Vincent Brody COPD Reflection Questions PDF

Preview

Summary

nursing...

Description

Medical Case 3: Vincent Brody Guided Reflection Questions 1. How did the scenario make you feel? The first time doing the scenario I was nervous because I did not know what to expect. After doing the scenario again I was little bit more confident in what I was doing as the nurse. The only thing I didn’t like is how I had to wait between doing vitals or whatever I was doing for it to be complete then move onto the next thing. For example, I felt like I could have saved time and do his temperature and count his respirations or pulse at the same time. I felt doing those things quickly and getting the results to the physician could have helped Mr. Brody quicker. 2. When a patient develops a rapid onset of shortness of breath, what are the nurse’s immediate priorities? Assess the patient’s airway and breathing is the number one priority. Provide oxygen if needed and call the provider to discuss what is taking place. You will also need to figure out why he is short of breath. Listen to the lungs for crackles, wheezing, absent breath sounds, etc. Place a pulse oximeter to monitor his oxygen levels. Sit the patient upright and indicate deep breaths can help. 3. What assessment findings would indicate that the patient’s condition is worsening? Some assessment findings that would indicate that the patient’s condition is worsening would be wheezing when listening to breath sounds, fever, shallow or rapid breathing, confusion, low oxygen saturation, increase in mucous production or changes in the color, cyanosis of lips or fingernail beds, and drowsiness. The biggest indication would be the patient complaining of chest tightness or shortness of breath. 4. Review Vincent Brody’s laboratory results. Which results are abnormal? Discuss how these results relate to his clinical presentation and chronic disease process. The patient’s ABG came back with an elevated HCO3 and PCO2 and a pH within normal range. Since the PCO2 was outside of normal range and on the alkalotic side Mr. Brody was in respiratory alkalosis. Some symptoms of respiratory alkalosis are heart

© Wolters Kluwer Health | Lippincott Williams & Wilkins

palpitations, shortness of breath, and chest pain which is what the patient is presenting. Mr. Brody also had a high hematocrit with is commonly found in patients with COPD. 5. What are safety considerations when caring for a patient with a chest tube? There are many safety considerations that need to be implicated when caring for a patient with a chest tube such as: every 2 hours checking the patients respiration rate, breath sounds, and oxygen saturation. Be sure to inspect the dressing and note any drainage present be sure to include the color and odor (if there is one). Check that the tubing does not have any kinks. Asses the skin surrounding the chest tube for any redness or swelling. 6. What patient teaching priorities would be important in the patient experiencing an acute exacerbation of COPD? One priority teaching would be teaching the patient breathing exercises such as taking deep breaths. That activity may produce fatigue or respiratory distress may be better tolerated after the patient has been up and moving around for a little bit. Education is key! Educate the patient about nutritional therapy. Teach some coping mechanisms that will be able to help the patient with shortness of breath or fatigue that could make the patient uncomfortable or irritable. 7. For a patient with COPD who is stable, what resources would you recommend? The number one resource I would recommend is smoking cessation programs! There are also pulmonary rehabilitation programs that the patient can attend. I would also note that annual health checkups/screenings are important when dealing with any disease/illness. A simple resource that patients can do is general health promotions such as eating healthy, exercising daily, etc. 8. What would you do differently if you were to repeat this scenario? How would your patient care change? The biggest thing I would do is touch up on COPD before redoing the scenario. The prequestions helped a bit, but I think sitting down and reading about COPD has a refresher would have helped prepare me. Also, possibly writing out or make notes of the plan of care for the patient would have helped guide me. Making notes would ensure that I

© Wolters Kluwer Health | Lippincott Williams & Wilkins

would cover everything I needed take before calling the physician to get orders such as the vitals, current medications, the status of the patient.

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