Opening Questions
How did the simulated experience of Danielle Young Bear’s case make you feel? I had to attempt this sim multiple times and got very frustrated at how I didn’t fully understand what it wanted me to do.
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Opening Questions
How did the simulated experience of Danielle Young Bear’s case make you feel? I had to attempt this sim multiple times and got very frustrated at how I didn’t fully understand what it wanted me to do.
Talk about what went well in the scenario. I performed the neuro and pain assessments fine, I assessed her spine and back, and I provided a lot of education to the patient about excessive use of acetaminophen.
Reflecting on Danielle Young Bear’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? I think by the 4th time of doing the scenario, I knew what to expect and what actions to take.
Scenario Analysis Questions1
PCC What priority problem(s) did you identify for Danielle Young Bear? Excessive intake of acetaminophen, chronic low back pain, possible interactions with OTC medication and herbal remedies.
S/EBP/PCC Provide medication reconciliation for this patient. The patient was taking tramadol, hydrocone/acetaminophen, Nyquil, Duloxetine, cyclobenzepine, tramadol, and acetaminophen.
S/EBP/PCC What problems did you identify during the medication reconciliation? She was taking 3 tablespoons of Nyquil for her cough which also has Tylenol in it, along with the hydrocodone that has Tylenol, and she was take Tylenol 4x per day. She was ingesting way too much acetaminophen based on the normal suggested amount which is 4,000 mg per day.
S/EBP/PCC Provide patient education related to information found during the medication reconciliation. I educated the patient about avoiding OTC medication that may have Tylenol in them already and how this could be harmful with the other medications she takes. I advised her to speak with her HCP about herbal supplements she takes or might take in the future.
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/
I Explore evidence-based alternative pain management resources to assist with pain control for Danielle Young Bear. Distraction techniques (watching TV, music, art), heat/cold therapy, position changes, alternative forms of analgesia such as creams to apply to the back.
Concluding Questions
Describe how you would apply the knowledge and skills that you obtained in Danielle Young Bear’s case to an actual patient care situation. I would make sure to get a full detailed list of the medications they took, get a pain history from them, perform a thorough pain assessment, determine what their pain affects and how they interprete their level of pain, and educate them on the risk of taking execessive amounts of NSAID’s and analgesics to control their pain.
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