University:
Villanova University
Course:
306 | Medsurge
Academic year:

2023
Views:

396

Pages:

2
Author:

ilikemyicons0y5

Marilyn Hughes Guided Reflection Questions 1. How did the scenario make you feel? This scenario made me feel comfortable to work with. I was fast and quick thinking to help the patient and quickly realize she was experiencing compartment syndrome. 2. How would you recognize that Marilyn Hughes’ condition was deteriorating? I quickly realized her situation was worsening when her blood pressure began to go up with an increasing heart rate, respirations and temperature as well. Despite being given pain medication, none of these objective symptoms went away. 3. What interventions exist to alleviate compartment syndrome, and what assessments indicate improved perfusion to the extremity? Interventions done to help this client would be to place the patient’s leg at heart level, this helps to improve and increase the client’s circulation in the limb. Another intervention is loosening the patients dressing to allow blood in the area to flow. Assessment of the color on the toes, the temperature surrounding the area, presence of pedal pulse and testing the patients capillary refill will help to assess improved perfusion to the extremity. 4. Why is it important to maintain the limb at heart level versus elevating it above heart level? This helps to flow perfusion with ease, or at least improve it. This will also help with pain and the swelling the patient is experiencing. It also prevents the patient from having further fluid accumulation in the affected limb. 5. What could have happened in this scenario if Marilyn Hughes’ condition was not treated expediently? Compartment syndrome is very serious. If prompt steps were not taken to restore the patient’s circulation, she could have potentially lost her leg because not enough blood supply, like ischemia, was reaching her. 6. What key elements would you include in the handoff report for this patient? Consider the SBAR (situation, background, assessment, recommendation) format. A 45year-old female presented to the ER with mid-shaft tibia-fibula fracture after slipping on the stairs in the morning. The patient had a surgery with internal fixation. The patient returned from the surgery at 1:45 pm with a below the knee splint dressing. The patient’s vitals were HR 103, BP 153/88, temperature 99. The patient also has an iv with lactate ringer at 75 ml/hr on the right arm. Patient has expressed severe pain without relief from pain medication and said the dressing felt too tight. When assessed, the dressing was placed too tight. The dressing was loosened. I would recommend to minimizing any leg elevation because it decreases arterial flow and narrows the arterialvenous pressure gradient 7. What would you do differently if you were to repeat this scenario? How would your patient care change? If I had to change anything it would be to react faster. I would ask questions faster and make a focus assessment first on what the patient really needs, as I would take vital signs I would also assess for the pedal pulse and assess her lower her leg to save time and react faster should something happen like in this scenario.