Medical Case 02 Jennifer Hoffman GRQ Edited PDF

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Medical Case 2: Jennifer Hoffman Guided Reflection Questions 1. How did the scenario make you feel? It made me feel like I wasn’t performing enough interventions, until I remembered that the main focus was the airway. 2. What assessment findings would indicate that the patient’s condition is worsening? If the O2 continued dropping, the wheezing increased/stopped (status asthmaticus), cyanosis, loss of consciousness. 3. When a patient develops a rapid onset of shortness of breath, what are the nurse’s immediate priorities? Assist patient to a safe, upright position, Assess and maintain airway patency, deliver supplemental oxygen, administer medication as ordered, and keep the patient calm. 4. Review Jennifer Hoffman’s laboratory results. Identify which results are abnormal, and discuss how this relates to her clinical presentation and the disease process. Her SpO2 was initially in the 70s. This is because the bronchial constriction and inflammatory process restrict the airway making inspiration and expiration difficult and impairing gas exchange. Tachycardia- gas exchange is poor so the heart is trying to pump faster to meet the demands for oxygenation. 5. What communication techniques are important for an extremely anxious patient who is having difficulty breathing? Talk calmly. Tell them what you are doing, how it will help. 6. What patient teaching priorities would be important for the patient who has experienced an acute exacerbation of asthma? Which medications to use regularly and how to use them properly and use of emergency inhalers. Also, how to avoid triggers which exasperate asthma attacks. 7. What resources would you recommend for the patient experiencing asthma? Many facilities have printed information available. If not, Asthma and Allergy Foundation of America has free information available at aafa.org/asthma.aspx 8. What would you do differently if you were to repeat this scenario? How would your patient care change? I ran the scenario a few times already. I included patient education on the last run and focused on oxygenation by delivering O2 via non-rebreather mask and administering the nebulizer immediately.

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