Mary Richards Reflection questions PDF

Preview

Summary

Lippincott vSim...

Description

Pharmacology Scenario 5: Mary (Mark) Richards

Guided Reflection Questions Opening Questions How did the simulated experience of Mary (Mark) Richards’s case make you feel? The full scenario simulations are still a relatively new activity for me, so this ICU experience was a little intimidating. Talk about what went well in the scenario. I think overall our group did well with understanding when to give medications and knowing the signs and symptoms of digoxin toxicity. Reflecting on Mary (Mark) Richards’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? If I were to repeat the scenario, I would be a little quicker and focus more on the heart and lung assessments. SOB, labored breathing and crackles in the lungs were present so I would administer oxygen right away and place the patient in semi-fowlers.

Scenario Analysis Questions1 What priority problem(s) did you identify for Mary (Mark) Richards? Mark had an existing condition of CHF and came in with signs and symptoms of digoxin toxicity including visual disurbances, nausea, dizziness, and weakness. Low SpO2, BP and HR require immediate attention. Are there any red flags noted when looking at the medications that Mary (Mark) Richards is taking? Why or why not? Yes, prolonged use of digoxin (cardiac glycoside) increases the risk of developing toxicity. Additionally, the patient is taking furosemide (diuretic) and amlodipine (calcium channel blocker) which can also increase the risk of toxicity.

1 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 | Pharmacology. © Wolters Kluwer.

What are the potential problems that could arise if Mary (Mark) Richards does not receive treatment immediately? What type of treatment would she benefit from? If Mark does not receive treatment immediately, he is at risk of developing severe bradycardia which could lead to sudden cardiac arrest or death. He would benefit from immediate administration of digoxin immune fab (digoxin antidote) and atropine if the heart rate drops below 50 bpm. Discuss what should be taught to Mary (Mark) Richards regarding her care at home. Mark should be taught the proper dosage of digoxin and the importance of avoiding contraindicated medications. If medications cannot be avoided, he should speak with his doctor on how to prevent future overdoses. He should also know the signs and symptoms of digoxin toxiticy and when to seek medical attention. What other interprofessional team members should be involved in Mary (Mark) Richards’s care? Cardiology, radiology, telemetry, laboratory, pharmacy, OT.

Concluding Questions

Describe how you would apply the knowledge and skills that you obtained in Mary (Mark) Richards’s case to an actual patient care situation. Now that I see what a situation involving CHF and digoxin toxicity looks like, I will be better prepared in an actual patient care situation. I will be able to use critical thinking based on the history and assessment to anticipate the orders for this type of patient.

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