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vibrentthing vibrentthing
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10 years ago
Here is the scenario: Brendon B is a 24 year old patient who just came up from the OR/PACU after emergency surgery for a ruptured appendix- he had an appendectomy. The nursing assistant (UAP or unlicensed assistive personnel) helped to transfer him into the bed and she tells you she laid him flat since his blood pressure is so low. He is sleeping and arouses slowly when his name is called loudly. He has a foley to straight gravity drainage, an NG tube to low Gomco suction, and an IV of D5/ ½ NS with 20 mEQ KCL infusing at 100 ml/hour. His temperature is 100◦ F, P 104, resp 18 and BP 100/60. When he awakens, he states the pain is 10/10 and he feels nauseous.   His abdomen is distended and bowel sounds are absent.


1. Identify 3-5 nursing diagnosis for the patient and case study and prioritize them.  State what additional assessment data you will need.

2. Create goals for the client and interventions. What things will you do to help the client achieve their goals.

3. Talk about evaluation- what will make you think that the client achieved the goals? What will you do if they do not- How would you revise the plan?
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