1.A patient admitted through the emergency department this morning requires assistance to reposition in bed. You note that she has a pressure injury (grade 2) on her sacrum that was not mentioned when handover was given. What actions should you take?
2.After morning handover of your 4 patients you have reviewed the charts and have entered the room your patients. It is 0730 and breakfast is usually delivered at 0740. Before you can introduce yourself, the following demands on your time occur concurrently:
Patient 1 Mrs Peterson is asking for help to the ensuite to use her bowels. You know Mrs Peterson had a stroke 2 weeks ago and has a moderate left hemiplegia and needs assistance to move. She is classified as a high falls risk.
Patient 2 Mrs Walters is going to theatre at 0800 and is not yet ready.
Patient 3 Mr Young is nil by mouth and has IV therapy running at 167mls per hour. The infusion pump alarm is sounding and the IV flask appears to be close to empty, Mr Young is also complaining of pain.
Patient 4 Mr Stavropoulous has been admitted for acute asthma. He is due for ventlin and prednisolone at 0800. His BGL at 0700 was 4.6mmol/l.
The ANUM is searching for Mrs Walters pre-operative checklist and want to know if you have seen it. In what order would you address these requests? Describe your rationale for each decision
A colleague is handing over her patients to you at 0715 and you are reviewing the medication chart. The patient has a past history of aortic valve replacement 2 years ago and is on warfarin. She also has arthritis and will require an arthroscopy later this week. She is due to start Clexane today to replace the warfarin pre-op. You note that she has been given ibuprofen and aspirin overnight for pain as nurse initiated medication. You think that NSAID’s and Aspirin are contraindicated for patients on warfarin. How will you manage this situation? Your colleague will be going home after handover