Vernon Russell 2 vsim scenario and questions PDF

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vernon russel guided reflective questions and post conf questions...

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Vernon Russell: Guided Reflection Questions by: Elizabeth Frattesi Opening Questions How did the simulated experience of Vernon Russell’s case make you feel? This case study gave me the opportunity to treat a patient with a stroke and hemiplegia which is a new learning experience for me. I was worried and anxious to help the patient when he started choking but I wasn’t 100% sure what to do at first. It made me think about being in a real situation where that could happen and not sure if I would respond properly and timely. Talk about what went well in the scenario. Everything in the simulation went well until the patient aspirated. The Vital signs were within normal limits, his neurological assessment had normal findings. The IV site showed no signs of redness, inflammation, edema, or bleeding upon assessment. I transitioned the patient to a seated position before administering the medication and he still had trouble swallowing. The patient was educated on fall safety precautions, the benefit of coughing and the risks and prevention of aspiration. Reflecting on Vernon Russell’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? From this case, I learned to better assess swallowing prior to giving medication. I could have had him swallow just water first or even just demonstrate the swallowing action before giving medication to swallow. Also, I had the patient seated but I could have started in the High-Fowler’s position first in preparation for potential of chocking. Scenario Analysis Questions S

What priority problem(s) did you identify for Vernon Russell?

The priority problems that I identified for the patient once the simulation was completed are risk for choking related to inability to swallow and risk for fall due to the muscle weakness caused by the rightsided stroke and left-sided hemiplegia. Stroke and neurological checks. Risk for internal bleeding. S/EBP Correlate the abnormal coagulation studies results to Vernon Russell’s current treatment that has been initiated thus far. The patient’s prothrombin time was abnormally long at 42 seconds as the normal range should be between 10-14. Therefore, the Aspirin which thins the blood is on hold until further lab results to avoid risk of internal bleeding. In addition, Thrombolytic Therapy was initiated to dissolve the found clots which caused the Stroke.

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

EBP/I What resources are available to the interprofessional health care team to guide the care of Vernon Russell and/or any stroke patient? There are many online resources available to the interprofessional health care team which can be useful in the care of this patient and other similar cases. Scholarly articles, books, support groups, and associations such as the National Stroke Association, The Internet Stroke Center, American Stroke Association, and The Atlas of Heart Disease and Stroke to name a few. Also, large departments have board days to discuss specific cases, and collaborate with each other.

PCC/S Discuss the rationale for Vernon Russell being placed on NPO status? This patient was put on NPO to avoid chocking after his aspiration with the medication. Due to his stroke his ability to swallow is non-functioning. PCC/S How did you respond to Vernon Russell’s question related to why he needs someone to help him walk, and what is your rationale for your response? Due to the right-sided stroke which resulted in left-sided hemiplegia, the muscles are now weak which could cause a fall and potential fracture or breakage of the bone. Therefore, the patient needs help walking and was put on fall precautions. PCC Utilizing Vernon Russell’s health history identify factors that predisposed him to having a stroke. The factors which put Mr. Russell at risk of a stroke are his underlying conditions of hypertension, CAD, diabetes, excessive smoking for prolonged time and lack of exercise. T&C Discuss why the referral for speech therapy is important in Vernon Russell’s care. A speech therapy order was put in to assess the patient’s ability to swallow and help him regain his ability to swallow. Typically, an individual treatment plan would be set up along with therapeutic exercises to strengthen the swallowing muscles. Concluding Questions Describe how you would apply the knowledge and skills that you acquired in Vernon Russell’s case to an actual patient care situation. In real life situation, I would monitor the patients vital signs and pulse strength, listen to the heart and lungs during assessment, regular supervision of IV site and drug administration as per doctor orders, assess swallowing and seating position prior to taking anything in, educate the patient on risks and prevention methods for falls and chocking.

From vSim for Nursing | Fundamentals. © Wolters Kluwer.

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