Christopher Parrish Reflected Guided Questions PDF

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Guided reflection questions answer on vsim fundamentals Christopher Perrish....

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Christopher Parrish Guided Reflection Questions Opening Questions How did the simulated experience of Christopher Parrish’s case make you feel? It was my first time to do a NG tube on a patient so it was very interesting.

Talk about what went well in the scenario. Administering precrelipase before starting the ng tube and patient education Reflecting on Christopher Parrish’s case, were there any actions you would do differently if you were to repeat this scenario? If so, how would your patient care change? I would explain the content of the tube feeding formula to the patient and his mother. Also, I would assess how he feels after starting the tube feeding. Scenario Analysis Questions PCC What priority problem(s) did you identify for Christopher Parrish? Since his cystic fibrosis was causing malabsorption and malnutrition, initiating tube feeding was necessary to maintain adequate nutrition. Also, because he lacks digestive enzymes, he was prescribed to take pancrelipase before starting the tube feeding PCC

What potential problems could arise due to Christopher Parrish’s identified Vitamin D deficiency? Hypocalcemia, hypophosphatemia, bone disorders (osteomalacia, rickets), heart disease, hypertension, diabetes, infections and immune system disorders, falls in older people, cancers (colon, prostate, breast), multiple sclerosis

PCC

Discuss the relationship between pancreatic enzymes, malabsorption, and CF. pancreatic enzyme helps absorption of nutrition in body by helping digest carbohydrates, proteins, and fats, gain and maintain a healthy weight, absorb essential nutrients such as vitamins and minerals. Without pancreatic enzymes, the main nutrients (carbs, proteins, fats) will be poorly digested and may cause several complications. One of the complication is CF

PCC/S/EBP  

What are important assessments related to administration of enteral feedings?

Checking provider’s order Patient education on enteral feeding

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 The Scenario Analysis Questions are correlated to the Quality and Safety Education for Nurses (QSEN) competencies: Patient-Centered Care (PCC), Teamwork and Collaboration (T&C), Evidence-Based Practice (EBP), Quality Improvement (QI), Safety (S), and Informatics (I). Find more information at: http://qsen.org/ From vSim for Nursing | Fundamentals. © Wolters Kluwer.

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Review patient’s medical record for X-ray confirmation of tube placement Visually inspect the enteral feeding formula for damage to the container, altered formula characteristics, and expiration date. Obtain a new formula if contaminated Always perform hand hygiene before assessing the enteral feeding Raise the head of bed at least 30 degreees or upright to prevent aspiration Assess patient’s GI status and risk of aspiration Put on gloves to comply with standard precautions Observe for a change in external tube length or the incremental marking where the tube exits the patient’s nose or mouth to detect tube migration Observe for a change in volume of aspirate from the feeding tube because a persistent inability to withdraw fluid (or only a few drops of fluid) from the tube may signal the upward displacement of a gastric tube into the esophagus. Review routine chest and abdominal X-ray reports. 4 24 Aspirate contents from the tube with an enteral syringe (as shown below) and evaluate the color of the aspirate. Fasting gastric secretions often appear grassy-green, brown, or clear and colorless. 424 If performed in your facility, measure the pH of aspirate from the tube. Fasting gastric pH is usually 5 or less, even in patients receiving gastric acid inhibitors. 424 Notify the practitioner if placement is in doubt. Arrange for an X-ray, if ordered, to confirm tube location. Assess the tube for infection

PCC/T&C

Using Erikson’s developmental stages, discuss the importance of peer relationships/support group with other young adults with cystic fibrosis.

Since Christopher is 18 years old, he’s in identity vs. role confusion in Erikson’s developmental stages. He is in the stage where physical/psycological changes occur drastically and he might have body image issue with CF. Losing weight and having enteral feeding can also affect his self-esteem as well. S/EBP Identify potential patient safety issues related to nutritional status in the care of Christopher Parrish. Patients who receive enteral feeding might gain weight drastically and that can cause numerous complications, he might develop food allergies as he gets older and have difficulty choosing the safe formula for enteral feeding. Depression might develop due to the fact the patient can’t consume food like other people and the depression might cause suicidal thoughts. T&C

What other interprofessional team members should be involved in Christopher Parrish’s care?

Dietitian, pulmonologist, respiratory therapist, pharmacist, social worker, psychologist. Concluding Questions

From vSim for Nursing | Fundamentals. © Wolters Kluwer.

Describe how you would apply the knowledge and skills that you acquired in Christopher Parrish’s case to an actual patient care situation. I learned how to initiate enteral feeding from this vsim, so I can apply this knowledge to people who needs enteral feeding because of their health issue.

From vSim for Nursing | Fundamentals. © Wolters Kluwer....