Unfolding Case Study: Respiratory
Trent University
NURS 3020 Clinical Practice Acute Care
I attended my first unfolding case study with my clinical group in the DNA building
where we worked together on a case regarding a thoracic trauma. I prepared for this lab by
completing the assigned readings on Nurse Achieve and reviewed our PowerPoint slides. I also
, watched the videos and completed the six Evolve quizzes pertaining to ensuring oxygen safety,
applying nasal cannula and face mask, setting oxygen flow rates, administering IM injections,
managing pain, and dressing changes. I also watched the videos on dry suction chest drainage
units and care and maintenance of a chest drainage unit. Furthermore, I completed the modules
listed on BB under essential skills and injectable medicines therapy on Safe Medicate in order to
refresh my mind. Having completed all of the prep work, I felt confident in my ability to
navigate the presenting case study with the help of my peers.
We were first given a general description of our patient and presenting problem from
triage which was very concise and did not give us much background information. We then broke
up into pairs and took a set of vitals on each other in order to practice documenting on paper
MAR and getting an accurate manual blood pressure. Following this, we decided that a focused
respiratory assessment was necessary for this patient due to his shortness of breath and abnormal
vital signs. We each discussed what was pertinent regarding this assessment including looking
for things like diminished breath sounds, adventitious breath sounds, tactile fremitus, accessory
muscle use etc. We concluded that he had diminished lung sounds in the right lower base and
was experiencing severe pain in the area evidenced by guarding with a rating of 8/10. He had no
bruising or tenderness in his abdomen near impaction which allowed us to rule out any signs of
internal bleeding but we were aware to monitor this. At this point we discussed our potential
nursing diagnoses and decided that impaired gas exchange and ineffective breathing pattern were
of utmost priority. As a group we decided that our next step would be to send him down for a
chest-x-ray to identify the cause of his symptoms and get blood work done to look at his ABG’s.
Following this, we were given physicians orders to administer pain medication because he rated
his pain an 8/10. The order stated 30mg of Toradol q6h for short-term management of moderate
Trent University
NURS 3020 Clinical Practice Acute Care
I attended my first unfolding case study with my clinical group in the DNA building
where we worked together on a case regarding a thoracic trauma. I prepared for this lab by
completing the assigned readings on Nurse Achieve and reviewed our PowerPoint slides. I also
, watched the videos and completed the six Evolve quizzes pertaining to ensuring oxygen safety,
applying nasal cannula and face mask, setting oxygen flow rates, administering IM injections,
managing pain, and dressing changes. I also watched the videos on dry suction chest drainage
units and care and maintenance of a chest drainage unit. Furthermore, I completed the modules
listed on BB under essential skills and injectable medicines therapy on Safe Medicate in order to
refresh my mind. Having completed all of the prep work, I felt confident in my ability to
navigate the presenting case study with the help of my peers.
We were first given a general description of our patient and presenting problem from
triage which was very concise and did not give us much background information. We then broke
up into pairs and took a set of vitals on each other in order to practice documenting on paper
MAR and getting an accurate manual blood pressure. Following this, we decided that a focused
respiratory assessment was necessary for this patient due to his shortness of breath and abnormal
vital signs. We each discussed what was pertinent regarding this assessment including looking
for things like diminished breath sounds, adventitious breath sounds, tactile fremitus, accessory
muscle use etc. We concluded that he had diminished lung sounds in the right lower base and
was experiencing severe pain in the area evidenced by guarding with a rating of 8/10. He had no
bruising or tenderness in his abdomen near impaction which allowed us to rule out any signs of
internal bleeding but we were aware to monitor this. At this point we discussed our potential
nursing diagnoses and decided that impaired gas exchange and ineffective breathing pattern were
of utmost priority. As a group we decided that our next step would be to send him down for a
chest-x-ray to identify the cause of his symptoms and get blood work done to look at his ABG’s.
Following this, we were given physicians orders to administer pain medication because he rated
his pain an 8/10. The order stated 30mg of Toradol q6h for short-term management of moderate
