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The nurse is caring for a patient with dark skin who is having gastrointestinal bleedin How can the nurse determine from skin co change that shock may be present? a.) The skin is ashen gray and dull b. The skin is dusky blue c. The skin is reddish pink d. The skin is whitish pink
Client: African-American female, 35 yo Diagnosis: Infection secondary to appendectomy History: Hypertension, diabetes mellitus type 2, right toe ulcer Ms. Nina Jackson is a 35-year-old African-American female who was admitted to the medical/surgical unit with a diagnosis of infection secondary to appendectomy. The client had an appendectomy 1 week ago. The admitting nurse noted that the area around the abdominal incision is warm to touch and slightly red. Pt rated pain scale of 0 to 10. Pt has a history of HTN and DM, type 2. She takes insulin to keep her BG level stable and adheres to a diabetic diet. She has antoe ulcer that has not healed for 6 weeks. The admitting nurse noted that her @ toe is swollen and contains purulent exudates Л. Pt stated upon admission, I feel weak in my knees and this toe ulcer is driving me crazy. I can barely feel my foot now and sometimes the pain is unbearable! Pt rated toe pain at 10 on a scale of 0 to 10. She is Full Code. She is allergic to sulfa and eggs. She is scheduled for a chest x-ray because of a recent positive (+) Mantoux. The clinician ordered these medications for her: 0.9% NS, Ⅳ running at 125 mL/hr to maintain hydration and fluid balance, enalapril 5 mg PO BID to stabilize high blood pressure, Extra Strength Tylenol 500 mg PRN q4-6 hr to relieve pain, 1 multivitamin tablet PO daily to supplement vitamin and mineral intake, NPH insulin subcut per insulin protocol to regulate blood sugar, and cefazolin 2 g in Ds W 50 mL IVPB q8h to fight the infection. She needs to be scheduled for CBCLab. She also needs to have a blood glucose capillary saple TID AC. Her VS and O2 sats should be checked q 4h and she should be weighed daily. The abdominal incision site and toe ulcer, along with pain level should be assessed. Contact precautions should be taken. She has bathroom privileges with assist of 1. A wound consult has been ordered for both the incision site and the toe ulcer. She also needs a focused respiratory assessment because of the (+) Mantoux. Mrs. Jackson is married and has two sonS, and 11 years old. She is a pleasant woman. She works as a account and loves playing video games with her sons. She is a Baptist and active in her church. 9
chosocial perspective, what is Mrs. Jackson likely to be most concerned 2. From a psy with regard to her illness? 3. What actions could the nurse plan to take to responds to Mrs. Jacksons psychosocial needs?
1. From a physiological perspective, what is Mrs. Jackson likely to be most concerned with regard to her illness?
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Answer #1

1. Skill colour ashen grey and dull

2. Based on her psycho social perspective she is concerned about her hospitalizations and the complications of her toe which may leads her to not be active, the bond between her children would be hindered if she is positive with tuberculosis. She has to also take contact precautions and have the bathroom assistants. She is DM 2 and the wound healing process is very slow. Financially she has to handle for her treatment.

3. The nurse can assess the patient condition completely and consult a social worker who can help her with some bathroom assistance, the home care availability facilities with the less cost to support Mrs. Jackson, available insurance plans to aid her financially.

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