NUR2811

7/29/2020 – IHuman, Right forehead hematoma, 70%

This scenario was about 78 year-old Eva Smith who arrived to the ED brought by husband for a
right forehead hematoma and headache s/p a fall four days ago. Patient was embarrassed to admit
that she has been experiencing urinary frequency for the past six months and was rushing to the
restroom without the use of her walker or her glasses causing her to trip and fall, hitting her head
and right knee on a chest of drawers. After MRI done in ED, she is being diagnosed with right
frontal subdural hematoma. To demonstrate evidence-based practice, I performed a through
neurological exam during the physical in accordance to the need for a neuro check every two
hours per physician and I also reassessed her pain a few hours after pain medication
administration to determine her current pain level. My content area that was my strongest was
categorizing priorities as acute, worsening, resolved, or no changes. My content area that was the
weakest was placing client problems into categories such as CNS, comfort, safety, etc. I used
good clinical reasoning by indicating that the patient’s increasing headache required assessment
STAT by the provider and that she should continue to have neuro checks around the clock until
the next MRI is performed. Aside from being unable to properly categorize the patient’s
problems I found that I made good clinical decisions with my patient’s care. The ATI I did today
was priority setting, which helped to reinforce different priority actions that should be performed
depending on the patient’s problem.