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Charlie Maes S.N.

Medical Case 3: Vincent Brody Guided Reflection Questions 1. How did the scenario make you feel? I felt like this scenario was a bit more challenging than previous ones but I enjoyed it. 2. When a patient develops a rapid onset of shortness of breath, what are the nurse’s immediate priorities? Assess breath sounds and O2 saturation. 3. What assessment findings would indicate that the patient’s condition is worsening? Respiratory depression, asymmetrical chest movement, chest pain, and drop in oxygen saturation. 4. Review Vincent Brody’s laboratory results. Which results are abnormal? Discuss how these results relate to his clinical presentation and chronic disease process. Most of the patients labs for his ABG’s were abnormal and were indicative of his respiratory acidosis. 5. What are safety considerations when caring for a patient with a chest tube? Patient with a chest tube is at an increased risk for infection and impaired breathing. 6. What key elements would you include in the handoff report for this patient? Consider the SBAR (situation, background, assessment, recommendation) format. That I assessed the patient and administered 2.5/3ml albuterol via nebulizer. Patient had audible wheezing and complained of chest pain and trouble breathing. Upon auscultation of the lung noticed diminished breath sounds in left lung, called provider. Chest x-ray ordered and performed showing left-sided pneumothorax. Morphine 2mg administered via iv push prior to procedure. Chest tube ordered and legal consent obtained. Chest tube was placed and patient handled procedure well. Patient stated “no pain” was present. Education provided and call light in reach. 7. What patient teaching priorities would be important in the patient experiencing an acute exacerbation of COPD? Pursed lip breathing is very important to learn and also medication administration. 8. For a patient with COPD who is stable, what resources would you recommend? I would recommend the patient get involved with support groups and can get more information on the American Lung Association web site. 9. What would you do differently if you were to repeat this scenario? How would your patient care change? Initially during my first attempt at the scenario I did not call the doctor before I got a chest x-ray, this would obviously not be possible in an actual situation but I should have not gotten ahead of myself and made sure I was doing exactly how I would in a real situation.

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