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Case Solu�ons For Priori�es in Cri�cal Care Nursing 9e Linda Urden, Kathleen Stacy, Mary Lough (100% Original Verified, A+ Grade) (Check T able Of Contect) 1 / 4
Table Of Content Case Study 1 Answer Case Study 2 Answer Case Study 3 Answer Case Study 4 Answer Case Study 5 Answer Case Study 6 Answer Case Study 7 Answer Case Study 8 Answer Case Study 9 Answer Case Study 10 Answer Case Solutions Manual Part 1 2 / 4
Copyright © 2024 by Elsevier Inc. All rights reserved.
Urden: Priorities in Critical Care Nursing, 9
th Edition Case Study 1
Answer(s): In order to meet established standards of care and legally competent nursing care, the nurse would first initiate call to surgeon in order to share concerns regarding possible delirium.
Rationales: The nurse has obligations to meet both the standards of nursing and legal standards.In this case the client has been demonstrating signs of delirium that can be a result of the low sodium confirmed by the electrolyte assessment results. A normal blood sodium level is between 135 and 145 milliequivalents per liter (mEq/L). Hyponatremia occurs when the sodium in your blood falls below 135 mEq/L. The client’s surgeon needs to be immediately notified of the assessment data that suggests delirium so that it can be corrected before it becomes a chronic health issue. While reassessing vital signs is appropriate as this nurse assumes care of the client to assure continued awareness of the client’s health status, it doesn’t have the priority that treating possible delirium has regarding the care of the client. While it is possible that after discussing the client focused concerns, the surgeon may order a reassessment of the client’s electrolytes to determine the current status of the client’s sodium level but again this doesn’t have the priority that treating possible delirium has regarding the care of the client. Correcting the sodium deficient would be an intervention in addressing the possibility of a possibly diagnosis of delirium.
Cognitive Skill: Take Action
Reference: Urden, L.D., Stacy, K.M., Lough, M.E. (2024). Chapter 2: Legal Issues, Priorities in Critical Care Nursing, 9e. St. Louis: Elsevier. 3 / 4
Copyright © 2024 by Elsevier Inc. All rights reserved.
Urden: Priorities in Critical Care Nursing, 9
th Edition Case Study 2
Answer(s):
Patient is a 78-year-old admitted for an elective total left knee arthroplasty (TKA). The client tolerated the surgery well and is now being considered for discharge. The client lives with an adult child in a very rural community. Prior to the surgery the client had been independent in preforming activities of daily living (ADLs). The client has a history of hypertension, managed with losartan 50 mg orally once a day and hydrochlorothiazide 25 mg orally once a day and is diagnosed with stage 3A asymptomatic kidney disease. During hospitalization the client experienced hyponatremia which contributed to intermittent delirium. While the client has been oriented to person, time, situation and place since sodium level has returned to within the normal range, both client and family have expressed concerns that the cognitive signs of delirium may reoccur. They also expressed concern of an increased risk for falls related to the temporary physical limits associated with the TKA.
Rationales: The client has several pre-existing issues that present a challenge to effective transition to home and for minimizing rehospitalization associated with acute health issue. Age, chronic illness, changes in baseline function, a history of cognitive impairment, and rural living are all special considerations for an effective transition. In addition, the client’s medication history presents with an increased risk of falls related to the possible side effects of both losartan and hydrochlorothiazide as well as a history of hyponatremia. A history of medical issues, in this case delirium and hyponatremia, increase the risk for development of these issues again. The concerns expressed related to falls and cognitive function must be addressed before discharge and monitor for during recovery.
Cognitive Skill: Recognize Cues
Reference: Urden, L.D., Stacy, K.M., Lough, M.E. (2024). Chapter 3: Facilitating Care Transition, Priorities in Critical Care Nursing, 9e. St. Louis: Elsevier.
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