Date:

12/06/2020

Type of activity: Assessment Technologies Institute (ATI) Real Life Registered Nurse Medical

Surgical 3.0

Module: Gastrointestinal (GI) Bleed

Score: Satisfactory

I started the scenario in ATI. The case focused on Ms. L., a 36-year-old client who was

admitted from the emergency department for abdominal pain, bloody stools, and dizziness. By

answering the case scenario questions, I helped Ester, the registered nurse (RN), to provide

patient care. One of my strengths was to recognize the differences between types of bowel

sounds (hypoactive, normoactive, and hyperactive). Another strength was recognizing the signs

and symptoms of a febrile reaction when the patient received a blood transfusion. I made good

clinical decisions by assessing the vital signs when Ms. L. reported she was feeling lightheaded

and dizzy. Since she was pale and her vital signs indicated hypotension and tachycardia, I

recognized the patient was at risk for hypovolemic shock. For this reason, I lowered the head of

the bed to promote improved circulation. I stopped the blood transfusion to prevent further

exposure to the sensitizing component of the blood. Also, I notified Dr. McGuire about the

patient’s condition using the situation background assessment recommendation (SBAR)

communication. These actions are evidence that I made appropriate decisions while providing

patient care. I demonstrated evidenced-base practice by asking Ms. L. if she had experienced a

reaction with any previous blood transfusions. However, since I misplaced two steps when

administering the blood transfusion, I need to review these steps and reinforce them with a

visual aid. I used good clinical reasoning by calculating the amount of morphine sulfate to
administer to Ms. L. and the rate of infusion to prevent serious adverse reactions. Moreover, I

taught the patient about the medication prescribed to reduce oral secretions prior to

endoscopy and some strategies to manage stress, such as practicing yoga, getting a pet, writing

in a journal, and going out with friends. Also, I instructed the patient about how to maximize

her diet and what medications to avoid.