Posted: September 26th, 2023
REPLY TO A CLASSMATE
Paragraph One: What went well for you in the simulation? Provide examples of when you felt knowledgeable and confident in your skills. Do you feel the scenario was realistic? Why or why not?
I felt that the simulation on Micheal Granger was very realistic as patients often come in for exacerbations of HF due to lack of knowledge or non-compliance with follow up care regularly. A lot of times patients are un-educated on the consequences of not following up with life style changes relating to their illness. This is a perfect example of what can happen symptomatically to a patient if they are not properly following up with their health. I felt knowledgable on the questions I needed to obtain from this patient in order to create a baseline and help form a plan of care with the doctor. I also felt confident with asking the patient about their history regarding fluid overload related to the heart failure. I felt for pulses, capillary refill, ROM, and asked about sensation when addressing the patients bilateral leg edema. In this simulation, I enjoyed listening to the lung sounds and being able to recognize the coarse crackles this patient had to his bases. Lung sounds and heart sounds can be difficult to assess at times in the health care field due to outside noises, and other factors so it was reassuring for me to be able to identify the crackles correctly.
Paragraph Two: What would you do differently next time if you were caring for a patient similar to Mr. Granger? Describe at least one area you identified where improvements could be made, specific to Mr. Granger’s assessment. Were you surprised by any of the feedback you were provided by iHuman? If yes, please explain.
I will examine each pupil at least twice next time I assess a patient in order to correctly identify PERLA. I was not properly educated on the importance of this and will now use this in my practice. I also did not listen to the patients bowel sounds for 8 seconds each and will ensure that I do that from now on to ensure I am properly hearing the sounds. I was surprised by this feedback as I did not know that we were supposed to listen for a full 8 seconds at each abdominal quadrant. A lot of times, working in the ED, assessment tools like this can start to be missed if not practiced regularly. It is important for me to be reminded of these pieces as I want to further my knowledge on physical assessment skills. A lot of that can be missed in the busy ED so I am very grateful to have such a thorough simulation tool that I can use to be reminded of assessment skills. If in this situation again, I would want to ensure that I provide the patient with proper follow up options in order to help with his diet changes and smoking cessation. Mr. Granger did agree to change his diet when returning home, but I feel that meeting with a dietician is beneficial to this patient because there are a lot of different food options out there that can hide salt. I want this patient to be able to properly and successfully form a meal plan that meets his needs.
Paragraph Three: What did you learn from this simulation that you could apply to nursing practice? Or, what did this simulation reinforce that you found valuable? Do you have any questions related to the scenario?
I learned how to properly listen for the S3 heart sound. Upon auscultating this patients heart I knew something was off, but wasn’t exactly sure what. I was able to locate recourses within the modules in Chamberlain that allowed me to educate myself on the S3 sound heard and will be able to carry this into my practice. I will admit that listening to heart sounds can be difficult for me as I feel there are so many different kinds to learn about. I am also used to primarily only listening to the aortic and pulmonic valve in my practice . It was educating for me to learn that it is best practice and most beneficial to the patient to listen to mitral and tricuspid as well. I do not want to miss any pertinent data when assessing my patients, and this simulation helped me to ensure I start using that in my every day practice. I do not have any questions related to this scenario at this time. I feel that the simulation gave me educational feedback that may have answered any questions that I had previously.
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