Evolve Case Study Management of Surgical Unit – Flashcards
Unlock all answers in this set
Unlock answersquestion
The charge nurse for the previous night shift is giving verbal report to Ms. Hatch and the oncoming staff nurses. During the report, one of the UAPs interrupts to state that a client is vomiting. How should Ms. Hatch respond?
answer
Request that a night shift nurse staff RN go to the room to evaluate the situation
question
After the UAP leaves the area, the night charge nurse states, ¨that UAP is incompetent. She can't figure out anything on her own.¨ As the day shift charge nurse, how should Ms. Hatch respond?
answer
Your concern needs to be addressed with the unit manager.
question
After receiving report, Ms. Hatch makes client care assignments for the nursing staff. Which client can be assigned to a PN rather than an RN?
answer
A 2 day postop client with an abdominal incision and JP drain
question
Which additional client should be assigned to the same PN?
answer
Experiencing hypoactive bowel sounds 2 days post op after colon resection (expected finding)
question
Ms. Hatch learns that one of the day shift nurses will be 30 minutes late. How should the care assignments be managed until the nurse arrives?
answer
Assign an additional client to each of the day shift staff nurses
question
When making initial rounds, the charge nurse should see which case first?
answer
A postop client with a trach who has signs of a tracheoesophageal fistula
question
Before starting rounds, Ms. Hatch learns from the PN that the client with a history of syncope is threatening to get out of bed alone and go to the restroom. At the same time, the client with the possible fistula has an oxygen level of 80%. Besides the charge nurse and PN, a UAP is available. How should the charge nurse respond this information?
answer
Assess the client with the possible fistula while the PN assists the other client to the restroom
question
Once the immediate priorities are managed, Ms. Hatch assesses the client with continuous bladder irrigation and notes that the drainage bag is full, but there is no urine in the return tubing. The client's bladder is distended and reports having serve bladder pain. How should Ms. Hatch delegate tasks to respond to this situation?
answer
While the RN irrigates the tubing, the UAP can empty the urine drainage bag
question
Continuing to make rounds, Ms. Hatch observes that the pre-op client with prolonged PTT is lethargic with pale, diaphoretic skin. BP is 70/40. When assisting the nurse to care for this client, the UAP can be assigned which task?
answer
Position the client as directed
question
The HCP prescribes immediate transfusion of 2 units of PRBC. Which task can be delegated to the UAP?
answer
Obtain vital signs and report to nurse before transfusion
question
A female client is schedule for surgery in 4 hours. The breakfast trays arrive on the unit with a tray for the pre-op patient. The primary nurse notes that there is no prescription regarding NPO status. Which action should the nurse implement?
answer
Hold the tray and contact the surgeon for clarification
question
After the meal situation is resolved, the client reports to the primary nurse that she feels uneasy about the procedure. What is the best initial response by the nurse?
answer
Tell me what is making you feel uneasy.
question
Which finding in a pre-op client warrants an immediate change in care assignments so that an RN assumes care rather than a PN?
answer
Dyspnea and a cough that produces frothy, white sputum
question
Since the RN will assume care of this additional patient, Ms. Hatch selects another client for the PN. Which client?
answer
Needing an indwelling catheter inserted after surgery
question
The PN is reassigned to care for the pre-op client and obtains the supplies necessary for a catheter. The PN tells Ms. Hatch that she has inserted catheters into females, but not males. What actions should the charge nurse implement?
answer
Go with the PN to supervise the procedure
question
Which task may be delegated to the UAP?
answer
Apply TED stockings
question
The primary nurse enters the client's room and observes that his TED stockings are down below his knees. The UAP states, ¨I know I applied them correctly, he must have pulled them down while I was getting him a clean gown.¨ How should the nurse respond?
answer
¨Let's work together to reapply the stockings while I talk to the client about the purpose of TEDs¨
question
Ms. Hatch overhears the primary nurse assign the UAP to take the vital signs of the preop client and report back any problems. How should Ms. Hatch respond?
answer
Advise the nurse of the responsibility to review all vital signs
question
What approach should Ms. Hatch use when introducing a new change?
answer
Explain the need to implement this change in policy
question
After introducing a new change, one nurse expresses concern. How should Ms. Hatch respond?
answer
I will bring your concern to the attention of the wound care team
question
Ms. Hatch observes a post-op client with a cold pack. The skin under the pack is pale and the client reports the cold pack has been in place for over 4 hours. After removing the pack, what action should Ms. Hatch take next?
answer
Consult with the nurse
question
How should Ms. Hatch respond to the nurse who blames the problem on the UAP?
answer
You are responsible for monitoring tasks delegated to the UAP
question
Both sides are angry. What action should Ms. Hatch implement to ad in the resolution of the conflict between them?
answer
Encourage both to practice effective communication with on another
question
The post-op client with which condition is most safe to transfer to the skilled care unit?
answer
Knee surgery requiring continuous use of passive ROM therapy
question
How should the charge nurse best utilize available staff during the process of transferring one client to the skilled care unit while admitting another client awaiting emergency surgery?
answer
The UAP can assist the PN in transferring the client to the skilled care unit while the RN admits the client awaiting surgery
