Case Study Field Nursing 1a You are working as a disaster relief nurse in Haiti and come across a male

patient who appears to be mid 40s. Through an interpreter, he is complaining of stomach pain for 24 hours. He is transported into your tent and placed on the stretcher. hat assessment would you perform and why! hat other data would you want to collect! Case Study Field Nursing 1b "pon assessment you find the following# $kin pink, sl diaphoretic %&0 '( )ausea with brownish green emesis appro' 2* m+s (0 minutes ago +ungs clear bilaterally , -- 20 shallow %cti.e -/0 in all e'tremities %bd distended and tender to palpation , patient guarding abdomen 1eripheral circulation to lower e'tremities )+ 2ased on this information , what would you need to further assess! Case Study Field Nursing 1c "pon further assessment of the abd , you note that there are absent bowel sounds in the lower left and right abd 3uadrant and hyperacti.e bowel sounds in the upper 3uadrants. hat do you think is happening with this patient! you think is needed! Case Study Field Nursing 1d %fter e.aluating your patient, you call the surgeon using the $2%-. Telephone orders recei.ed are# insert )4 tube, notify anesthesia, prep patient for surgery , how would you write this order! Your role is to insert the )4 tube. techni3ues will you use! hat e3uipment, patient education, and hat would you e'pect the hat medical inter.ention would

hy are you inserting an )4 tube into this patient! outcome to be after insertion! Case Study Field Nursing 1e

The surgeon wants to operate to remo.e the bowel obstruction. hat other nursing inter.entions would you need to perform to prepare this patient for surgery! $ince you may not ha.e a.ailable medical e3uipment for preparation, think of alternati.e ways to prepare this patient for surgery 5skin prep6sha.e6time7 out6marking site, etc8.

Case Study Field Nursing 1f %fter surgery under general anesthesia, the patient returns to you for post7op care. You assess .6s which re.eals 21 9226:2 1 ;; - 9<. 1atient lethargic but easy to arouse. %&/ '(. $kin pink. )4 tube to low cont suction draining brownish green secretions, small amount in suction tube. +ungs cl bilaterally. =sg to abd >6=6?. %bsent 2$ @ 4 3uads. %bd soft, non7distended. ?A 0.BC )$ at 92*m+6hr .ia gra.ity. 1ain le.el (690 controlled with 0orphine $ulfate ?A. %ble to mo.e all e'tremities. %re you comfortable with this assessment! Case Study Field Nursing 1g Two hours later, you notice the patient to become more agitated but %&/'(, pain ;690 in abd, abd distended and tender, dsg to abd with bright red drainage saturating pad. hat would you do! hy! Case Study Field Nursing 1h A6$ re.eal , 21 ;;6*0 1 922 --24. 1t continues to become increasingly agitated. You call the surgeon to e.aluate. The surgeon orders an H&H 5write this telephone order8. The surgeon decides to take the patient back to the /-. "pon reentry into the abd wound, there is noted to be bleeding into the abd ca.ity at an estimate of 9000m+. The surgeon repairs the bleed and the patient is returned to you since there is no ?>" or 1%>". hat are you going to assess! hy! You obtain the H&H from the computer and report the results to the surgeon. The surgeon also orders 2 units 1-2> to infuse as soon as they become a.ailable. hat nursing inter.entions would you need to perform to prepare the patient for a blood transfusion! hat type of blood would you e'pect to use since we do not know the patients blood type! hat would the nurse monitor before and during the blood transfusion! Case Study Field Nursing 1i %fter starting the blood transfusion, the patient de.elops chest pain and dyspnea , what are nursing inter.entions and why! Case Study Field Nursing 1j Two days later the patient is stable, 2$ present passing flatus, )4 remo.ed, pt //2 amb with assist, and on the road to reco.ery. hy!