solved: You are an RN, working 7 AM to 3 PM on a 30 bed medical unit

  

You are an RN, working 7 AM to 3 PM on a 30 bed medical unit in acommunity teaching hospital. The day staff consists of a nurse manager, 5 RNs, 4 PCTs (Patient Care Technicians), and a unit clerk.   Patient rounds with the hospitalist, nurse practitioner, physician specialists and charge nurse occur at 8 AM. A Hospitalist and Nurse Practitioner coordinate the medical care of patients admitted to this unit. A Registered Dietician (RD), Pharmacist, Case Manager, and Social Worker are assigned to this unit. You arrive and receive report for your assignment as follows:Sharon Haskins    Age: 56 years                 Weight: 84 KgAdmitting Diagnosis:         Uncontrolled Diabetes Mellitus, Renal Insufficiency              Past Hx:  Hypertension, Peripheral Arterial Disease                Diet: 1800 cal 2 Gm Na ADA diet              Medications:                                Metformin 1000 mg PO BID                                Glipizide XL 10 mg PO daily                                Lisinopril 10 mg PO daily                                Cilostazol 100 mg PO BID                                Morphine sulfate 3 mg IV q3h PRN pain left leg                Received Morphine x 2 during night with moderate relief                Fingerstick blood sugar 0600: 328                Labs:HgA1c: 11.2Hg 10.1 Hct 34.2K 5.2BUN 86Cr 2.1                Diagnostics:                                Ankle brachial index:                                                Left: 0.54                                                Right: 1.1                Consults:                                Vascular surgeon to discuss possible AV shunt placement, angioplasty left lower extremity                                Endocrinologist re: insulin therapy                                   Sophia Vergara               Age: 86 years                 Weight: 46 Kg                Admitting Diagnosis:  Hyperglycemic-hyperosmolar state (HHS)Admitted to ICU two days ago. Transferred to the Metabolic Unit last eveningPMH: Hypertension, Type 2 DMRecently migrated from Guatemala Unknown medications prior to admission                Lethargic, confusedLives alone, no next of kin on chart                Restless most of the night                Continent of urine and stool                Hg 10.7 Hct 31.2                BUN 44 Creatinine 1.6                Fasting glucose this AM 122                Discharge planning for placementAs a coordinator of patient care, nurses occupy roles in leadership. Choose one patient from this week’s scenario and identify different health care team members across the care continuum that are either involved in or impacted by care coordination. Discuss how you would establish relationships to collaborate to improve patient care outcomes in transitions of care.  Include at least 2 current references.  Health Science Science Nursing NUR MISC Share QuestionEmailCopy link Comments (0)