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Seeing the Patter

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RNPRPEPBESTIE

United States

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Compléter Fill in the PatternVersion en ligne Seeing the Patter par RNPRPEPBESTIE 1 A 61 - year - old man admitted for pneumonia had been sitting up in bed earlier in the afternoon watching television and eating small amounts of dinner . During the evening rounds the nurse notices he is now lying back with his eyes closed and responding more slowly to questions . He quietly states , " I just feel really tired ? breathing feels like more work . " His oxygen saturation that had been 95% on 2 L earlier is now reading 91% . His respiratory rate has increased from 20 to 26 / min and his pulse has risen from 92 to 112 / min . An arterial blood gas drawn that morning showed a PaCO ? of 42 mmHg . A repeat value now shows 55 mmHg . He becomes increasingly drowsy as the assessment continues . These findings suggest the patient is moving toward 2 Four hours after an uncomplicated vaginal delivery , a 32 year old client had been smiling and bonding with her newborn . When the nurse returns to reassess , she appears pale and says she feels dizzy when trying to sit upright . Her blood pressure that was 118 / 70 earlier is now 92 / 56 , and her pulse has increased from 84 to 116 / min . The nurse notes her fundus , previously firm , now feels soft on palpation . Laboratory results drawn on admission showed a hemoglobin of 11 . 2 g / dL . A repeat level now reads 9 . 6 g / dL . She asks quietly if it is normal to feel this weak after delivery . These findings suggest the patient is moving toward 3 A 54 year old man arrives at the emergency department after returning from a long overseas flight . He initially reports soreness in his calf but is able to walk into triage without difficulty . While waiting , he begins to feel short of breath and describes a vague sense of uneasiness . His oxygen saturation drops from 97% at triage to 92% . His heart rate increases from 88 to 108 / min while his blood pressure remains near baseline . Laboratory testing later shows an elevated D - dimer compared with the normal reference range . He becomes reluctant to walk due to increasing breathlessness . These findings suggest the patient is moving toward 4 A 72 year old resident in a long term care facility had been participating in morning activities but is now noted to be more confused and restless . The nurse observes he keeps attempting to stand without assistance . His temperature has risen from 98 . 6°F earlier in the day to 100 . 8°F . His heart rate has increased from 86 to 104 / min , and his blood pressure is slightly lower than his usual readings . Laboratory results reveal a white blood cell count that has increased from 8 , 900 / mm³ last week to 14 , 600 / mm³ today . A urine sample appears cloudy with a strong odor . These findings suggest the patient is moving toward 5 A construction worker is brought to urgent care after feeling unwell during several hours of outdoor work in high temperatures . Earlier he reported nausea but insisted on finishing his shift . During assessment he appears flushed and slightly disoriented . His temperature is now 103 . 4°F . His pulse has increased from 96 earlier at a workplace clinic to 132 / min , and his blood pressure has decreased to 94 / 60 . Laboratory testing shows rising creatinine compared with his previous baseline results from a recent physical exam . He becomes increasingly unsteady when attempting to stand . These findings suggest the patient is moving toward 6 A 26 year old client is recovering on the orthopedic unit following surgical repair of a femur fracture . He had been talking with friends earlier and tolerating oral fluids . Later in the shift he becomes increasingly restless and complains of sudden shortness of breath . His oxygen saturation drops from 96% earlier to 89% on room air . His heart rate increases from 88 to 118 / min . The nurse notices small red pinpoint spots across his upper chest and neck . An arterial blood gas shows a PaO ? lower than earlier values . These findings suggest the patient is moving toward 7 A 35 year old client remains in the clinic waiting area after receiving an immunization . She initially reported only mild soreness at the injection site . Within several minutes she tells the nurse she feels " strange " and begins rubbing her throat . Her skin appears flushed and she develops scattered hives across her arms . Her pulse increases from 78 to 110 / min and her blood pressure decreases from 124 / 80 to 92 / 58 . She becomes increasingly anxious and states she feels like her throat is tightening . These findings suggest the patient is moving toward 8 A 68 year old client receiving anticoagulant therapy for atrial fibrillation has been resting comfortably earlier in the evening . Later he complains of a sudden severe headache and becomes increasingly confused . His blood pressure rises from 132 / 76 to 178 / 92 while his pulse decreases slightly . He vomits once during the assessment and struggles to follow commands . Laboratory results show his coagulation values higher than therapeutic range . These findings suggest the patient is moving toward 9 A 57 year old client is recovering after abdominal surgery . Earlier he reported mild discomfort but was able to rest . Several hours later he becomes increasingly restless and states he feels pressure in his lower abdomen . His blood pressure increases from 124 / 74 to 148 / 88 and his pulse rises from 82 to 102 / min . The nurse notes minimal urine output since the catheter was removed and bladder scanning shows a volume higher than expected . These findings suggest the patient is moving toward 10 A client admitted for bipolar disorder had been calm and cooperative earlier in the shift . Later the nurse notices increased pacing and rapid speech . Heart rate rises from 84 to 110 / min and the client reports sleeping less than two hours overnight . He begins making impulsive decisions and refuses meals . He becomes increasingly difficult to redirect . These findings suggest the client is moving toward

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