Foundation of Nursing Practice

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School

University of Nairobi *

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Course

2351

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Nursing

Date

Nov 24, 2024

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docx

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Uploaded by nickhande

1 Foundation of Nursing Practice Student's Name Instructor's Name Course Date

2 Foundation of Nursing Practice Situation The situation that led to the calling of physicians was because a patient-reported feeling dizzy and light-headed while at home. Moreover, the patient's wife reported that Mr O almost fell because of his current condition. Mr O was later admitted to AMU with syncope and was not admitted to the hospital for the first time. Practitioners learned that Mr O was treated for myocardial infarction and congestive heart failure in the past. Background The pertinent background information showed that Mr O felt healthy after being discharged from the hospital and took NSAIDs at home to relieve him of his chronic back pains. Mr O arrived in AMU with the help of his wife at 1600 and was assessed by a nurse named Jenny, RN. The nurse confirmed that Mr O has a blood pressure of 138/84 with a regular pulse of 76 and a respiratory rate of 16. Moreover, the nurse confirmed that Mr O was afebrile at 98.6 with normal lab results. The nurse noticed that Mr O's IV infiltrated while being transported; thus, Jenny opted to begin a new IV but included warm compression on the old site. Jenny later reported to the attending practitioner, Ben, at 1900. Room number: AMU Room Number 5. Assessment The PCA found the attending practitioner, Ben, RN, at 2130 to inform him that he successfully helped the patient get off the bedpan. Moreover, the nurse assessment confirmed

3 that the patient had a large stool that was black and tarry in colour after complaining of not feeling well. Ben confirmed Mr O's vital signs were a pulse of 114, BP 94/66, and a respiratory rate of 24. The patient had pulse oxygen of 97% but was clammy and had pale skin. Based on the patient's assessment level and myocardial infarction, the patient showed a severe abdominal abnormality that needed urgent medical attention. On the other hand, the patient reported feeling an overall abdominal pain of 6 out of 10. Ben confirmed that the pain distended, thus an urgent need of addressing such matters in detail. Recommendation Based on Mr O's distended abdominal pains, the patient had severe abdominal pain that made his skin pale because of dehydration. Mr O needs urgent medical care to prevent possible negative outcomes linked with myocardial infarction and congestive heart failure. Practitioners need to conduct regular IV check-ups to ensure Mr O's condition does not deteriorate. Increase fluid intake by drinking plenty of clean water while reducing coffee, tea, and alcohol intake. On the other hand, the patient's viral respiratory signs indicate possible bacterial infection; thus, antibiotic use becomes indicative. Physicians need to take not if Mr O requires additional workup. Thorough patient observation is necessary to promote patient care from the patient's assessment. Prompt Response What was your thought on the clinical scenario? My thoughts on the scenario were that it was a good scenario that focused on the foundation of nursing practice. Jenny played a vital role as a registered nurse (RN) who was

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4 dedicated to treating the patient by being precise with the preferred treatment approach. Similarly, Jenny RN's assessment at 1900 showed a regular pulse of 76 compared to Ben's report of a pulse ox of 97%. Regardless of the patient's IV being infiltrated during transportation, Jenny put a warm compress on the old sire prior to reporting to Ben, RN, at 7 PM. Despite Mr O feeling completely normal and healthy at the first assessment, Mr O's had diffused abdominal pain. The patient should be on more medication because of their low respiratory rate and blood pressure. What do you think could have been added to the SBAR? I believe that cardiac lab tests need to be conducted to assess the previous causes of his congestive heart failure. What could be added to the SBAR about the collection of stool specimens is virology tests to further analyze Mr O's syncope. Similarly, the previous history of congestive heart failure shows that Mr O requires a thorough assessment to determine other procedures that need to be conducted. If I had the chance to take the conversation again, I would show how nurses handle the urgency of patients in real life. The inclusion of lab results in the SBAR tool is necessary because it allows practitioners to clearly understand different happenings within the clinical settings, thus knowing which matters require urgent medical attention. What do you think we did not need in the SBAR? Nurses should not fill the recommendations because I believe it is the responsibility of doctors to draw the final recommendations for patients. However, I believe all the other sections of the SBAR approach constitute reliable interventions used by practitioners to reach a meaningful treatment plan that is effective and reliable. Home care practitioners need to consider using SBAR strategies to communicate patients' symptoms through a reliable approach, thus

5 solving medical problems. The SBAR tool needs to be readily available to practitioners because it has been proven to be the most dependable approach used to prevent the re-hospitalization of patients suffering from severe chronic-related illnesses by addressing them in a convenient manner. If we made this conversation again, what should we do differently? I would use an actual phone and use different medical equipment to depict a clinical environment if the conversation was to be held again. Similarly, I would instruct my patient (Mr O) to lie flat on his belly while I was assessing his overall pain level. When given an opportunity to hold the conversation again, I would ensure the patient showed his diffused abdomen because of severe pain. Additionally, I would include a specimen that portrayed the black stool to allow for realism with the chosen treatment approach. On the other hand, I would allow my patient to highlight previous experiences with a myocardial infarction and congestive heart failure while stating medications used before for treatment. Do you think the significance of the situation was clearly presented to the physician? Regardless of having actual nursing equipment used to deal with various abdominal pains, the situation was clearly presented, and I found it easy to relate to the first scenario than the others. On the other hand, when aiming at achieving a well-presented situation, I would stress on the part where the patient Mr. O's blood pressure about 5 hours ago was138/84 which is a little elevated and now his blood pressure is 94/66 but not within a hypertensive state. Additionally, I would stress that at 2130 his blood pressure seen by the 40% drop in the systolic and 15% in diastolic blood pressure showed that thorough assessment was required. Nonetheless, the presented situation was significant because it aimed at showing different procedures used by

6 registered nurses to address adverse health conditions brought about by myocardial infarction and congestive heart failure. In essence, understanding the importance of SBAR approach is mandatory to health care practitioners aiming at delivering high-end quality care that is patient-oriented and effective. SBAR allow health practitioners because it improves communication effectiveness by creating a standardized communication process. Encouraging the implementation of SBAR strategies in current medical settings is appropriate for fostering better and improved patient outcomes.

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