Guided Reflections
September 27, 2020
1. How did the scenario make you feel?
-I felt somewhat confident, but simulations and real-life scenarios are a big difference.
2. When reflecting on the care of Stan Checketts, what are signs and symptoms you can assess in
the next patient you care for who might be at risk for dehydration?
-Dry skin and mucous membranes, poor skin turgor, feeling of very thirsty, less urination than
usual, dark-colored urine, fatigue, and weakness
3. Discuss signs and symptoms of hypovolemic shock.
-tachycardia, quick/shallowing breathing, weakness, confusion, less urination, low blood
pressure, and cool clammy skin
4. Discuss assessment and expected findings in a small bowel obstruction.
-Abdominal cramping/tenderness described by the patients (worse with movement), inability to
have a bowel movement or pass gas, rapid pulse, and increased respirations, hyperactive bowel
sounds, ct/xray may reveal gas, fluids or both in the small intestines with a collapsed distal bowel
5. What key questions does the nurse ask in an acute abdominal pain assessment?
-History of present illness
-What makes it worse
-Quality of the pain, describe pain
-Where is the pain and does it radiate elsewhere
-How bad is pain on a scale of 1 to 10
-When did the pain start and what were you doing when it happened
6. In evaluating Stan Checketts’ laboratory values, what if any abnormalities did you find?
-abnormal values Sodium, urea nitrogen, creatine, hemoblobin, hematocrit and wbc
7. Stan Checketts had a nasogastric (NG) tube inserted for gastric decompression. What are the
preferred methods for confirming placement of the NG tube?
-x-ray
8. What key elements would you include in the handoff report for this patient? Consider the SBAR
(situation, background, assessment, recommendation) format.
-52 y-o male, severe abd pain with n/v for past few days. Abd distended and tender s/s of
dehydration decreased urination
9. What would you do differently if you were to repeat this scenario? How would your patient care
change?
-I honestly did pretty good the first time so I wouldn’t change anything.