5KNIA511 – Adult Nursing 2 – Open Book Exam Formative Question

 

 

FORMATIVE OPEN BOOK EXAM QUESTION

Please follow Levett Jones’ Clinical Reasoning Cycle to answer the following scenario.

Below you have been provided with a case scenario of a patient with a health problem: you can submit a 250 word plan for how you would answer the question, plus one table and a reference list.

 

The following scenario provides information that considers the patient’s (Joy Potter) situation (step 1) and gives you the cues/information (step 2).  You need to process the information (step 3) identify the problems/issues (step 4) and establish/identify your goals (step 5) applying the Levett-Jones cycle (below).

 

 

CASE SCENARIO

 

Phase 1 & 2 – Consider the patient situation & collect cues/information –

This information is provided for you.

 

Patient Scenario

Joy Potter is 47 years old with a history of mild to moderate asthma she is in recovery following a day case orthopaedic procedure.

 

Joy is breathless, wheezy, coughing and unable to speak in more than one- or two-word sentences.

She deteriorates during your assessment to silent chest.

Her asthma usually well controlled with Clenil and Salbutamol inhalers.

Animal hair and hay fever are triggers for her asthma.

Joy is not aware about her Peak Flow measurements.

Last had oral steroids (Prednisolone) 2 years ago with a chest infection.

Never had nebulisers. No asthma related hospital admissions.

Never been ventilated.

No other medications. No known drug allergies.

 

You have been looking after this patient for about 15 minutes.

Over the last

5 minutes the patient has been complaining of chest tightness and coughing a lot.

She sounds wheezy. You know she is asthmatic from the anaesthetic chart, but

no asthma medication has been prescribed. You have called the doctor to review the patient.

 

You undertake observation of Joy’s vital signs and record the following data:

BP: 165/85 mmHg; HR: 95 bpm; Temperature: 36.7 C; RR: 28 bpm; O2 sats: 94% on 2L nasal specs. Joy is awake, agitated, “gasping” for air, sitting upright in the bed. Eyes are open and pupils are equal.

 

The doctor arrives and prescribes salbutamol nebuliser 5 mg, in 6 ml of 0.9% NaCl with 8 L of O2 (You have been signed-off as competent to administer nebulisers).

You repeat the vital signs after the nebuliser and you get the following data:

SaO2: 96% RR: 24/min, Wheeze. BP 165/85. HR: 125 bpm. D: Awake. Eyes open. Pupils equal. Difficulty talking. Weak cough.

 

QUESTION

Step 3 – Process the above information and use the information to:

Step 4 – Identify problems/issues

Step 5 – Establish goals and a treatment plan

You can submit a 250 word plan for how you would answer the question, plus one table and a reference list.