, Start tube pump. Educate on nutrition Administer pancreatic enzymes with meals and snacks. Provide a well-balanced, high protein, high calorie diet with adequate fat. Assess weight daily.

CONCEPT MAP WORKSHEET [Christopher Parrish] [Student] [11/1/20]

vSim ISBAR ACTIVITY

STUDENT WORKSHEET

INTRODUCTION: Your name, position (RN), unit you are working on

My name is _______ and I am a nursing student on the medical surgical unit 2315.

SITUATION: Patient’s name, age, specific reason for visit

Christopher Parrish 18 years old who is seen in the hospital for cystic fibrosis.

BACKGROUND:

Christopher Parrish has cystic fibrosis and was admitted to the hospital today at 1900. Current orders are to perform vital signs every 4 hours, daily input and output, and weight. Insert and start the tube feeding pump. Administer pancreatic enzymes orally before the tube feeding, multi-vitamin with snacks. Test blood glucose. Give patient education on proper nutrition.

Patient’s primary diagnosis, date of admission, current orders for patient

ASSESSMENT: Current pertinent assessment data using head to toe approach, pertinent diagnostics, vital signs

Head to toe assessment Patient is alert and oriented x3 Heart: strong S1 and S2, regular without mummers Capillary refill: time is less than 2 seconds Lungs: clear and equal and bilaterally, no sounds of crackling in all four quadrants Skin: normal elasticity, color normal, no sweating GI: bowel tones are heard in all quadrants GU: bowel movements regular and solid Vital Signs: Temperature: 99 degrees F Pulse: 85 beats per minute, regular, strong Oxygen: 96 SpO2, Pulse 84 Blood pressure: 120/72 mmHG Respiration: 12 breaths per minute, chest is moving equally Pertinent diagnostics: Creatine: 0.3 Albumin: 3 g/dL Protein: 5.8 g/dL Vitamin D: 10 ng/mL

CONCEPT MAP WORKSHEET [Christopher Parrish] [Student] [11/1/20]

Radiology: x-ray of the thorax shows a nasogastric tube correctly placed in the stomach Intake and outtake: water 50 mL at 2300 Check nasogastric tube: is consistent with documentation in the health record Pain assessment: no pain Glucose 95 mg/dL Administered medications: 5 tablet oral dose of pancrelipase, ordered rate of fluid nutrition 1.5 kCal/mL was 60 mL/hour RECOMMENDATION: Any orders or recommendations you may have for this patient

Check vitals every 4 hours, check tube feeding and make sure patient isn’t aspirating, administer 5 tablet oral dose of pancrelipase or as ordered, another order of tube feeding every 8 hours of fluid nutrition 1.5 kCal/mL was 60 mL/hour or as ordered, administer vitamin supplement as indicated/ordered, patient will get a AP X-ray next shift,

CONCEPT MAP WORKSHEET [Christopher Parrish] [Student] [11/1/20]

PATIENT EDUCATION WORKSHEET NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE MEDICATION: Pancrelipase CLASSIFICATION: Therapeutic class- digestive enzymes Pharmacologic class-pancreatic enzyme PROTOTYPE: Pancrealipase SAFE DOSE OR DOSE RANGE, SAFE ROUTE 500 lipase units/kg PO per meal to a maximum of 2,500 lipase units/kg per meal (or 10,000 lipase units/kg per day) or less than 4,000 lipase units/g fat ingested per day. PURPOSE FOR TAKING THIS MED Replaces endogenous exocrine pancreatic enzymes and aids digestion of starches, fats, and proteins. PATIENT EDUCATION WHILE TAKING THIS MEDICATION Instruct patient to take drug before or with meals and snacks, but always with food and generous amounts of liquid. Advise patient not to crush or chew capsules; retention of a capsule in the mouth before swallowing may cause mucosal irritation and stomatitis. Capsules containing enteric-coated microspheres may be opened and sprinkled on a small quantity of soft food at room temperature. Stress importance of swallowing immediately, without chewing, and following with glass of water or juice. Tell patient to store drug in airtight container at room temperature. Instruct patient not to change brands without consulting prescriber. Advise patient to report unusual or severe stomach area pain, bloating, trouble passing stool, nausea, vomiting, or diarrhea, which may indicate fibrosing colonopathy....