Jennifer Hoffman Guided Questions.docx - Medical Case 2...

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Medical Case 2: Jennifer HoffmanGuided Reflection Questions1.How did the scenario make you feel? I noticed that when the patient’s breathing became louder, I got more anxious about completing the steps in a timely fashion. Since I completed this vSim second, it was a lot easier for me, probably due to the learning curve. This scenario was also a lot easier because there was no informed consent needed or special treatments like X-rays and chest tube insertions. I didn’t have to call the provider for any reason when treating Jennifer.2.What assessment findings would indicate that the patient’s condition is worsening?A variety of assessment findings would indicate to the nurse that the patient’s conditon was worsening. The skin color would be cool to the touch with cyanosis/ pallor forming around the lips/ gums/ nailbeds etc. The O2 saturation would continue to decrease, further indicating hypoxemia. She could potentially develop status asthmaticus, which would cause her audible wheezes to cease due to a worsening obstruction. Her ABGs would show an increasing PaCO2 making her more hypercapnic and a decreasing PaO2, indicating respiratory acidosis. The CO2 retention would be the patient’s cause of death if left untreated. 3.When a patient develops a rapid onset of shortness of breath, what are the nurse’s immediate priorities?The focus would be the patient’s oxygenation and breathing. The nurse should first sit the patient up in high fowler’s position and administer oxygen as ordered. If the patient is due for another treatment of albuterol, this should definitely be given to dilate the airways. Steroid medication should also be delivered to the patient as part of treatment. After the patient is controlled, it would be important to teach the patient pursed-lip breathing and diaphragmatic breathing to ensure the highest amount of oxygen in the lungs.4.Review Jennifer Hoffman’s laboratory results. Identify which results are abnormal, and discuss how this relates to her clinical presentation and the disease process. An ABG probably should have been ordered for this patient, however I didn’t note any orders in the patient’s chart. © Wolters Kluwer Health | Lippincott Williams & Wilkins
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5.What communication techniques are important for an extremely anxious patient who is having difficulty breathing? Typically, patients who have difficulty breathing become extremely anxious due to lack of O2 and increased heart rate. It’s important for the nurse to remain calm. I noticed during the simulation that when I asked the patient how she was feeling, she replied “cant…breathe…”. This made me nervous, but I stayed focused and continued to administer the proper medications to make the patient more comfortable and ease her breathing. If this were a real life scenario and I showed anxiousness or fear to the patient, this could cause her symptoms to worsen, making her more anxious. It’s always important for the patient to see the nurse calm and in control of the situation.
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