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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
2.
Your concern needs to be addressed with the unit manager
3.
An afebrile client who is 2 days postoperative with an abdominal incision and a Jackson-Pratt drain
4.
A client who is experiencing hypoactive bowel sounds on the second postoperative day after a colon resection
5.
Assign an additional client to each of the day shift staff nurses
6.
A postoperative client with a tracheostomy who has signs of a tracheoesophageal fistula
7.
Assess the client with the possible fistula while the PN assists the other client to the restroom
8.
While the RN manually irrigates the tubing, the UAP can empty the urine drainage bag
9.
Position the client as directed
10.
Obtain the client’s vital signs and report the results to the nurse before the transfusion is started
11.
Hold the tray and contact the surgeon for clarification of the client’s preoperative needs
12.
“Tell me what is making you feel uneasy.”
13.
Dyspnea and a cough that produces frothy, white sputum
14.
A postoperative client who is needing an indwelling urinary catheter inserted after surgery
15.
Go with the PN to supervise the procedure
16.
Apply the client’s antiembolism (TED) stockings
17.
“Let’s work together to reapply the stockings while I talk to the client about the purpose of TEDs”
18.
Advise the primary nurse of the responsibility to review all vital signs obtained by the UAP
19.
Explain the need to implement this change in policy
20.
“I will bring your concern tot he attention of the wound care team.”
21.
Consult with the primary nurse caring for the client
22.
“You are responsible for monitoring tasks delegated to the UAP.”
23.
Encourage both staff members to practice effective communication with one another
24.
Knee surgery requiring continuous use of passive motion therapy
25.
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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