Case Kenneth Bronson VSim

Mariah Diaz Medical Case 1: Kenneth Bronson Guided Reflection Questions 1. How did the scenario make you feel? – This one made me feel a little more nervous than the first vsim. I enjoyed it and this vsim challenged me. 2. What signs and symptoms led you to the conclusion that Kenneth Bronson was experiencing an allergic reaction? – antibiotics are the most common drug allergy. Immediately after drug administration he started complaining of shortness of breath, difficulty breathing, and then a few minutes later, he had a rash on his chest. 3. Discuss the differences between mild, moderate, and severe anaphylactic reactions. - Mild—Symptoms are localized and does not affect the Pt systematically. For example: rash, hives. -Moderate—can be localized or systematic, if localized it is more severe, if systematic, it is not life threatening, examples include rash, hives, difficult breathing or swelling. -Severe—a life threatening reaction, patient is hypersensitive to whatever causes the reaction. Is life threatening can lead to death. Examples are swelling of the throat, cramps, vomiting, mental confusion and even a decrease in blood pressure. 4. Discuss the importance of follow-up assessments post-reaction. – The patient shoul be monitored closely just in case of a delayed reaction. 5. What further needs does Kenneth Bronson have at the end of the scenario that future nursing care should address? – the patient should be monitored for 6-12 hours and given education on anaphylactic reactions. Also make sure to inform them on what they are allergic too so in the future they will know what to tell providers to prevent this. 6. Reflect on how you would communicate with family members in an emergency situation if they were present at the bedside. – Explain to the family that We will do everything we can to fix this situation and to keep calm. Once the situation is under control and the patient is stable then I would take the time to explain to the family exactly what happened and how we treated it. 7. After completing the simulation and reflecting on your experience, what would you do differently (or the same) for the patient experiencing acute respiratory distress? K would administer the medication slowly! That was my biggest mistake. I would also stop the administration of the antibiotic at the proper time. 8. How could you prepare for clinical in order to plan ahead for potential patient emergencies? – To study an make sure I know any possible reactions that a patient could have and how to avoid it. Making sure I always ask patients if they have any known allergies to prevent any possible mistakes. Medical Case 1: Kenneth Bronson Documentation Assignments 1. Document Kenneth Bronson’s new allergy information in his patient record. – Allergic to Ceftriaxone, patient had anaphylaxis 2. Document your initial focused respiratory assessment of Kenneth Bronson. – Reduce lung sounds at the right lung base, 17 bpm, chest moving normal on both sides 3. Document the assessment changes that occurred before and after the anaphylactic reaction. – After administering antibiotic, I observed reduced breath sounds at the right lung base airway sounds, obstructed, after administering prescribed meds, airway continues to sound obstructed. 4. Identify and document key nursing diagnoses for Kenneth Bronson. – Impaired gas exchange, R/T bronchospasm as evidence by changes in O2 sat. Ineffective airway clearance R/T bronchospasm as evidence by wheezing. 5. Referring to your feedback log, document the nursing care you provided. – Assessed patient previous medical history, assessed pain level, auscultated patient’s lungs, took respirations, attached Non-invasive BP cuff, attached O2 monitor, attached ECG assessed IV site, flushed IV, administered ceftriaxone, patient started to make audible wheezing, stopped infusion of antibiotic, assessed lung sounds, called physician, administered 10L O2 using nonrebreather mask, administered epinephrine, administered diphenhydramine, albuterol, and methylprednisolone. Reassess lung sounds, assessed heart sounds, provided education to the patient, phone physician to update.