Surgical Scenario Doris Bowman Feedback Log vSim

Doris Bowman Age: 39 years Diagnosis: Immediate Postop. Abdominal Hysterectomy Score 100% Feedback Log You arrived at the patient's side. You introduced yourself. 0:08 You washed your hands. To maintain patient safety, it is important to wash your hands as soon as you enter the room. 0:10 Patient status - ECG: Sinus tachycardia. Heart rate: 106. Puise: Present. Blood pressure: 156/93 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 93%. Temp: 99 F (37 C) 1:10 Patient status - ECG: Sinus tachycardia. Heart rate: 104. Pulse: Present. Blood pressure: 152/91 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 94%. Temp: 99 F (37 C) 1:25 You identified the patient. To maintain patient safety, it is important that you quickly identify the patient. 1:33 You asked if the patient was allergic to anything. She replied: 'No, I am not allergic to anything." 1:56 You looked for normal breathing. She is breathing at 21 breaths per minute. The chest is moving normally on both sides. 2:10 Patient status - ECG: Sinus tachycardia. Heart rate: 103. Pulse: Present. Bicod pressure: 149/90 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 95%. Temp: 99 F (37 C) 2:25 You attached the pulse oximeter. It is a good idea to monitor the saturation and pulse here. This will allow you to reassess the patient continuously. 2:42 You checked the radial pulse. The pulse is strong, 105 per minute and regular. It is correct to assess the patient's vital signs. 3:05 You checked the temperature at the mouth. The temperature was 99 F (37 C). 3:10 Patient status - ECG: Sinus tachycardia. Heart rate: 103. Pulse: Present. Blood pressure: 149/90 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 95%. Temp: 99 F (37 C) 3:44 You attached the automatic noninvasive blood pressure (NIBP) measurement cuff. This will allow you to reassess the patient continuously. 3:57 You attached a 3-lead ECG. It is correct to attach the monitor to the patient. 4:10 Patient status - ECG: Sinus tachycardia. Heart rate: 102. Pulse: Present. Blood pressure: 153/91 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 95%. Temp: 99 F (37 C) 4:14 You assessed the patient's IV. The site had no redness, swelling, infiltration, bleeding, or drainage. The dressing was dry and intact. This is correct. Assessing any IVs the patient has is always important. 4:42 You examined the patient's skin. There is normal skin turgor. Her skin is cool, and she is very sweaty. 5:00 You assessed the patient's dressing. This is correct. Assessing any dressings the patient has is always important. 5:10 Patient status - ECG: Sinus tachycardia. Heart rate: 102. Pulse: Present. Blood pressure: 153/92 mm Hg. Respiration: 21. Conscious state: Appropriate, SpO2: 95%. Temp: 99 F (37 C) 6:10 Patient status - ECG: Sinus tachycardia. Heart rate: 102. Puise: Present. Blood pressure: 153/91 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 95%. Temp: 99 F (37 C) 6:42 You listened to the lungs of the patient. The breath sounds are normal. 7:10 Patient status - ECG: Sinus tachycardia. Heart rate: 102. Pulse: Present. Blood pressure: 152/90 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 95%. Temp: 99 F (37 C) 7:59 You listened to the heart of the patient. There were only normal heart sounds. This is reasonable. 8:10 Patient status - ECG: Sinus tachycardia. Heart rate: 102. Pulse: Present. Blood pressure: 150/90 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 95%. Temp: 99 F (37 C) 9:10 Patient status - ECG: Sinus tachycardia. Heart rate: 102. Pulse: Present. Blood pressure: 152/91 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 95%. Temp: 99 F (37 C) 9:18 You listened to the abdomen of the patient. You could hear hypoactive sounds from the abdomen. 10:10 Patient status - ECG: Sinus tachycardia. Heart rate: 102. Pulse: Present. Blood pressure: 154/92 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 95%. Temp: 99 F (37 C) 10:21 You asked the patient if she had any pain. She replied: 'Yes! Ahh...' 10:25 You asked: How bad is the pain? She replied: 'It's pretty bad, I'd give it a 6.' 10:38 A 2 mg dose of morphine was injected IV. You should consider administering this drug slowly. It was reasonable to give an opioid here. It is important to use the basic rights of medication administration to ensure proper drug therapy.. 10:39 The patient started developing respiratory depression. 10:42 You flushed the cannula. 10:51 Patient status - ECG: Sinus rhythm. Heart rate: 99. Pulse: Present. Blood pressure: 147/88 mm Hg. Respiration: 15. Conscious state: Appropriate. SpO2: 95%. Temp: 99 F (37 C) 11:01 Patient status - ECG: Sinus rhythm. Heart rate: 92. Pulse: Present. Blood pressure: 135/81 mn Respiration: 7. Conscious state: Appropriate. SpO2: 95%. Temp: 99 F (37 C) 11:20 The patient's respiration rate dropped below 6 breaths per minute. 11:21 You looked for normal breathing. She is breathing at 6 breaths per minute. The chest is not 11:21 You looked for normal breathing. She is breathing at 6 breaths per minute. The chest is not moving very well. 11:22 Patient status - ECG: Sinus rhythm. Heart rate: 90. Pulse: Present. Blood pressure: 121/72 mm Hg. Respiration: 5. Conscious state: Somnolent. SpO2: 94%. Temp: 99 F (37 C) 11:44 You started assisting a patient who was breathing. You were able to provide sufficient ventilation. 11:57 You administered 0.2 mg of naloxone IV. Naloxone is the appropriate drug to give here to reverse the effect of the opioid. 12:00 You flushed the cannula. 12:08 Patient status - ECG: Sinus rhythm. Heart rate: 92. Pulse: Present. Blood pressure: 120/69 mm Hg. Respiration: 11. Conscious state: Appropriate. SpO2: 93%. Temp: 99 F (37 C) 12:17 You looked for normal breathing. She is breathing at 15 breaths per minute. The chest is moving normally on both sides. 12:20 Patient status - ECG: Sinus rhythm. Heart rate: 94. Pulse: Present. Blood pressure: 119/68 mm Hg. Respiration: 16. Conscious state: Appropriate. SpO2: 93%. Temp: 99 F (37 C) 12:23 You stopped ventilating the patient. 12:33 You placed a nasal oxygen cannula. This was part of your orders. 12:42 You provided patient education. This is correct. It is important to use every opportuni patient education. 13:20 Patient status - ECG: Sinus tachycardia. Heart rate: 102. Puise: Present. Blood pressure: 140/7 Respiration: 21. Conscious state: Appropriate. SpO2: 95%. Temp: 99 F (37 C) 13:58 You asked the patient if she felt nauseated. She replied: 'No. I don't have any nausea.' 14:02 You looked for normal breathing. She is breathing at 21 breaths per minute. The chest is moving normally on both sides. 14:20 Patient status ECG: Sinus tachycardia. Heart rate: 100. Pulse: Present. Blood pressure: 140/78 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 95%. Temp: 99 F (37 C) 15:10 A patient handoff was performed. Nursing management objectives for the patient in the post anesthesia care unit are to provide care until the patient has recovered from the effects of anesthesia, is oriented, has stable vital signs, and shows no evidence of complications. Pain control is a critical component of postoperative care and often includes IV opioid analgesic medications to provide immediate but short-acting pain relief. The most common adverse effects of opioid analgesic agents are constipation, nausea, vomiting, pruritus, and sedation. Respiratory depression is a less common but serious adverse effect. Prevention of clinically significant opioid-induced respiratory depression begins with administration of the lowest effective opioid dose, careful titration, and close nurse monitoring of sedation and respiratory status throughout therapy. If respiratory depression occurs, the nurse provides appropriate oxygenation and ventilation and calls for help. You got 100%