0700 handoff. The day RN works with one LPN/VN and one UAP. Patient A, 72, is postoperative day 1 after right total hip arthroplasty and receives prescribed VTE prophylaxis. At 0500 he developed sudden shortness of breath and new right calf tenderness with unilateral swelling. BP is 138/86, HR 110, RR 24, temperature 37.6 C (37.5 C last evening), and SpO2 89 percent on room air; he is anxious, and his breath sounds are clear. Patient B, 68, is improving after community-acquired pneumonia, has been afebrile for 12 hours on oral antibiotics, and needs reinforcement of previously taught discharge instructions; she has crackles in the right base, fewer than on admission, and SpO2 is 96 percent on room air. Patient C, 45, is postoperative day 2 after laparoscopic cholecystectomy; she reports right shoulder pain of 5 out of 10, the same ache from abdominal gas insufflation she described yesterday, three hours after the last PRN analgesic; vital signs are stable, and reassessment is due. Patient D, 81, is being treated for a urinary tract infection; her documented baseline is oriented times three, and she is now oriented to person and place. She repeatedly tried to get out of bed and pulled at her IV overnight. At 0600 she voided 200 mL of cloudy urine, as on each day since admission. BP is 134/82, HR 88, temperature 36.7 C, SpO2 95 percent on room air, and a bed alarm is active.
0700交班。日班護理師與一位LPN/VN和一位UAP合作。個案A，72歲，右側全髖關節置換術後第1天，並接受處方VTE預防。0500時，他出現突發性呼吸困難和新發生的右小腿壓痛伴單側腫脹。血壓138/86，心率110，呼吸24，體溫37.6°C（昨晚37.5°C），以及室內空氣下血氧飽和度89%；他感到焦慮，且呼吸音清晰。個案B，68歲，社區型肺炎後正在好轉，口服抗生素治療下已無發燒12小時，需要加強先前教導的出院衛教；她有右肺底部囉音，比入院時少，室內空氣下血氧飽和度96%。個案C，45歲，腹腔鏡膽囊切除術後第2天；她報告右肩疼痛5分（滿分10分），與她昨天描述的因腹部氣體灌注引起的相同疼痛，距離上次按需止痛藥已三小時；生命徵象穩定，且已排定重新評估。個案D，81歲，正在接受泌尿道感染治療；她記錄的基準是三項定向感皆正常，而她現在定向感為人與地點。她整夜反覆嘗試下床並拉扯她的靜脈輸液。0600時，她排尿200毫升混濁尿液，與入院以來每天相同。血壓134/82，心率88，體溫36.7°C，室內空氣下血氧飽和度95%，且床邊警報器啟動。