TEMPERATURE 1. Determine the correct route to obtain a temperature on each of the patients that present to the clinic with the concern of a "fever". Describe the route you are going to take the temperature and why you selected the device. 2. Identify factor(s) that affect temperature according to each scenario. List up to 4-5 other factors that affect body temperature. You are the nurse working at a local clinic. Patient 1: Mrs. Smith is an 86 y/o female presenting to the clinic with complaints of possible "fever" for 3 days. She lives alone in a one-bedroom apartment. She drove herself today to the clinic wearing a long sleeve thin dress shirt, skirt with panty hose and closed toe shoes. Mrs. Smith has a light coat on. The patient is alert and oriented x4 (name, time, place and situation). Mrs. Smith is able to follow commands. Patient 2: Nicole Waters is a 2-month old infant presenting to the clinic with her parents. The Mom states "I took Nicole's temperature at home under her arm and the thermometer said 100.1". She's been fussy and not wanting to feed as usual for the past 24 hours. The baby arrives in her car seat in a onesie with socks, hat, and a baby blanket over her in the car seat. Patient 3: Mr. Taro is a 34-year-old male who presents to the clinic with fatigue, cough, sore throat, body aches, chills, and possible "fever" for 3 days. He smells of cigarette smoke when he arrives to the clinic where you are taking vital signs. He also is drinking a cup of coffee. Mr. Taro is alert and oriented x 4 and follows commands. Patient 4: Mrs. Jordan brings her 3-year-old child, Ace, to the clinic who just experienced a seizure. Mother reports Ace has been running a fever on and off for 2 days. He's never had a seizure before the mother reports. The patient is drowsy but arousable without evidence of seizure activity. The patient is dressed appropriate for the weather and is being carried by the mother. Patient 5: Mrs. Cooper presents to the clinic with possible low grade fever. She is 7 months 3 days pregnant. No other complaints. The patient is dressed appropriately for the weather. She is AOx4. Mrs. Cooper is currently drinking a cold soda. Is there a difference in body temperature across the lifespan? Why or why not?

CASE STUDIES RESPIRATIONS Determine the correct method to count respirations on each of the patients that present to the clinic with the concern of a "cough". Describe how you are going to take the respirations and why. 2. Identify factor(s) that affect respirations according to each scenario. List up to 3 other factors that may affect the respirations and describe why or how it affects respirations. 3. List the normal range of respirations for each scenario. You are the nurse working at a local clinic. Each patient is in the treatment room with you. Patient 1: Mrs. Smith is an 86 y/o female presenting to the clinic with complaints of "cough with possible fever" for 3 days. She lives alone in a one-bedroom apartment. She drove herself today to the clinic wearing a long sleeve thin dress shirt, skirt with panty hose and closed toe shoes. Mrs. Smith has a light coat on. The patient is alert and oriented x4 (name, time, place and situation). Mrs. Smith is able to follow commands. Patient 2: Nicole Waters is a 2-month old infant presenting to the clinic with her parents with complaints of a cough. The Mom states "I took Nicole's temperature at home under her arm and the thermometer said 100.1". She's been fussy and not wanting to feed as usual for the past 24 hours. The baby arrives in her car seat in a onesie with socks, hat, and a baby blanket over her in the car seat. Patient 3: Mr. Taro is a 34-year-old male who presents to the clinic with fatigue, cough, sore throat, body aches, chills, and possible "fever" for 3 days. He smells of cigarette smoke when he arrives to the treatment room where you are taking vital signs. He also is drinking a cup of coffee. Mr. Taro is alert and oriented x 4 and follows commands. Patient 4: Mrs. Jordan brings her 3-year-old child, Ace, to the clinic with complaints of a cough, earache and low grade fever for 3 days. The patient is dressed appropriate for the weather and sits on the treatment table while on his mother's lap. Patient 5: Mrs. Cooper, a 26-year-old female, presents to the clinic with a cough for 2 weeks She is 7 months 3 days pregnant. No other complaints. The patient is dressed appropriately for the weather. She is AOx4. Why is there a difference in respirations across the lifespan?

CASE STUDIES PAIN Answer the questions completely using your resources, articles, concept and assessment text. Note: the setting of where the nurse is working changes with each scenario. You are the nurse working in the ICU: Patient 1: Mrs. Ortega is a 76 y/o Hispanic female admitted to ICU with diagnosis of a pelvic and right femoral head fracture due to a motor vehicle accident 2 days ago. She is alert and oriented to person only, which is her baseline according to her daughter. She has a history of stroke and hypertension. Mrs. Ortega is receiving Fentanyl by continuous IV drip and Toradol IV 10mg every 6 hours. Vital signs: Temperature 100.1 orally; 110 HR; 24 Respirations; 148/90. It is 0700 and Mrs. Ortega has received her Toradol IV and routine high blood pressure medication at 0600. Questions: 1. What should you take into consideration about Mrs. Ortega's cultural beliefs about pain management? 2. Which assessment tool will you use to determine Mrs. Ortega's pain scale? 3. Which vital signs are most concerning related to her pain? Why? 4. How will you obtain information about Mrs. Ortega's pain? Which questions will you ask? 5. How is pain different in an older adult? Patient 2: A 3 y/o male child, Ace, presents to the clinic with a fever, sore throat and bilateral earache. His mother, Mrs. Jordan, is present and reports his fever has been as high as 104 today but it came down with Motrin. The mother denies any other complaints. Onset of symptoms yesterday. Vitals signs: Temperature 102.1 orally; 129 heart rate; 28 respirations; 88/60 blood pressure; oxygen saturation 100%. Questions: 1. Which assessment tool will you use to determine Ace's pain scale? 2. Which description words can you use with Ace asking him to describe the quality of his pain? 3. Which vital sign(s) are most concerning and why? Patient 3: Sarah is a 16 y/o female Asian high school student who fell playing tennis. She presents to the urgent care with her parents with the chief complaint of "right wrist pain". The nurse notes obvious deformity of the right wrist. Ice is placed immediately on the right wrist and she is taken to a treatment room. Vital signs obtained: 98.8 orally; 96 heart rate; 20 respirations; 110/68 blood pressure; 100% oxygen saturation. Questions: 1. Which assessment tool will you use to determine Sarah's pain scale? 2. Other than a pain scale, which other data will you obtain about Sarah's pain? 3. Are there any cultural beliefs about pain and pain management you should be concerned about