Vernon Case Study

Answer :

Vernon case study questions

Nursing Concepts II (Community College of Baltimore County)

Surgical Case 4: Vernon Watkins

Guided Reflection Questions

1. How did the scenario make you feel?

a. Stressed out, I couldn't get his O2 stats up.

2. Discuss your use of adjunct oxygen therapy for this patient, including why you chose a particular oxygen device, rate, and flow.

a. I chose the NC at 2L at first when his 02 was at 92% to maintain it then dropped to 91 and I bumped it up to 4L.

3. Discuss Vernon Watkins9 arterial blood gas (ABG) analysis result and explain what caused this result.

a. Patients9 pH was 7.49 which is alkalotic and HCO3 was 21 which is acidic and PCO2 was 25 which is alkalotic. The patient was in respiratory alkalosis

4. Discuss the use of a heparin nomogram (guideline for heparin titration) and safety related to this intervention.

5. What key elements would you include in the handoff report for this patient? Consider the SBAR (situation, background, assessment, recommendation) format.

a. 69 yr old male came in for a bowel perforation 4 days ago and underwent a hemicolectomy. Now complaining of pain in the leg: 3 on a scale of 0-10, chest pain and shortness of breath. BP was 150/90 HR: 104 SPO2 was 92% no fever I placed NC on 2L. Dressing is warm dry and intact. I think the patient might be having a PE

6. Discuss why Vernon Watkins may be at risk for right ventricular failure as a complication of his pulmonary embolism (PE).

a. The PE is increasing his BP and HR and causing strain on the right ventricle.

7. Discuss how you would communicate with the patient in acute respiratory distress in this emergency situation and what effective communication techniques you would use.

a. I would try to calm the patient as much as possible. Comfort him and let him know I am there for him and teach him pursed lip breathing to try and control his shortness of breath.

8. Consider what would have happened if Vernon Watkins9 family members had been present at the bedside and describe how you would have supported them during this acute episode.

a. If the patient9s family would have been present I think they would have been scared because the patient was complaining of chest pain and that he couldn9t breathe. I would of reassured them that we are doing everything we can to try and get control of his PE.

9. What would you do differently if you were to repeat this scenario? How would your patient

care change?

a. I would make sure I do all the steps in the correct order. The first time I did the scenario I kind of freaked out and just tried everything I could to get him to stop saying I can't breathe. That included me doing things without a dr. order. Which is clearly not the right thing to do.