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Access eBooks via Vital source (Critical Thinking, Clinical Reasoning, and Clinical Judgment 7th Edition)
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Scenario #1
1) Study skill 6.6: Clustering related cues by signs and symptoms.
2) Complete the instructions pertained to the following scenario
Imagine that you just admitted Mr. Nelson, a 41-year-old businessman who has acute abdominal pain. He’s never been in the hospital and tells you he hates everything about hospitals. He’s been vomiting for 2 days and is unable to keep any food down. His abdomen is distended, and he has no bowel sounds. He is scheduled to go to the operating room at 2 pm for emergency exploratory surgery. He tells you he’s worried because his brother died in the hospital. Suddenly he doubles over and says, “This is really getting worse!” You take his vital signs, and they are as follows: T 101° F, P 122 beats/min, R 32 breaths per minute, BP 140/80 mm Hg. These signs are the same as those taken an hour ago, except that before, his pulse was 104 beats/min.
Instructions
A) Group information in a way that you can see patterns by cluster data based on the purpose:
to determine the status of medical problems or physiological responses, cluster the data according to body systems.
to determine the status of nursing problems, cluster the data according to a nursing framework
B) Identify relationships between signs and symptoms.
C) Write a response to the following questions to Scenario #1
Describe Mr. Nelson’s physical status
Describe Mr. Nelson’s human responses
Explain the relationship between Mr. Nelson’s signs and symptoms
Scenario #2
1) Study Skill 6.7: Distinguishing Relevant from Irrelevant
2) Complete the instructions pertained to the following scenario
Imagine you work in community health and make a visit to Mrs. Roberts, who is 80 years old and had a cerebrovascular accident (CVA) a month ago. Today you notice she seems to be increasingly confused: she knows where she is but forgets what day it is and doesn’t seem to remember her daily routine. You know that confusion in the elderly can be caused by any of the following: medications, infection, decreased oxygen to the brain, electrolyte imbalance, and brain pathological conditions.
Medical notes
The patient recently started taking buspirone hydrochloride for anxiety
Temperature: 100.8°F orally
History of myocardial infarction 5 years ago
The patient seems dehydrated
The patient has no known allergies
The patient follows a regular diet
Instructions
List the abnormal data and make connections between the data
Ask what information is relevant to the presented complaint.
Write a response to Scenario #2 explaining what information is pertinent to the patient’s confusion
Scenario #3
1) Study Skill 6.8: Recognizing Inconsistencies.
2) Complete the instructions pertained to the following scenario
You interview Cathy in the prenatal clinic 2 weeks before delivery. You ask her how she feels about the baby coming. She tells you she’s happy that she gets to see the baby in only 2 weeks. When you ask her if she has any questions about the delivery, she tells you she’s been going to birthing classes with her boyfriend and feels like she knows what to expect. You review her records and notice that her first clinic visit was 2 weeks ago, when she came with her mother.
Instructions
A) Compare what the patient states (subjective data) with what you observe (objective data).
B) Identifying cues that contradict each other. Example: Imagine that you’re caring for “Fred” after chest surgery and he tells you that he has no pain. However, he moves very little and barely breathes when you ask him to take a deep breath. The way he’s moving is inconsistent with his statements of being pain-free.
C) Write a response to the following questions to Scenario #3
What are the inconsistencies in the preceding scenario?
What might a nurse do to resolve the inconsistencies?

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