Medical Case 2 Guided Reflection Questions | Complete Solution
1. How did the scenario make you feel?
The scenario made me feel confident and
... [Show More] efficient because of the background knowledge I have on asthma. Once I entered the scenario I immediately noticed that Hoffman was in distress. For example, her skin appeared to be cyanosis which is a symptom of poor circulation and her o2 stat was 65 %, very low. Further, when I asked my patient to tell me more about her symptoms she answered, “I can’t breathe”. Being an individual with asthma I know how it feels to struggle breathing; thus, this made me feel empathy for my patient. Furthermore, it is in my nature to want to relieve my patient so once I administer the medication and her O2 stat became stable it made me feel like a competent nurse.
2. What assessment findings would indicate that the patient’s condition is worsening?
Cyanosis is an indicator that the condition is worsening. This is a bluish coloring of the skin and a symptom of severe shortness of breath. Wheezing is also a common indicator that the asthma is getting worse. Further, if the patient is wheezing upon inspiration and expiration this can be worse. If the patient has a cough that has not gone away or has gotten worse this can indicate the condition is getting worse. The patient has communicated that their chest is tightening. Also, a rapid heartbeat can be an indication of asthma severity. Thus, if interventions are not started it can lead to cardiac arrest. Also, a more obvious indication would be the patient’s inability to talk.
3. When a patient develops a rapid onset of shortness of breath, what are the nurse’s immediate priorities?
The nurse’s immediate priorities for the patient that develops rapid onset of shortness of breath would be to assure that the patient is sitting upright. Sitting the patient up to assure that the lungs have space to expand. Then, the nurse should auscultate the lungs and obtain a set of vital signs specifically an o2 stat, respiration rate, and pulse. Also, the nurse should check the patients order to see if the patient’s primary provider order includes asthma medication such as albuterol and/or oxygen. If so, the nurse should administer the medication and then assess the patient after the treatment. Also, it is an immediate priority of the nurse to contact the physician if the symptoms persist after treatment.
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.
Hoffman’s abnormal result included an o2 stat of 65%, which was well below the normal range
95-100%. In other words, Hoffman was receiving 65% of oxygen. Also, the EKG showed that
the patient was experiencing tachycardia which mean the heart was beating faster than normal.
This can be a result from patients distress of struggling to breath also the lungs are using an
excessive amount of energy causing the heart to work hard and beat faster. Also, the patient has
an increased heart rate which was higher than the average range of 60- 100. These are all
evidence that Hoffman’s condition was severe in addition to her cyanosis and inability to talk.
5. What communication techniques are important for an extremely anxious patient who is having difficulty breathing?
It is important to understand that the patient who is experiencing anxiety and difficulty breathing will also struggle to talk. Therefore, it is important to ask them simple questions and try to keep the conversations simple and short. Also, nonverbal communication is appropriate for this patient. For example, if the nurse is going to teach the patient deep breathing techniques demonstrations would be more effective rather than verbal instructions. Furthermore, it is important to demonstrate to the patient how to correctly use their inhaler and encourage them to demonstrate back to assess if the teaching was effective. Demonstrations are an example of non-verbal communication. Also, its essential to use simple terms when communicating with a patient and keep in mind that they may not understand complex medical terms.
6. What patient teaching priorities would be important for the patient who has experienced an acute exacerbation of asthma?
Deep breathing techniques are essential teaching priority for a patient who has experienced an acute exacerbation of asthma. Informing the patient about triggers that may cause their exacerbations of asthma such as smoking, dust, and other allergy factors and encourage them to avoid them. It’s important for the nurse to educate the patient about their medication and make sure they have an understanding of what the medications is intended to do. Also, as mentioned before it’s important to teach the patient how to correctly use their inhaler to assure they will receive the medication effectively and assess if the teaching was effective. Also, its important to teach the patient about the relationship between a good dieting and exercising and preventing asthma exacerbations.
7. What resources would you recommend for the patient experiencing asthma?
I would recommend the patient to purchase air humidifier. Furthermore, I would try to recommend resources that are not too costly for my patients. For example, keeping the environment dust free and avoiding smoke does not cost anything but it will help prevent asthma exacerbations. Also, I would recommend an allergy specialist. I would encourage the patient to make a list of all their triggers and to avoid them. Additionally, I would recommend essential oils which also aid in relaxation. Stress management techniques are essential for asthma patients because stress unmanaged can lead to asthma exacerbations. Stress management techniques include meditation, deep breathing, and exercising. For example, taking a walk in the park is not only exercise it also an opportunity to relieve stress and get fresh air.
8. What would you do differently if you were to repeat this scenario? How would your patient care change?
If I were to repeat this scenario I would perform the assessment more quickly and efficiently. I say this because I immediately noticed that Hoffman was in distress and wanted to immediately start treatment. Luckily, I was able to repeat the scenario more than once because the first time I did the simulation I forgot to auscultate the lungs. The second time I redid the scenario I forgot to assess and auscultate the lungs after the treatments. Each time I repeated the scenario I was more efficient. For example, the first time I asked Hoffman questions about her condition but the second time because I knew she was experiencing difficulty breathing I skipped the interview portion of the assessment and obtained the other aspect of the assessment which made it quicker for me to start my intervention and treatments. Also, I remembered to assess the patient after treatment. These corrections not only improved the quality of the care I provided, it also improved the safety of the patient. Thus, improve Hoffman’s o2 stat and left her stable. [Show Less]