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Medical Case 2: Jennifer Hoffman Guided Reflection Questions

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1. 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.

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Medical Case 2: Jennifer Hoffman
Guided Reflection Questions

1. 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.




m
2. What assessment findings would indicate that the patient’s condition is worsening?




er as
co
A variety of assessment findings would indicate to the nurse that the patient’s conditon




eH w
was worsening. The skin color would be cool to the touch with cyanosis/ pallor forming




o.
around the lips/ gums/ nailbeds etc. The O2 saturation would continue to decrease,
rs e
further indicating hypoxemia. She could potentially develop status asthmaticus, which
ou urc
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
o

if left untreated.
aC s
vi y re


3. When a patient develops a rapid onset of shortness of breath, what are the nurse’s
immediate priorities?
ed d




The focus would be the patient’s oxygenation and breathing. The nurse should first sit
ar stu




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
is




breathing and diaphragmatic breathing to ensure the highest amount of oxygen in the
Th




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.
sh




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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