NURS 4027

 It’s your first shift this week and you get your patient assignment. 4 patients who all have their unique medical situation:  A insulin dependant diabetic lady with a leg ulcer needing complex dressing changes BID  An elderly man admitted for urinary incontinence and suspected prostate cancer  A young man admitted for constant and consistent uncontrolled migraines  A mid aged woman with chronic renal disease

 Lady with diabetic leg ulcer  Elderly man with prostate cancer  Young man with migraine  Middle aged lady with renal failure

 It’s 10 am and you’re suppose to go for coffee. All of a sudden, an emergency alarm sounds from room 3 and you can hear a patient yelling for a nurse. Just as you start to run toward room 3, your collegue and friend who’s caring for a patient in room 8 yells, “Oh my God! Sandra get in here. I need help!” Where do you go?

 After the commotion settles, you’re working with a post-op knee replacement patient. The patient complains of a lot of pain in the operative site and asks you to go get some pain med. He says, “bring me some of the morphine. Last night nurse Kelly brought me that and it works a lot better”. You go to the chart and notice that he’s not ordered any morphine but infact, nurse Kelly did give some. What do you do?

 You are interviewing a patient who has been brought in by security. They found him wandering the parking lot without shoes in the snow and rambling about God. As you’re asking your questions, he jumps out of his chair and pulls a knife out of his coat and says, “I’m going to kill you bitch.” You....

 The doctor orders Diazepam and Ativan IM but you’re thinking, there’s no way I’m going to be able to safely give this. Police and security are holding him down and yelling at you, “give the damn shot.” What is your next step?

 Your patient is on a continuous nitroglycerine drip to maintain his blood pressure. He has an art line in place. You notice on the monitor that the BP reading has dramatically changed in the last 6 or 7 seconds. It’s now reading 56/45. What do you do?

 After making sure all the connections are OK, you zero the art line and the blood pressure is registering again on the monitor properly. After another few hours, you start to notice that his BP is decreasing.  140/90  119/82  102/79  90/60  What are your next steps?

 You have just successfully delivered your first baby (the doctor didn’t make it in time). It’s a healthy baby girl weighing 7 lbs, 1 oz. Mom and Dad are delighted. As Mom passes the baby to Dad for the first time, blood starts to gush from her vagina and she faintly says, “What’s happening to me? I feel awful.” What do you do?

 You’re assigned to care for a gentleman with acute schizophrenia. You entre the breakfast area and notice that he’s not eating his rice crispies but counting them. What is your first response with him?

 He tells you that if you don’t leave him alone right now, he’s going to kill you. He holds up his spoon in a threatening manner and it scares you. What is your next move?

 A 13 year old girl presents to you in the foyer of the health unit. She’s obviously been crying and she says to you, “I think I’m pregnant. I want an abortion but I can’t tell my parents. Can you help me find a doctor who will give me an abortion?” What is your first move?

 You’re working with an older man who has presented to your clinic with chest pain. You’re not sure but you think he’s having the big one. You draw blood and ask the secretary who’s working there where the lab is so that you can check his Troponin and CK for cardiac MI markers. The secretary responds with, “I dunno. The nurse usually spins the blood”. What do you do?