Clinical Assessment Preparation

CPNE Study Guide

Based on the patient scenario listed above along with the MD orders, lab findings, and vital signs listed below, determine which procedure you will perform for this patient. Change PICC line dressing, hange leg dressing, or Perform intermittent catheterization? Medical Record Smith, John DOB: 6-1-70 MR: 0115678 Date: 3/7/17 Time: 1630 Physician Orders • Diet: 140 grams carbohydrate diet, no concentrated sweets • Activity: OOB to chair with assistance every shift • Vital signs: every 4 hours • CBC and Electrolytes, BUN, and fasting glucose daily • Obtain capillary blood glucose before meals and at bedtime. See medication orders for insulin coverage • Bladder scan after each time patient voids and if patient has not voided within 6 hours • Intermittent catheterization using sterile technique if post-void bladder scan estimated volume was greater than 200 mL or if patient is unable to void within 6 hours • Sterile dressing change to wound on the right lower leg every 12 hours. Cleanse wound with sterile normal saline. Pack wound with sterile saline-soaked 4x4 gauze. Cover with dry sterile 4x4 gauze and sterile ABD pad • Sterile PICC line dressing change every 3 days Laboratory Results Laboratory Results Today Flag Yesterday Flag Units Reference Range Sodium 144 145 mEq/L 135-145 Potassium 3.7 4.0 mEq/L 3.5-5.0 Chloride 102 103 mEq/L 97-107 Glucose 245 H 300 H Mg/dl 70-110 Calcium 9.2 9.0 Mg/dl 8.6-12.2 Blood urea Nitrogen 20 19 Mg/dl 10-20

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