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HESI Case Studies–Management-Management of a Surgical Unit (Linda Hatch)

1. During the report, one of the UAPs interrupts to state that a client who is 1 day post abd surgery is now vomiting large amounts of green fluid. How should Ms. Hatch respond to this situation?
Request that a night shift staff RN go to the room to evaluate the situation
Your concern needs to be addressed with the unit manager
An afebrile client who is 2 days postoperative with an abdominal incision and a Jackson-Pratt drain
A client who is experiencing hypoactive bowel sounds on the second postoperative day after a colon resection
Assign an additional client to each of the day shift staff nurses
A postoperative client with a tracheostomy who has signs of a tracheoesophageal fistula
Assess the client with the possible fistula while the PN assists the other client to the restroom
While the RN manually irrigates the tubing, the UAP can empty the urine drainage bag
Position the client as directed
Obtain the client’s vital signs and report the results to the nurse before the transfusion is started
Hold the tray and contact the surgeon for clarification of the client’s preoperative needs
“Tell me what is making you feel uneasy.”
Dyspnea and a cough that produces frothy, white sputum
A postoperative client who is needing an indwelling urinary catheter inserted after surgery
Go with the PN to supervise the procedure
Apply the client’s antiembolism (TED) stockings
“Let’s work together to reapply the stockings while I talk to the client about the purpose of TEDs”
Advise the primary nurse of the responsibility to review all vital signs obtained by the UAP
Explain the need to implement this change in policy
“I will bring your concern tot he attention of the wound care team.”
Consult with the primary nurse caring for the client
“You are responsible for monitoring tasks delegated to the UAP.”
Encourage both staff members to practice effective communication with one another
Knee surgery requiring continuous use of passive motion therapy
The UAP can assist the PN in transferring the client to the skilled care unit while the RN admits the client awaiting emergency surgery

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