Doris Bowman - Guided reflection questions PDF

Preview

Summary

Guided reflection questions ...

Description

Surgical Case 3: Doris Bowman Guided Reflection Questions 1. How did the scenario make you feel?  I felt in control during this scenario. Everything went well and I feel confident if I had to have this in a real-life situation. 2. What further intervention would have been required if naloxone hydrochloride (Narcan) had not been effective in this case?  If the first dose of naloxone hydrochloride was not effective within 2-5 minutes, another dose should be given. Repeated doses may be necessary if a person continues to show signs of overdose after the first dose. 3. Discuss readiness for discharge from PACU criteria.  A patient remains in PACU until fully recovered from anesthetic agent. Indicators of recovery include a stable BP, adequate oxygen saturation level and respiratory function. 4. What key elements would you include in the handoff report for this patient? Consider the SBAR (situation, background, assessment, recommendation) format.  Doris Bowman, 39-yr old female who underwent a total abdominal hysterectomy with bilateral salpingo-oopherectomy under general anesthesia. Patient had complained of a pain level of 6/10. She was treated with 2mg of Morphine IV push and almost immediately went into respiratory distress. She has an abdominal incision covered with 4x4 gauze and no drainage, dressing is c/d/i. IV of potassium chloride in 5% dextrose and normal saline is infusing at 125 mL/hr. She has Foley catheter placed with 210 mL urine output. Vitals BP: 142/80 mm Hg, RR: 21, SpO2: 93%, Pulse: 107, TEMP: 99F. PAIN: 5/10. I recommend that Ms. Bowman be monitored closely, keep an eye on her vitals, breathing, and pain level. 5. What further complications could have occurred if the respiratory depression had not resolved?  If respiratory depression progresses and your carbon dioxide level increases. You will develop cyanosis, headaches, feeling faint, and confusion. Adversely, seizures and swelling in the legs and feet. 6. If Doris Bowman’s family members had been present during the scenario, describe how you would support them when her condition deteriorated.  If the family members where around when Ms. Bowman went into respiratory distress, I would explain that this can be a normal side effect that occurs with Morphine and how administering Narcan will reverse these effects. I would maintain a supportive environment and briefly explain to the patient and family what’s being done to relieve

© Wolters Kluwer Health | Lippincott Williams & Wilkins

this condition. I would provide ongoing emotional support and explanations to the patient and family as she recovers. 7. What would you do differently if you were to repeat this scenario? How would your patient care change? 

If I was to repeat this scenario, I would be sure to maintain adequate ventilations per breath and make sure the correct amount of O2 is being given. I would also be sure to stop the ventilation as soon as possible as continued ventilation may be harmful to the patient.

© Wolters Kluwer Health | Lippincott Williams & Wilkins...