You are caring for 12-year-old Elizabeth who has been hospitalized for an appendectomy. Her mother tells you that she is concerned about her lack of physical development compared to her peers. As a nurse you know that adolescents are preoccupied with their bodies and develop individual images of what they think they should look like.…

A 24-year-old female patient who smokes two packs of cigarettes per day has come to the clinic to talk with the nurse about quitting smoking. She began smoking when she was 14 years old. She complains to the nurse at the clinic, “I just can’t seem to kick the habit no matter how hard I…

Tonya discusses the concerns Mr. Jacobs has about his sexual relationship with his wife. She knows that a radical prostatectomy can cause nerve damage that impairs a man’s ability to have a normal erection. Tonya says, “You’ve told me that you’re worried about you and your wife. Can you tell me more?” Mr. Jacobs says,…

Tonya is preparing to change the dressing over Mr. Jacobs’ wound, and Mrs. Jacobs is present to observe. Tonya determines Mr. Jacob’s level of pain to be sure that he is comfortable. She decides to include discussion of wound and urinary catheter care during her time with the family. Before beginning instruction with the Jacobs,…

Tonya examines Mr. Jacobs’ surgical incision and notices a 1.25-cm (0.5-inch) circle of yellowish drainage on the gauze dressing. On close inspection of the suture line, she also observes an area of swelling around two stitches. Mr. Jacobs notices Tonya’s expression as she looks at the dressing and asks, “Is anything wrong?” Tonya responds, “A…

You are a staff nurse on a 32-bed cardiac step-down unit. The hospital obtained Magnet recognition last year. You are assigned as the preceptor for Tony, RN, who is a new graduate nurse, who just started his nursing career on your floor.   ·          You and Tony just received morning shift report on your patients.…

You are caring for a 17-year-old female African American patient with sickle cell disease who has been admitted for treatment of sickle cell crisis. Sickle cell disease is a genetic abnormality that affects hemoglobin in the red blood cells. The defect is found primarily in African Americans. In a sickle cell crisis weakened red blood…

Mrs. Andrews did well after her spinal surgery and was discharged home on the third postoperative day. Two weeks later she told her family that she was having increased pain in her back. She stated that she was not always wearing her back brace as instructed at the time of surgery because “it makes me…

Mr. Coburn, the 56-year-old school teacher who was seen earlier in the week for hyperthermia, arrives at the walk-in health center complaining of feeling dizzy and nauseated. You immediately note that he appears to be having some difficulty catching his breath during coughing spells. A new graduate nurse takes Mr. Coburn’s admitting vital signs as:…

You receive morning report for Ms. Malone, age 63, admitted to the hospital yesterday with fatigue, a cough, and dyspnea; she is diagnosed with chronic heart failure. She states that she had increasing difficulty with shortness of breath and swelling in her legs. Pedal pulses are +1 bilaterally. On auscultation you hear bilateral crackles in…