Critical thinking concept map

Answer

• Medical Diagnosis: Scrotal Abscess  (Cyst)                 Concept(s):                             Exemplar(s):

  Pathophysiology (In your own words):       Epididymitis is the most common cause of scrotal abscess (Ramareddy & Alladi, 2016). The patient has a history of scrotal pain, which is one of the pathophysiologic presentations of epididymitis. Besides, bilateral testicles appear relatively enlarged as well as homogenous with reduced vascular flow.       It is characterized by a constellation of signs and symptoms that include swelling and/or tenderness, and new-onset pain (Velasquez, Boniface & Mohseni, 2020).

  Complications/Potential Complications (Physiologic Adaptation(s)/Reduction of Risk Potential):   No varicocele, hydrocele, and the scrotal wall is symmetrical in thickness.                             Potential complications include pyuria, hypospadias, and necrotizing enterocolitis (Ramareddy & Alladi, 2016).

  Psychosocial Concerns (Psychosocial Integrity):   Anxiety, stress and depression due to pain and/concerns of fertility or ability to sire children.

   

  Assessment (Physiological Adaptation) **performed by the student	Altered physiologic parameters include enlargement of both testicles, and reduced vascular flow. However, there is no hydrocele or varicocele. Besides, there is no evidence of focal mass or abscess (Ramareddy & Alladi, 2016).
  Labs and  Diagnostics (Reduction of Risk Potential)	CBC, Urine sample, CMP, Ultrasound
  Planning and Goals (short term and long term goals) **Actual priority problems with prioritized goals	-          The patient will appear relaxed and able to sleep/rest appropriately (Belleza, 2018). -          Demonstration of stable vital signs, normal skin turgor, palpable pulses of good quality, appropriate urinary output, and moist mucus membranes (Belleza, 2018). -          Treatment of underlying infection. -          Relief of pain. -          Achievement of timely healing (Belleza, 2018).
  Nursing Interventions (Basic Care and Comfort, Safety and Infection Control) **What did the student/nurse perform throughout the day	-          Educate the patient about anticipated treatment plan (Belleza, 2018). -          Address patient concerns (Belleza, 2018). -          Monitor fluid volume by recording input and output. Noting changes in heart rate, blood pressure, respiratory rate, and rhythm (Belleza, 2018). -          Evaluation and relief of pain (Belleza, 2018).

   

   

   

   

  Medication Name (Generic) and Drug class	Patient’s Dose, Route, and Frequency	Why is patient receiving this medication?	Nursing considerations (labs, assessment, etc.)	Side effects and Major adverse effects	Patient Teaching
  Zofran	4mg, IV,	For prevention of chemotherapy-induced and/or radiation induced vomiting and nausea (Griddine & Bush, 2020).	It should be administered 1 – 2 hours before radiotherapy, 1 hour before radiotherapy, and 30 minutes before chemotherapy (Griddine & Bush, 2020).	Headache, dry mouth, constipation, fatigue, and malaise (Griddine & Bush, 2020).	Patient education on potential adverse effects.
  Morphine	4mg, IV	For management of chronic scrotal pain (Murphy, Bechmann, & Barrett, 2020).	Investigate history of illegal opioid use or addiction (Murphy, Bechmann, & Barrett, 2020).	Constipation, central nervous system depression, urinary retention, nausea, vomiting, and dizziness (Murphy, Bechmann, & Barrett, 2020).	Patient education on adverse events.
  Rocephin	1mg, IV	For management of bacterial infection (Durham, Wingler, & Eiland, 2017).	Check if it is appropriate to prescribe ceftriaxone (Durham, Wingler, & Eiland, 2017).	Rash, nausea, blood clots, diarrhea, dizziness, upset stomach, swelling, pain/swelling of the tongue, and/or anemia (RxList, 2020).	Patient education of adverse events.
  Deoxycline	100mg, PO	For management of bacterial infection (Patel & Parmar, 2020).	Assess the patient for anaphylactic reaction and hypotension (Patel & Parmar, 2020).	Mild diarrhea, nausea, photosensitivity, vomiting, headaches, skin rash/itching, tooth discoloration, and headaches (Patel & Parmar, 2020).	Educate the patient on potential adverse events.
  Delaudid	1mg, IV	For pain relief (Abi-Aad & Derian, 2020).	Assess the patient for respiratory depression (Abi-Aad & Derian, 2020).	Pruritus, flushing, dizziness, asthenia, constipation, somnolence, dry mouth, and nausea/vomiting (Abi-Aad & Derian, 2020).	Educate the patient on potential adverse events.

   

  Patient Teaching (Health Promotion, Safety and Infection Control, and Management of Care): The patient should be educated on adverse events of prescribed medications, the importance of adherence to medication plan, pathophysiology and prognosis of scrotal abscess, and treatment plan.

  Patient Summary (SBAR Format):   S- The 33-year-old African-American male presents with a history of scrotal pain. He came to the emergency department for assessment of the pain.   B- His vital signs include SpO2 99%, bp 133/87, HR 78, pain level 8/10, and RR 16. The patient is alert and oriented +4. Current medications include Zofran, morphine, Rocephin, Deoxycline, and Delaudid. A-    Bilateral testicles appear relatively enlarged and homogenous with diminished vascular flow. Scrotal wall is symmetrical in thickness. No hydrocele. No varicocele. R-    Urological consultation is recommended and short term repeat ultrasound are recommended. No evidence of focal mass or abscess identified. Exam is markedly limited due to patient pain.