Guided Reflection Stan Checketts

1. How did the scenario make you feel?

When I read the introduction, I felt confident, I knew it had to be something I had seen in

the hospital during clinical. In Hit 2, our simulation was Small Bowell Obstruction and I

actually had a patient during clinical with this diagnosis so it was not that bad.

2. When reflecting on the care of Stan Checketts, what are signs and symptoms you can

assess in the next patient you care for who might be at risk for dehydration?

Some signs and symptoms of dehydration to asses include Poor skin turgor, dry skin, and

mucous membranes. Dizziness and weakness. Not urinating or having dark yellow urine.

3. Discuss signs and symptoms of hypovolemic shock.

Low blood pressure, cool clammy skin, confusion or wooziness, feeling weak and quick

shallow breading.

4. Discuss assessment and expected findings in a small bowel obstruction.

Assessment findings include abdominal pain, which the patient described as cramping, it

gets worse with movements. Nausea was present but no actual vomiting. The abdomen was

bloated and tender on palpation with hyperactive bowel sounds. There was no passing of

blood, fecal matter. Expected findings from CT scan and abdominal X-ray would include gas,

fluids or both in the small intestine and a collapsed distal bowel.

5. What key questions does the nurse ask in an acute abdominal pain assessment?

In an acute abdominal Pain, the nurse should use the acronym PQRST.

P- Provocation: what caused the pain?

Q- Quality: what does it feel like, can you describe the pain.?

R- Region= where is the pain located, does the pain radiate anywhere?

S- Severity scale, how bad is the pain on a scale of 0-10?

T-Time. When did the pain start, what where you doing when the pain started?

6 In evaluating Stan Checketts’ laboratory values, what if any abnormalities did you find?

The abnormal labs were Sodium, urea nitrogen, creatinine, Hemoglobin, Hematocrit and

White Blood Count.

7. Stan Checketts had a nasogastric (NG) tube inserted for gastric decompression. What are

the preferred methods for confirming placement of the NG tube?

The preferred method to confirmed placement would be X-Ray.

8. What key elements would you include in the handoff report for this patient? Consider the

SBAR (situation, background, assessment, recommendation) format.

Guided Reflection S - Medsurge

Surgical Critical Care Medicine (ANES 780)