{"id":24568,"date":"2021-01-12T04:59:09","date_gmt":"2021-01-12T04:59:09","guid":{"rendered":"http:\/\/onlineclassesguru.com\/?p=24568"},"modified":"2021-01-12T04:59:09","modified_gmt":"2021-01-12T04:59:09","slug":"you-are-a-new-graduate-nurse-working-in-a-general-surgical-ward-on-an-evening-shift-it-is-16oohrs-and-you-receive-a-new-admission-from-the-emergency-department","status":"publish","type":"post","link":"https:\/\/onlineclassesguru.com\/index.php\/2021\/01\/12\/you-are-a-new-graduate-nurse-working-in-a-general-surgical-ward-on-an-evening-shift-it-is-16oohrs-and-you-receive-a-new-admission-from-the-emergency-department\/","title":{"rendered":"YOU ARE A NEW GRADUATE NURSE WORKING IN A GENERAL SURGICAL WARD ON AN EVENING SHIFT. IT IS 16OOHRS AND YOU RECEIVE A NEW ADMISSION FROM THE EMERGENCY DEPARTMENT."},"content":{"rendered":"<style type=\"text\/css\"><\/style><h4>YOU ARE A NEW GRADUATE NURSE WORKING IN A GENERAL SURGICAL WARD ON AN EVENING SHIFT. IT IS 16OOHRS AND YOU RECEIVE A NEW ADMISSION FROM THE EMERGENCY DEPARTMENT.<\/h4>\n<p>MS. VERA WONG IS A 24-YEAR-OLD FEMALE WHO HAS BEEN ADMITTED WITH A 12-HOUR HISTORY OF LOWER ABDOMINAL PAIN, INCREASING IN INTENSITY OVER THE LAST 4 HOURS IN THE RIGHT ILIAC FOSSA (RIF). SHE HAS NO RELEVANT MEDICAL HISTORY ALTHOUGH SHE IS OBESE WEIGHING 145KG AND IS 168CM TALL.<\/p>\n<p>You are a new graduate nurse working in a general surgical ward on an evening shift. It is 16oohrs and you receive a new admission from the Emergency Department. Ms. Vera Wong is a 24-year-old female who has been admitted with a 12-hour history of lower abdominal pain, increasing in intensity over the last 4 hours in the right iliac fossa (RIF). She has no relevant medical history although she is obese weighing 145kg and is 168cm tall.<\/p>\n<p>She was reviewed by the surgical team in the Emergency Department and a provisional diagnosis of<br \/>\nacute appendicitis was given. She is also to be reviewed by the surgical registrar on the ward later in<\/p>\n<p>the evening for possible surgery if her symptoms persist. Ms. Wong is currently Nil by Mouth and has<\/p>\n<p>a McGill pain score of7\/10. You review her medication chart and note the following PRN medications:<br \/>\nMorphine 1oomg lMl q4h, Metoclopramide 1omg lMl q8h and Paracetamol 1gm PO q6h.<\/p>\n<p>You introduce yourself to Ms. Wong and she informs you that she is in significant pain and requests<\/p>\n<p>pain relief. You inform Ms. Wong that you will administer a Morphine injection for her pain.<\/p>\n<p>You ask a fellow Registered Nurse to check out the Morphine which is supplied in the following ampoule<br \/>\nstrengths: 1omg\/1ml and 3omg\/1ml.<\/p>\n<p>You check out 3x 3omg ampoules and 1x 1omg ampoule whilst<\/p>\n<p>correctly completing the S8 register. You prepare the injection using a sterile<\/p>\n<p>technique along with<\/p>\n<p>Metoclopramide1omg. You administer the medication lMl to Ms. Wong.<\/p>\n<p>It is now 18oohrs and you are undertaking your<\/p>\n<p>medication and observation round when you get to<\/p>\n<p>Ms. Wong, you find her to be unrousable with a respiratory rate of6. You immediately<\/p>\n<p>activate the<\/p>\n<p>Rapid Response Team. When the Team arrives they undertake a primary survey and assess the<br \/>\npatient notes. You inform them of<\/p>\n<p>the medication you have administered. The team administers<\/p>\n<p>Naloxone Hydrochloride 12ooug l\/. Ms. Wong\u2019s level of consciousness and<\/p>\n<p>respiratory rate improve.<\/p>\n<p>The surgical registrar attends the MET call also and states he accidentally wrote 1oomg instead of<br \/>\n1omg forthe<\/p>\n<p>morphine dose.<\/p>\n<p>Case Study Questions<\/p>\n<p>01. This case study illustrates a medication errorwhere the wrong dose was prescribed and<br \/>\nadministered. In 500 words, state howthis adverse event could have been prevented. You should<br \/>\nsystematically work through the six rights<\/p>\n<p>and discuss what strategies you would employ to<\/p>\n<p>ensure you administerthe right dose.<\/p>\n<p>02. In 250 words, identify and discuss the relevant<\/p>\n<p>Australian Nursing and Midwifery Accreditation<\/p>\n<p>Council (ANMC) competency standards that are breached in this case.<\/p>\n<p>03. As a Registered<\/p>\n<p>Nurse, priorto administering any medication, what key information related to the<\/p>\n<p>pharmacology ofthe medication should you have a<\/p>\n<p>comprehensive knowledge of? (250 words)<\/p>\n<p>04. The following morning you are on a day shift, the Nurse Unit Manager asks you into the office.<br \/>\nShe informs you that the adverse drug administration has been logged on the hospital incident<br \/>\nmanagement system (IMS) and that you are<\/p>\n<p>required to write a report and also be interviewed by<\/p>\n<p>the RCA (Route Cause Analysis) team. You are feeling very apprehensive about writing<\/p>\n<p>the<\/p>\n<p>report and meeting the RCAteam regarding this incident. In 250 words, what are the main points<br \/>\nyou will cover in the report? What<\/p>\n<p>resources or support services can you identify to assist you in<\/p>\n<p>this situation?<\/p>\n<p><center><a href=\"http:\/\/onlineclassesguru.com\/orders\/ordernow\"><img decoding=\"async\" src=\"https:\/\/encrypted-tbn0.gstatic.com\/images?q=tbn:ANd9GcTyj99p60XCLyLk1htB7-1neRt8-2QdnenNlQ&usqp=CAU\"target=\"_http:\/\/onlineclassesguru.com\/orders\/ordernow\"\/><\/center><p>","protected":false},"excerpt":{"rendered":"<p>YOU ARE A NEW GRADUATE NURSE WORKING IN A GENERAL SURGICAL WARD ON AN EVENING SHIFT. IT IS 16OOHRS AND YOU RECEIVE A NEW ADMISSION FROM THE EMERGENCY DEPARTMENT. MS. VERA WONG IS A 24-YEAR-OLD FEMALE WHO HAS BEEN ADMITTED WITH A 12-HOUR HISTORY OF LOWER ABDOMINAL PAIN, INCREASING IN INTENSITY OVER THE LAST 4&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-24568","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v17.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>YOU ARE A NEW GRADUATE NURSE WORKING IN A GENERAL SURGICAL WARD ON AN EVENING SHIFT. IT IS 16OOHRS AND YOU RECEIVE A NEW ADMISSION FROM THE EMERGENCY DEPARTMENT. - onlineclassesguru<\/title>\n<meta name=\"description\" content=\"YOU ARE A NEW GRADUATE NURSE WORKING IN A GENERAL SURGICAL WARD ON AN EVENING SHIFT. 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