Mario is a married, healthy 43-year-old father of two, worksfull-time as a carpenter. He has a puncture wound to his rightinner forearm 4 days ago, last friday, while moving a dirty pieceof equipment at work. Cellulitis developed around the wound, andMario was admitted for IV antibiotics /monitoring.
Mario is nervous to get home and work. Thinks his boss will notunderstand his injury. His wife Mia is with him and is alsoconcerned about Mario’s ability to return to work. Mario iscooperative and asks many questions. Mario’s temperature returnedto baseline, and he is slated for a Tuesday morning discharge tohome.
The situation takes place on Tuesday at 9 am, at which time abasic assessment is due. The provider has requested an SBAR updateto help plan for discharge, but the hospital unit has multipledistractions and Mario’s visitor asks many questions.
******T = 98.7 F (37 C) BP = 116/70 P = 72 RR = 16 O2 Sat = 99%(room air) Heart sounds: Regular Lung sounds: Clear bilaterallyAbdominal sounds: Present Pulses: Normal Pain: 2/10 Mr. Mariostates, “My arm looks better. Not as red as it was yesterday. Canmove it without much pain.” Wife asks, “How does Mario seem to you?Can Mario go home today?”
-Mario is sitting up in bed with the head of bed at 45 degrees.His wife is at the bedside asking many questions. The telephone inthe room rings with a call from the nutrition services departmentrequesting Mr. Mario’s breakfast selections. During your initialassessment Mr. Mario is talking and asking questions:
• “I feel pretty good today. The chills are gone. Do you think Ican I go back to work soon? and will I have to take medication whenI go home, I don’t need them?”
• “Pain level is 2 out of 10. My arm is still a little tender,but it’s much better than yesterday.”
• “When I got the puncture wound, it didn’t hurt much so Ididn’t clean it. Is that why it got infected?
. During your initial assessment what are the five priorityitems in which to take note of and why?
. How are you as the nurse going to answer Mr. Mario tobest reassure him and decrease his anxiety?
