NURSING > EXAM > RachaelHeidebrink .WELL EXPLAINED WITH VERIFIED ANSWERS GRADED A. (All)

RachaelHeidebrink .WELL EXPLAINED WITH VERIFIED ANSWERS GRADED A.

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Student Name: Mitchell Vargovich Simulation Name & Number: Rachael Heidebrink #8 1. ISBARR you could have done during that simulation (can be calling a provider or reporting off to another nurse). Hello, Dr. Krown. This is Mitchell Vargovich, an RN on the floor. I’m calling to do a patient hand off on Rachael Heidibrink. is a 22-year-old white female who was admitted 4 days ago with a fractured right greater trochanter sustained in a motorcycle accident. A right hip hemiarthroplasty was performed 3 days ago. On post-op day 1 she started complaining of severe shortness of breath, and her SpO2 dropped to 88% on room air. A VQ scan revealed a pulmonary embolism in the left lung, and she was then started on a heparin drip. Ms. Heidebrink’s SpO2 is 93% on 2 L of oxygen via nasal cannula. She has an IV line in her right arm with the heparin drip infusing at 14.8 mL/hr. She is rating her pain as 2 out of 10 right now. She has a urinary catheter draining clear yellow urine. Ultrasound scanning shows no sign of deep vein thrombosis (DVT), and her right hip dressing is dry and intact. I also gave her 5mg of warfarin and heparin 10,000 units in 10ml NS. The pharmacy also changed the dose of the heparin drip from 14.2ml/hr to 14.8ml/hr. Additionally, I provided education on warfarin, how easily bruised she can become, medication dosage change based on labs, and bridge therapy. 2. A Nursing Note you could have written if you had that patient in clinical. Can be a Focus note, DAR note or shift summary note. D; Pt INR was 0.9 A; Pt was given 5mg of warfarin. R; Pt is at ease. 3. Reflection questions for this simulation. Opening Questions How did the simulated experience of Rachael Heidebrink’s case make you feel? Tell me the actions you felt went well within this scenario. It went decent. I get confused on iv push/bolus/drip. Especially nervous taking care of someone who is young and just had a traumatic injury. Reflecting on Rachael Heidebrink’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 would have had another nurse check the dosage before administering Scenario Analysis Questions* PCC/EBP What priority problem(s) did you identify for Rachael Heidebrink? PE Diagnosed one day following her hip surgery EBP/S What potential problems could arise from anticoagulation therapy? Bleeding. The patient was on warfarin and heparin. PCC/T&C Discuss the importance of providing patient education for a patient being discharged on oral anticoagulation therapy. Adequate teaching is given and understood by the patient. Involve family and caregivers also. S/S to look for and how often to get lab draws done. T&C/S What other interprofessional team members should be involved in Rachael Heidebrink’s care? Orthopedic, hematologist, family, case manager, pt, physician, dietician Concluding Questions Describe how you would apply the knowledge and skills that you obtained in Rachael Heidebrink’s case to an actual patient care situation. Heparin and warfarin are always given at our hospital. I think this simulation was good at looking at the lab values then determining how much medication to give. Upon determining the medication to give, I had to check the dose with another nurse. I will use this in real life.

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