DE SAGUN, LEILA CAMILLE A.

BSN3Y1-1B

COURSE TASK- CU 10

GEORGE IS A 75-YEAR-OLD PATIENT WITH UROSEPSIS BEING TREATED IN THE

INTENSIVE CARE UNIT (ICU). THE NURSE ASSESSES GEORGE AND FINDS THAT
HE HAS BLOOD IN HIS URINE AND STOOL AND IS OOZING BLOOD FROM HIS
CENTRAL LINE SITE AND HIS GUMS.

WHAT DOES THE NURSE SUSPECT MAYBE OCCURRING WITH GEORGE?

 The nurse probably suspects internal bleeding. The patient having urosepsis it caused by
infection. Patients that have sepsis will most likely have internal bleeding.

WHAT MEDICATIONS SHOULD THE NURSE AVOID ADMINISTERING TO GEORGE?

 Medications that interfere with platelet function:

 beta-lactam antibiotics
 acetylsalicylic acid
 nonsteroidal anti-inflammatory drugs

THE NURSE IS MONITORING GEORGE’S VITAL SIGNS EVERY 15 MINUTES. WHAT

OTHER MONITORING IS ESSENTIAL TO INCLUDE ALONG WITH THE VITAL
SIGNS?

 The Nurse should monitor:

 Assessment of the skin and mouth- Maintaining skin integrity
 Monitoring for Imbalanced Fluid Volume

WHAT MEDICATION DOES THE NURSE ANTICIPATE INFUSING?

 The medication does the nurse should anticipate infusing are:

 Heparin infusion
 Fresh frozen plasma
  Vit K

FRED, A 43-YEAR-OLD CONSTRUCTION WORKER, HAS A HISTORY OF

HYPERTENSION. HE SMOKES TWO PACKS OF CIGARETTES A DAY, IS NERVOUS
ABOUT THE POSSIBILITY OF BEING UNEMPLOYED, AND HAS DIFFICULTY
COPING WITH STRESS. HIS CURRENT CONCERN IS CALF PAIN DURING MINIMAL
EXERCISE, WHICH DECREASE WITH REST.

What does the nurse is the hallmark symptom of peripheral arterial occlusion disease?

 The hallmark symptom of peripheral arterial occlusion disease is INTERMITTENT

CLAUDICATION, a symptom that describes muscle pain on mild exertion, classically in
the calf muscle, which occurs during exercise.

The patient is having ankle-brachial index (ABI) determined. The right posterior tibial
reading is 75 mm Hg, and the brachial systolic pressure is 150mm Hg. What would the ABI be
for this patient?

 The ABI would be 0.50

The nurse is educating Fred about managing his condition. What methods can the nurse
suggest increasing arterial blood supply?

 A planned program involving systematic lowering of the extremity below heart level
 Berger Allen exercises- an active postural exercise intended to improve the peripheral
circulation and composing of three steps
 45-degree elevation by using foot board
 90-degree dependency
 180-degree horizontal position of the legs.
 Graded extremity exercise.
 Treadmill
 Lower extremity cycling
 Aerobic upper exercise therapy
WHAT IS THE BEST METHOD FOR THE NURSE TO ASSESS FRED’S PERIPHERAL
PULSES TO OBTAIN CONSISTENT RESULTS WITH OTHER HEALTH CARE
PRACTITIONERS?

 Palpation using the fingertips to find the intensity of the pulse which is graded on a scale
of 0 to 4, 0 indicating no palpable pulse, 1 indicating a faint pulse, 2 suggesting a slightly
more diminished pulse than normal, 3 is a normal pulse, and 4 indicating a bounding
pulse.
 When palpating a peripheral pulse, assess three qualities:
 Rate
 Rhythm
 and force.

GEORGIA, A 30-YEAR-OLD WOMAN, IS DIAGNOSED AS HAVING SECONDARY

HYPERTENSION WHEN SERIAL BLOOD PRESSURE RECORDINGS 170/100 MM HG.
HER HYPERTENSION IS THE RESULT OF RENAL DYSFUNCTION.

How will Georgia’s kidney help maintain her hypertensive state?

 The kidneys remove waste products and excess water from the body and so help to
regulate blood pressure

The nurse informs Georgia that she should see her ophthalmologist. Why is it important that
Georgia adhere to follow up with an ophthalmologist?

 The two of the main causes of chronic kidney disease includes high blood pressure and
diabetes which can both lead to retinopathy. Retinopathy involves damage to the blood
vessels in the retina. It is important so it does not to lead to any eye disease.

Georgia is prescribed with Furosemide (Lasix) 20mg once every day. What does the nurse
understand about the action of Lasix?

 It is a Diuretic
  It can treat fluid retention (edema) and swelling caused by congestive heart failure, liver
disease, kidney, disease, and other medical conditions.
 It prevents your body from absorbing too much salt. This allows the salt to instead be
passed in your urine.

What health education can the nurse suggest to Georgia to reduce complications and improve
disease outcomes?

 Educate the patient about the disease process. Take medications as prescribed by the
doctor. Maximum rest. Salt restricted diet. Daily exercise as recommended.