SHADOW HEALTH DELEGATION | Questions with 100% Correct Answers | Verified | Updated

Bedside Shift Report Holly: Mr. Liu, this is your new nurse. They'll be taking over for me. Samuel: Hello. Nice to meet you. I'll be checking in with you every hour or so. Holly: All right, Mr. Liu, I'm going to hand you off to your new nurse using a Bedside Shift Report. At Shadow General, we perform our handoffs at the patient's bedside to make sure that you can stay involved in your care. Samuel: Sounds good. Holly: OK, I'm going to start with Mr. Liu's Situation . . . Holly: Mr. Liu is a 28-year-old man with pneumothorax secondary to blunt chest trauma. He has three broken ribs, and is being treated with a chest tube and water-seal drainage unit. What else do you need to ask Holly about Samuel Liu's Situation? Who is Mr. Liu's provider? The provider name belongs in the Situation section of a Shadow General SBAR, and it's a good idea to get a verbal confirmation of information even when it already appears in your patient's EHR. Bedside Shift Report Holly: Mr. Liu reported at our ED a week ago with 3 broken ribs (left 7th-9th) after falling off his neighbor's roof. A chest X-ray revealed that he was negative for pneumothorax. He was observed for 8 hours and discharged with instructions to return if his symptoms worsened. Yesterday, he was reaching for something on a high shelf when he experienced sharp chest pain on his left side followed by difficulty breathing. Holly: He reported to the ED within the hour, where he was diagnosed with pneumothorax secondary to blunt chest trauma, confirmed via chest X-ray. Physical examination revealed tracheal deviation to the left, air in the left side of the chest, and absent breath sounds on the left side of the chest. Holly: At 1600 hours yesterday, Mr. Liu received a 28 F chest tube, inserted at the left 4th intercostal space, anterior axillary line. Holly: Mr. Liu has a hydromorphone patient-controlled analgesia pump at a concentration of 2 mg/mL. He was given a loading dose of 0.4 mg, and set up with with an on-demand bolus of 0.1 mg. The PCA pump has a lockout interval of 10 minutes and an hourly dose limit of 0.6 mg. All the best from Dr. A Dr. Assessments Page 2 of 7 Holly: Mr. Liu's vital signs are all within normal limits. His respirations are 18 per minute and his oxygen saturation is 94%. Holly: Current provider's orders are to monitor the chest tube and drainage unit every hour, to record patient vitals every hour, and to monitor Mr. Liu's pain level and level of consciousness every hour, in addition to checking the dressing at the site of the chest tube insertion once every 2 hours. What else do you need to ask Holly about Samuel Liu's Background? Does Mr. Liu take any home medications or have any allergies? You request new information, suitable to the Background section of the SBAR report, which will support your ability to administer treatment to your patient safely and confidently. Bedside Shift Report Holly: The chest tube and water-seal drainage unit are working as expected. Chest tube to water seal, no air leak noted. No drainage. The dressing at the site of the chest tube insertion is clean with no sign of infection. No problems. Mr. Liu is currently stable, alert and oriented x4. What else do you need to ask Holly about her Assessment of Samuel Liu's condition? How effective is the pain medication? Learning about the efficacy of the pharmacological treatment for your patient's pain will help you to determine what further interventions may be necessary. Bedside Shift Report Holly: I recommend that, every hour, when you check in with Mr. Liu, you monitor his chest tube and drainage unit, monitor and record his vital signs, and check the dressing on his chest tube insertion site. It will also be important to check his respiratory status and level of consciousness. What else do you need to ask Holly about her Recommendation for Samuel Liu's care? What does Mr. Liu's schedule look like today? Scheduled patient procedures and visitations are part of the Recommendation section of a Shadow General Bedside Shift Report. It is important to know about these events so that you can build your own schedule to best support your patient's needs. Bedside Shift Report Holly: Do you have any additional questions for me? What else would you like to ask Holly? All the best from Dr. A Dr. Assessments Page 3 of 7 Is there anything else I should know? The correct selection gives Samuel Liu a chance to contribute to a conversation about his own care. Team Delegation Delegate getting Mr. Liu a glass of water. Step One: Nadia and Wade are correct. Step Two: Nadia is correct. Step Three: Nadia is correct. Team Delegation Delegate replacing Mr. Patel's saline IV bag. Step One: Diya and Leslie are correct. Step Two: Diya is correct. Step Three: Diya is correct.