Medical Case 3: Vincent Brody
Guided Reflection Questions
1. How did the scenario make you feel?
This scanerio was slightly harder than the last. Again, I think it is difficult because it is computer
time not real
...
Medical Case 3: Vincent Brody
Guided Reflection Questions
1. How did the scenario make you feel?
This scanerio was slightly harder than the last. Again, I think it is difficult because it is computer
time not real time. So you brain doesn’t just automatically note things. You have to check on
them or ask. There is a lot that is left out about your interpretation of the pt. Because it is a
stimulation.
2. When a patient develops a rapid onset of shortness of breath, what are the nurse’s
immediate priorities?
To assess airway, breathing and responsiveness if that isn’t apparent.
3. What assessment findings would indicate that the patient’s condition is worsening?
The pt’s drop in Sa02, the increase in pulse rate, the pt begins c/o pain and increasing sob.
The pt appears to be working harder to 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.
5. What are safety considerations when caring for a patient with a chest tube?
Dislodgment
Disconnection from suction, or any of the tubes coming lose.
Bringing it above the pt’s chest level for an extended period of time.
No having a appropriate water seal.
6. What key elements would you include in the handoff report for this patient? Consider the
SBAR (situation, background, assessment, recommendation) format.
S- Pt was admitted after going to the hospital from his doctors office due to a COPD
excerbation. It is discovered that the pt has a left sided pneumothorax. Chest tube has been
placed and confirmed. Pt is improving at this time.
B- Pt has a extensive hx of COPD, with frequent hospitalization. Pt was outside gardening
when this exacerbation started. Pt is complaint with home inhaler regimne.
A- Caox4, Pt has had a increase in Sao2 to 94% w/ 02, Pulse rate of 106, B/p 128/76, RR-22
pt states that he still has trouble breathing, but that it is getting better. Pt Breath sounds are
equal bilaterally, and mild wheezing is noted, Pt has no pain noted at this time.
R- Continue albuterol per doctors orders, monitor pt for pain, keep pt on continious, ekg and
Sa02 monitoring, Increase pt’s acuity to level due to the addition of cx tube, Monitor chest
tube atrium for any changes or problems, Call Doctor to define the plan for pt’s care since
his status has changed.
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