Nursing Situation Johnny Johns-Hygiene and skin assessment Name :… N

Nursing Situation Johnny Johns-Hygiene and skin assessment Name :… Nursing Situation Johnny Johns-Hygiene and skin assessment Name: Johnny Johns               DOB: 07/03/1957                      Ht: 68″             Wt: 250lbsAllergies: NKDA, Shellfish, dust mites              Code status: Full codeHospital: Lynn Simulation Hospital                   Unit: Intensive Care Unit (ICU)Admitting diagnosis: Respiratory failure secondary to meningococcal pneumoniaHPI: Admitted from the medical-surgical floor 2 days ago with diagnosis of meningococcal pneumonia. Johnny Johns’ condition deteriorated rapidly, requiring admission to the ICU.PMH: DiabetesPSH: nil He requires total care. You (nurse) schedule his hygiene care and skin assessment around the other care he requires to ensure all his needs are met.ReportIntroduction: Good Day nurse X this is nurse Y giving hand-off report for Mr. Johns in ICU room 5The Situation is: Johnny John in ICU 5 is a male of  63years. He was admitted to the ICU 2 days ago from the 2nd floor. He is being treated for Respiratory Failure secondary to meningococcal pneumoniaThis is the Background: He has a four-day history of sudden onset of fever with chills, cough, body aches, feeling very tired, and nausea. He came to the ER where diagnostic tests were done and he was admitted to the medical surgical floor X 2 days. His condition deteriorated rapidly hence his admission to the ICU.He has no known medical or surgical history.Assessment: He is on droplet precautions.He was hemodynamically unstable on admission to the ICU and so has not been repositioned. His vital signs are stabilizing now. An alternating pressure bed was requested and should arrive by tomorrow. He has been having mouth care Q2h. Due now.Recommendation/request: He would do well with a complete bed bath and bed change. He needs a full skin assessment.After receiving report, you will check the client chart. Nursing ordersGive a full bed bath (including Oral hygiene, hair care, shaving, nail care, perineal care)Assess the skin Make the occupied bedComplete the Braden    please write a nursing care plan and SBAR for this nursing situation.? ??            Health Science Science Nursing NURSING NUR3119 Share EmailCopy link Comments (0)

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