Complete the pretest, vSimm and post-test on Doris Bowman. You must make a 100%
on both the pre & post tests and a 95% on the vSimm. Once complete, save an image
showing your name and score on the vSimm and post test and answer the following
questions in your own words. Cite reference sources at the end of the document.
Please remember this is an individual assignment – no collaboration. The instructors
will be monitoring and are available for questions throughout the clinical day .
Surgical Case 3: Doris Bowman
Documentation Assignments
1. Document your initial focused assessment findings.
My initial focused assessment findings were hypoactive bowel sounds, respirations were 21
and the chest was moving equally on both sides. Her radial pulse was strong at 105 bpm,
she was put on ECG monitor. Her dressing was dry and intact, her IV site showed no signs of
swelling, bleeding, drainage or infiltration. BP was 150/90 and her skin was cool and sweaty.
Urinary output from the catheter was 210 cc.
2. Document ALL of your interventions/findings in the order they were completed right after
the vSimm told you something was wrong with her breathing until you notified the
provider of the incident.
I checked respirations rate it was 10 per min, then I checked her responsiveness. I checked
the pupils and they were 1 mm. I then phoned the provider who was no help and he wanted
to continue with existing orders. I then asked for help and provided positive pressure
ventilation, with the ventilation rate of 10 and oxygen rate of 10 L/min. I then listened to her
heart and lungs, then assessed the dressing again.
3. List the 2 top priority nursing concerns with supporting evidence.
Ineffective breathing pattern r/t respiratory depression AEB respiration rate of 10
breaths, decreased pulse ox reading of 70%
Impaired gas exchange r/t altered oxygen supply AEB respiration rate of 10
4. Provide a list of appropriate nursing interventions you could do to address your priority
concerns?
Continue to monitor respiration rate and ECG monitoring, as well as the pulse ox.
Guided Reflection Questions
1. How did the scenario make you feel?
In the beginning, I believed that she was hemorrhaging because her H&H was low as well as
her hemoglobin. I thought that she was going into cardiac arrest, so I began to set her up for
CPR. I had to phone the provider like 3 times and he only wanted to continue with existing
orders, so I know that it had to be something else. Until I checked the pupils which were 1
mm, and I knew that pinpoint pupils could have been the opioid I administered.
2. What further intervention would have been required if the dose of naloxone
hydrochloride (Narcan) had not been effective in this case?
© Wolters Kluwer Health | Lippincott Williams & Wilkins
on both the pre & post tests and a 95% on the vSimm. Once complete, save an image
showing your name and score on the vSimm and post test and answer the following
questions in your own words. Cite reference sources at the end of the document.
Please remember this is an individual assignment – no collaboration. The instructors
will be monitoring and are available for questions throughout the clinical day .
Surgical Case 3: Doris Bowman
Documentation Assignments
1. Document your initial focused assessment findings.
My initial focused assessment findings were hypoactive bowel sounds, respirations were 21
and the chest was moving equally on both sides. Her radial pulse was strong at 105 bpm,
she was put on ECG monitor. Her dressing was dry and intact, her IV site showed no signs of
swelling, bleeding, drainage or infiltration. BP was 150/90 and her skin was cool and sweaty.
Urinary output from the catheter was 210 cc.
2. Document ALL of your interventions/findings in the order they were completed right after
the vSimm told you something was wrong with her breathing until you notified the
provider of the incident.
I checked respirations rate it was 10 per min, then I checked her responsiveness. I checked
the pupils and they were 1 mm. I then phoned the provider who was no help and he wanted
to continue with existing orders. I then asked for help and provided positive pressure
ventilation, with the ventilation rate of 10 and oxygen rate of 10 L/min. I then listened to her
heart and lungs, then assessed the dressing again.
3. List the 2 top priority nursing concerns with supporting evidence.
Ineffective breathing pattern r/t respiratory depression AEB respiration rate of 10
breaths, decreased pulse ox reading of 70%
Impaired gas exchange r/t altered oxygen supply AEB respiration rate of 10
4. Provide a list of appropriate nursing interventions you could do to address your priority
concerns?
Continue to monitor respiration rate and ECG monitoring, as well as the pulse ox.
Guided Reflection Questions
1. How did the scenario make you feel?
In the beginning, I believed that she was hemorrhaging because her H&H was low as well as
her hemoglobin. I thought that she was going into cardiac arrest, so I began to set her up for
CPR. I had to phone the provider like 3 times and he only wanted to continue with existing
orders, so I know that it had to be something else. Until I checked the pupils which were 1
mm, and I knew that pinpoint pupils could have been the opioid I administered.
2. What further intervention would have been required if the dose of naloxone
hydrochloride (Narcan) had not been effective in this case?
© Wolters Kluwer Health | Lippincott Williams & Wilkins
