Laura Katherine Castano Barragan

Journal 4

Date: 7/22/2020

Professor El Kholy, Amira

I-Human, Acute acetaminophen ingestion, 78%

I started the scenario in I-Human with A. O, 19-year-old female admitted to the unit for

acute acetaminophen ingestion of 7.5 g (15 500mg capsules) at 2000 as attempt of suicide. my

score for the case was 78%. The patient has a hx of depression since she was 15 years old. Since

16 she takes fluoxetine 20 mg a day but lately her mood has been changing related to recent

stressors such as: no friends in college, failing grades in school, missing family and friends,

boyfriend told her that he wanted to stop seeing her. The patient only social support in college is

her boyfriend. Previous attempt of suicide in high school. Vital signs were within the normal

range during the shift. She still feels interested in life, most of her days are happy, she feels

hopeful but her mood is depressed right now. Fatigue is present. S/s like nausea and abdominal

pain are resolved. Erythema and itchiness around iv site. Antihistamine was administered. Skin

warm, pale and diaphoretic. Hypoactive bowel sounds. Monitor for antihistamine response and

shortness of breath. I recommended to get a psych consult and evaluate and educate in coping

mechanisms. Evaluate modification in pharmacological therapy for depression. Also, monitor

acetaminophen levels and LFT for changes.

 I was able to select most of the correct assessments in the health history and the physical,

however I didn’t select specific actions to assist the patient during her stay. For example, I

selected that she needed to be put in suicide precautions but didn’t specified that a sitter was

needed all the time. I identified her depression as a cause for the suicide and all the recent

stressors that lead to the event to base the plan of care. My strength in this scenario was the

focus I put into identifying the psychological symptoms and intervening on time for the allergic

reaction at the iv site. My weakness was to not anticipate all the actions to help the patient solve

the stressors she is having in her life right now.