ROLE Ch.9 Take home quiz: Critical Thinking
Must be typed and completed by the student alone (no assistance from others).
1. For the following scenarios, what are the identified nursing diagnoses or problem statements?
a.An 8-year-old, newly diagnosed as an insulin-dependent diabetic, will be going home.
b.A 72-year-old with COPD, recovering from pneumonia, currently receiving 2 L of oxygen per nasal cannula, with a pulse oximeter reading between 90% and 94%. The patient becomes dyspneic and tachycardic while getting up to use the bathroom and returns to baseline after 10 minutes of rest.
c.A 24-year-old woman in her third trimester of pregnancy with panedema and blood pressure of 150/88 mm Hg and 160/99 mm Hg on two occasions 4 hours apart. She complains of not being able to get her rings off and of a headache.
d.A newborn is in the first 24 hours of birth and before going home.
2. For the following situations, what assessment questions would you need to ask?
a.You complete an 0700 blood sugar reading on your patient and get a level of 265.
b.You get a blood pressure reading of 190/110 mm Hg on an individual who is attending a wellness fair.
c.The health care aide reports that a patient, admitted to your unit to rule out GI bleed, just had a 100-mL emesis.
d.You walk into a room to do an assessment on your patient and find him sitting on the floor next to the bed.
e.After waking your patient you assess your patient’s lungs and find fine crackles bilaterally in the bases.
f.You are assessing a 6-year-old patient who has just had a full liquid dinner, and you note that the patient is blue around the lips.
3. You are scheduled to discharge a patient home. The patient has an ongoing problem identified as “decreased tissue perfusion, peripheral r/t vascular changes of diabetes, and as evidenced by pulse per Doppler only, complaint of cold feet, pain, numbness, and tingling to the toes. The patient has had a femoral-popliteal bypass and now has 1+ pedal pulses bilaterally.” Design a discharge plan of care, including the necessary teaching that will need to be done.
4. From a clinical experience as a student or as an LPN, describe a situation that you believe could have been solved in a better way if sound reasoning had been used instead of emotions or feelings. How might the situation have been different, in relationship to outcomes, if rational thought had been used?
5. In response to a call light, you enter a room to find a 68-year-old patient on the floor next to the bed. The patient is in his first day post-op surgical resection of the colon, had slept all night without complaint, and the report states that the patient had not been agitated or confused but doing well.
a.What assumptions, if any, can you make about this situation?
b.What are the questions that you need to ask?