Sam Knight PEDIATRICS

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Sam Knight Room 301 Sam Knight, A 17-year-old male, who sustained a head injury while playing football. He was noted to have concussion symptoms upon examination by the team physician and removed fr ... om the game. Sam was admitted 2 hours ago for observation. He has been alert and oriented x 4, complains of a slight headache, but no visual disturbances or nausea. An IV of LR is infusing at 125 ml/hour to left forearm. Upon entering the room, the nurse notes the following: Sam is talking, but slurring his words, Pupils are dilated, Sam states his headache is getting “worse” and is complaining of nausea. Vital signs: B/P 110/60. HR78. T98.9, RR 14 and irregularYou responded correctly to 5 out of 6 evaluations: Category Your response Explanation Educational Needs  Increased acuity Possible subdural hematoma and concussion will require educational directions. Health  Increased acuity Patient is talking but slurring his words. Pupils are dilated ... states his headache is getting “worse” and is complaining of nausea. LOC  Increased acuity Patient is talking but slurring his words. Pupils are dilated. Pain  Normal acuity Patient states his headache is getting “worse”. Psych  Normal acuity Status assessment reports no indication of increased Psychiatric acuity Safety  Increased acuity Patient has IV of LR infusing at 125 ml/hour to left forearm making him a fall risk. Continue... Sam Knight Room 301 Sam Knight, A 17-year-old male, who sustained a head injury while playing football. He was noted to have concussion symptoms upon examination by the team physician and removed from the game. Sam was admitted 2 hours ago for observation. He has been alert and oriented x 4, complains of a slight headache, but no visual disturbances or nausea. An IV of LR is infusing at 125 ml/hour to left forearm. Upon entering the room, the nurse notes the following: Sam is talking, but slurring his words, Pupils are dilated, Sam states his headache is getting “worse” and is complaining of nausea. Vital signs: B/P 110/60. HR78. T98.9, RR 14 and irregular.PEDIATRICS PAUSE You correctly diagnosed 5 out of 6 options: Physiological Description Your Response Explanation Acute Pain  True Status assessment reports headache is getting "worse". Risk for aspiration  False Patient with neurological deficit should not have anything to eat or drink. Tissue Perfusion, altered  False Status assessment reports no indication of Tissue Perfusion, altered Urinary Retention, high risk for  False Status assessment reports no indication of Urinary Retention, high risk for Safety Description Your Response Explanation Deficient Knowledge  True Status assessment reports signs of neurological deficit (slurring of words, pupils dilated, headache getting worse). Risk for injury  True Status assessment reports signs of neurological deficit and has an IV line. Continue... Sam Knight A 17-year-old male, who sustained a head injury while playing football. He was noted to have concussion symptoms upon examination by the team physician and removed from the game. Sam was admitted 2 hours ago for observation. He has been alert and oriented x 4, complains of a slight headache, but no visual disturbances or nausea. An IV of LR is infusing at 125 ml/hour to left forearm. Upon entering the room, the nurse notes the following: Sam is talking, but slurring his words, Pupils are dilated, Sam states his headache is getting “worse” and is complaining of nausea. Vital signs: B/P 110/60. HR78. T98.9, RR 14 and irregular.PEDIATRICS PAUSE You correctly ordered 5 out of 5 actions: Your order Correct the room, you notice the overhead lights are bright and bed alarm settings are [Show More]

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