VSIM Christopher Parrish Diagnosis Cystic Fibrosis feedback log (Updated Test Solutions)

VSIM Christopher Parrish Diagnosis Cystic Fibrosis feedback log 2021. Christopher Parrish Diagnosis: Cystic Fibrosis Location: Medical-Surgical Unit 2315 Report from day shift nurse: Situation: Christopher Parrish is an 18-year-old male who was admitted at 1900 today. His mother visited him at his college dormitory and was very concerned with his health; he seemed weak and had lost weight since she last saw him. She took him to see his primary care provider, and the provider admitted him and has ordered a tube feeding. I placed an 8-Fr, 42-inch feeding tube in his right nares about an hour ago it was difficult to get it at first, but after a little push I was able place the NGT. X-ray just came, results should be below. The feeding pump was just delivered to his room. He is up to the bathroom prn; otherwise bed rest. Background: Christopher was diagnosed with cystic fibrosis as a child and has had frequent hospitalizations previously. He also has DM type I. He reports fatigue and has recently lost 6 kg (13.2 lb) after he registered at the local college and moved to live in a dormitory. Chris's mom was here earlier, but she is a single parent and has two younger boys, so she had to go home. Assessment: Christopher is awake and alert. Withdrawn. This is odd, his heart rate is now ST on the monitor 120’s, before his HR was NSR 80’s. Breath sounds are diminished with a respiratory rate at 26/min. His color is a bit pale. Oxygen saturation of 92% on 2L nasal cannula, he appears to require more oxygen after NGT insertion. Blood pressure was 118/78 mm Hg an hour ago now 98/65 mm HG. He reports no pain and states he's not had much appetite the past few weeks. He has a hard time catching his breath and complete sentences. His belly is flat and nontender. Bowel sounds are normoactive. He has a wound 5 inches x 1 inch non healing on his calf from skateboarding 7 days ago. Recommendation: His regular diet is high calorie, high fat, but he wasn't too hungry this evening; just had a bit of his chocolate shake. You will need to give his pancreatic enzymes orally before you start the tube feeding. You should prioritize his assessment before providing him education. X-ray of thorax shows a nasogastric tube correctly in the stomach Chest X-ray: there’s is pneumothorax most likely from the NGT insertion. The heart in not enlarged. There are no signs of congestive heart failure. There are some area of consolidation at the base of the lungs. Medication List: 1. Pancre-lipase enzymes 5 capsules daily before meals and 3 capsules with snacks 2. Multivitamins 2 tabs q AM 3. Tylenol 500 mg q 6 hrs PRN mild pain 4. Enoxaparin Sodium 40mg/0.4ml syringe sub q daily. 5. Albuterol 360 mg via metered dose inhaler 6. Protonix 40 mg iv push q am 7. Ceftriaxone 2g IV q12h 8. Insulin Lispro (Humalog) per sliding scale AC/HS. passing grades