VSIM RED YODER part 1 Guided Reflection 6.16./Rated A already

Sherman “Red” Yoder, Part 1 Guided Reflection Questions Opening Questions How did the simulated experience of Red Yoder’s case make you feel? The home assessment was a new simulation for me. In this scenario the ...

Sherman “Red” Yoder, Part 1 Guided Reflection Questions Opening Questions How did the simulated experience of Red Yoder’s case make you feel? The home assessment was a new simulation for me. In this scenario the regular head to toe assessment wasn’t necessary, but it never hurts to get a full picture of the patient. This simulation provided extensive practice with asking questions and gaining a health picture for this patient. I thought that it was difficult to ask the questions without the form in from of me to go by. What nursing actions did you feel were appropriate within this scenario? This simulation provided extensive practice with asking questions and gaining a health picture for this patient. The nurse needed to assess the patient, identify concerns and plan care for the patient. Discussing Red’s understanding of his diagnosis of diabetes and the necessity to stick to the correct insulin routine, diet and exercise and discussing his sleep and alcohol use patterns were all appropriate. Assessing his foot ulcer and evaluating Red’s ability to care for the wound and the availability of family support was also important. Scenario Analysis Questions* EBP What are the priority nursing actions for Red Yoder based on physical findings and social and family interaction? Educating Red on how alcohol use can affect diabetes outcomes is important. Addressing adherence to a diabetic diet and staying hydrated was important and was also acknowledging and addressing his daughter’s concerns regarding Red’s care in this aspect, as she is the one who brings his groceries. It is important for diabetics with wounds to stay hydrated and eat nutritious foods to promote healing and fight infection. Correct Insulin administration and scheduling is important to maintain blood sugars in diabetics. EBP What potential problems can you identify for Red Yoder? The patient could potentially have his foot amputated if his wound isn’t maintained and assessed for proper healing. He could get also develop a bone infection or other systemic infection causing the need for prolonged hospitalization. S/QI For the following Safety/Quality Improvement measures, what nursing actions should be taken during Red Yoder’s case? Safety/Quality Improvement Measures Nursing Actions Assessment of patient’s ability to self-administer his insulin Teach and then have Red demonstrate proper administration of insulin Assessment of patient’s ability to monitor blood glucose Demonstrate the correct process and then have Red re-teach back to the nurse. Safety issues related to needle disposal Teach the patient about the importance and possibly provide the patient with an appropriate receptacle. PCC/I What appropriate assessments were made to help you decide what interventions Red Yoder needed? Skin assessment Health and education assessment- Diet, wound care, diabetes knowledge Sleep Routine Alcohol Usage Wound assessment Vitals assessment T&C Why is it important to include Red Yoder’s family as members of his health care team? It is difficult for Red to assess the bottoms of his feet on his own, he is going to need some support from his family. His family also provides support with groceries and getting to his doctor appointments, so making sure they understand the plan of care with give Red more accountability in his health routine. Concluding Questions Reflecting on Red Yoder’s case, were there any actions you would do differently? If so, what were these actions, and why would you do them differently? I completed the simulation twice. During the first simulation I was confused as to where I find the answers to the alcohol and sleep assessments, so I completed the questions based on what little information I had of Red. I then realized there were options to have the conversation with the patient in the communication controls. Secondly, I realized there were multiple ways to ask the same question, and some were better than others. If I completed it again, I would pay closer attention to the way questions were asked. How would you apply the knowledge and skills that you obtained in Red Yoder’s case to an actual patient care situation? In real life, I would try to have a natural conversation with the patient. Asking questions directly from some of the assessment tools available to nurses can be difficult and feel very unnatural. The information is very personal and people tend to guard the truth when they think they are being judged based on their answers. And questionnaires about alcohol use elicit a defensive response in people who drink. Having an open conversation and remaining unbiased is important. Remembering the phrasing of a question can make a huge difference when using these tools.