SCENARIO #1

Patient is on CONTACT ISOLATION for Clostridium difficile bacteria in stool (see text page 125-132). Patient complains of diarrhea and weakness. He/she is on bedrest and needs the bedpan frequently. Make sure he/she has access to the call light and provide adequate privacy.

  1. Help patient with the bedpan. Be sure to cover the pan when removing it and give a towelette to the patient. NACES #11; TEXT PAGES 428-429
  2. Partial bath: face, arm, underarm. NACES #24; TEXT PAGES 350-351
  3. Provide hand and fingernail care. NACES #21; TEXT PAGES 367-368
  4. Give the patient a back massage. TEXT PAGE 352
  5. Make an occupied bed. NACES #19; TEXT PAGES 282-284
  6. Change the patient’s gown. TEXT PAGE 371-372
  7. Take vital signs and record.

SCENARIO #2

Patient is on CONTACT ISOLATION for MRSA in urine and blood (see text pages 125-132). He/she needs a nasal swab, urine specimen and stool specimen sent to the lab. He also is ready for a shower and a.m. care.

  1. Assist patient to ambulate to the shower. NACES #6; TEXT PAGE 213
  2. Obtain stool specimen from hat in bathroom. TEXT PAGES 408-411 & 433
  3. Obtain urine specimen from urine hat and measure output. NACES #10; TEXT PAGES 408-411 & 430-431
  4. Obtain nasal swab for lab specimen.
  5. Make an unoccupied bed. TEXT PAGE 280-282
  6. Assist with oral hygiene. NACES #3; TEXT PAGES 338-339
  7. Provide hand and fingernail care. NACES #21; TEXT PAGES 367-368
  8. Assist patient to get dressed. Be sure to offer 2 choices of clothing. NACES #4; TEXT PAGE 359

SCENARIO #3

Patient is comatose and requires oral care, a full bed bath, nail care, and complete linen change. The patient has a foley catheter that is full and needs emptying. Be sure to provide perineal care, catheter care, and measure urine output. Also note: it is important that you talk to your patient and explain what you are going to do, even though the patient is in a non-responsive state.

  1. Provide oral care. NACES #3; TEXT PAGE 327-328 & 341-342
  2. Complete bed bath, including foot care. TEXT PAGES 347-350
  3. Provide perineal care and catheter care. NACES #12 & 13; TEXT PAGES 342-343 & 434
  4. Empty catheter drainage bag and measure urine. NACES #10; TEXT PAGE 435
  5. Make an occupied bed. NACES #19; TEXT PAGES 282-284

SCENARIO #4

Patient is on CONTACT ISOLATION for Methicillin-resistant Staphylococcusaureus (MRSA) infection of a right leg wound (see text page 125-132). He/she is weak on the right side. He/she wears dentures. He/she has been in the emergency department since 2 a.m. and needs to be admitted to your unit. He/she will need vitals, height & weight taken and recorded. Be sure to disinfect the scale after weighing your patient. A urine and stool specimen will need to be sent to the lab (check commode). This patient must have intake and output accurately measured and recorded.

  1. Prepare stool specimen for the lab. Document stool. TEXT PAGE 408-411 & 433
  2. Measure and record urine output. Prepare urine specimen for the lab. NACES #10; TEXT PAGES 396-398; 412-413; 430-431
  3. Take vital signs, height and weight. VITAL SIGNS: NACES # 15 & 16; TEXT PAGES 314-317 HEIGHT AND WEIGHT: NACES #2; TEXT PAGES 303 & 317-318Accurately record.
  4. Assist patient to wash face and strong arm/underarm. NACES #24; TEXT PAGES 350-351
  5. Clean dentures and assist with oral care. NACES #3; TEXT PAGES 338-340 AND NACES #7; TEXT PAGES 340-341
  6. Assist patient to dress, offering two choices of clothing.NACES #4; TEXT PAGE 359 & 369-371
  7. Offer fluids and a small meal. Assist the patient to eat (he/she is unable to eat without being fed). NACES #22; TEXT PAGES 390-391
  8. Wash patient’s hands after meal. Assist with washing face.
  9. Accurately record fluid intake and percentage of meal taken.TEXT PAGES 396-398