Critical Thinking Activity

Critical Thinking Activity

1. Pt name: S.C.

Pt was admitted with severe head pain on 9/13/11. Pt was in the hospital on 9/6/11. 55 y.o. female. I did not see previous tests, but notes described four cerebral aneurysms. Pt has subarachnoid hemorrhage. Past hx: of depression, renal failure, HTN. Past surgical hx: tubal ligation, torn rotator cuff. No IV or telemetry connected. Pt intake is 240 no Output documented. Semi-solid BM on 9/14/11. Smokes 1 pack cigarettes/day, uses marijuana 1/week, drinks 2 oz alcohol 4xweek. Lungs clear bilaterally, even, and unlabored. Regualar diet. Fall risk 75 morse scale. Unemployed, Single. O2 96% room air. Diagnostic angiogram with coiling schedule for 9/15/11. No IV.

Vitals: BP: 117/82, R: 18, T: 99.6, P: 86 apical: 86. O2 sat 96%

Intake: 240ml Output: no elimination.

2.

Labs: Glucose: 123 (70-100), K+: 3.0 (3.5-5.0), BUN: 18 (6-24), Ca 8.9 (8.4-10.5),

Sodium: 139 (135-145), Cl: 105 (98-108). HDL 30 (<40 high risk).

Complications: HTN, SAH, artherscerosis.

Meds and allergies: Codeine

Lopressor: Thiazide-diuretic prevent Na absorption, regulates BP.

Novolog: fast-acting insulin for control of Blood sugar.

Glutose: glucose supplement for low BS.

Zofran: serotonin 5-HT3 receptor blocker. Help prevent N/V

Proventil: bronchodilator. increases airflow to lungs

Phenergan: anithistamine, tx motion sickness, N/V

Lyrica: anti-epileptic/ anit-convulsant tx of pain r/t to diabetic neuropathy

Nimodipine Ca+ channel blocker prevent damage to brain r/t lack of blood flow increases blood flow.

Colace: stool softener

Xanax: Benzodiazipine tx anxiety

Zocor: HMG CoA reductase inhibitor decreases LDL, increases HDL.

Dilaudid: Opioid moderate to severe pain.

Norco: narcotic pain reliever Pain relief

Apresoline: valodilator tx of HTN

Duragesic: Opioid analgesic

Medication Ref.

Taber's Medical Dictionary via IPOD touch. Venes D(Eds.). (2009). Taber's encyclopedic medical dicitionary (21st ed.),; FA.Davis.Ipod touch

3.

The nursing priorities for my patient are Pain management, and Safety.

Pain: r/t physical disability. pt states pain is a result of aneurysms, and cerebral hemorrhage. She stated her pain as 8 (0-10). This was determined from ax pt.

Safety: Injury r/t sensory or motor deficits. Her medications: xanax, Phenergan, Apresoline all have S/E of dizziness or