Feedback Log & Score - Christopher Parrish Apr 01, 2020 8 - 53 PM

9/18/2020 Feedback Log & Score — Christopher Parrish Apr 01, 2020 8:53 PM
Date of Completion
Apr 01, 2020 8:53 PM
Christopher Parrish
Age: 18 years
Diagnosis: Cystic Fibrosis
Score
1 
0  92%
0 
Feedback Log
0:00 You arrived at the patient's side.
0:00 You reviewed the patient information.
0:00 You reviewed the patient log.
0:00 You reviewed the diagnostics.
0:00 You reviewed the clinical observations.
https://simserver.wkhpe.com/debriefing/debrief.aspx?dss=https%3A%2F%2Fsso.wkhpe.com%2FDebriefingLog%2FSingle%3Fid%3D32504a97-e863-… 1/7
0:00 You reviewed the MAR.
0:00 You reviewed the orders.
0:00 You reviewed the intake and output.
 0:08 You washed your hands. To maintain patient safety, it is important to wash your
hands as soon as you enter the room.
0:10 Patient status - ECG: Sinus rhythm. Heart rate: 81. Pulse: Present. Blood pressure: 120/72
mm Hg. Respiration: 12. Conscious state: Appropriate. SpO2: 97%. Temp: 99 F (37.3 C)
 1:24 You introduced yourself. This was reasonable.
 1:41 You identified the patient. To maintain patient safety, it is important that you
quickly identify the patient.
 1:51 You asked if the patient was <Allergy>allergic<> to anything. He replied:

'No, I am not allergic to anything.'
2:28 You asked the patient if he needed anything. He replied: 'I guess you need
to start my tube feeding.'
2:35 You asked the patient how he felt. He replied: 'I am tired.'
2:40 You asked what happened. He replied: 'I haven't been eating much
lately.'
2:46 You asked the patient when the symptoms started. He replied: 'I
haven't been eating much for more than a week or so.'
2:53 You asked: What were you doing when the symptoms started? He replied:
'Nothing special.'
3:01 You asked the patient if he had any difficulty in breathing. He replied: 'No,
my breathing's fine.'
3:08 You asked the patient what other symptoms he had. He replied: 'I
don't have any other symptoms.'
3:15 You asked the patient if he had had anything to eat or drink today. He replied:
'No, I haven't eaten anything yet today.'
3:29 You asked the patient if he felt nauseated. He replied: 'No. I don't
have any nausea.'
3:52 You asked the patient: Have you had any signs of dehydration such as leg
cramps, palpitations, weakness, fatigue, or dizziness? He replied: 'No, I
don't think so.'
4:06 You asked the patient: Do you follow a special diet prescribed by your doctor? He
replied: 'Yes. A high-fat, high-calorie diet.'
4:17 You asked the patient: Do you use any vitamins or food supplements? He replied:
'Yes, I do take special vitamins. I have to take extra vitamins because of
my CF. I don't take any supplements.'
4:30 You asked the patient: Are you getting the meals you need on a daily basis? He
replied: 'Well, I am in college and sometimes I may not make it to the
cafeteria in time. That has happened a few times. I have snacks in my room, but
they don't really replace a meal.'
4:47 You asked the patient: Do you weigh yourself frequently during the week? He
replied: 'No, I usually don't weigh myself often, but I have been
weighing myself every week since I noticed I was losing weight.'
4:59 You asked the patient: How many bowel movements do you have every day and
what is the consistency? He replied: 'I usually have one or two, and
they're mostly formed but soft.'
5:20 You asked the patient: Has there been a normal amount of feces in the pouch
today? He replied: 'I do not have a pouch.'
5:45 You asked the patient what medication he was taking, if any. He replied:
'Yes, I take enzymes for digestion.'
5:53 You asked the patient if he had taken his medication, if any. He replied: 'I
didn't take my meds yet.'
5:58 You asked the patient if he was a smoker. He replied: 'No, I don't
smoke.'
6:04 You asked the patient if he had any medical problems. He replied: 'Yes, I
have cystic fibrosis.'
6:14 You asked the patient if he was awake. He replied: 'I'm

awake.'
6:20 You asked the patient what year it is. He replied: 'It is 2020.'
6:25 You asked the patient if he knew where he was. He replied: 'I'm at
the hospital.'
6:30 You asked the patient what date it was. He replied: 'The 1st'
6:45 You put on gloves.

7:06 You examined the patient's skin. There is normal elasticity of the skin. His
color is normal, and he is not sweating.
 7:24 You examined the patient's chest. He is breathing at 12 breaths per

minute. The chest is moving equally. There is normal elasticity of the skin. His
7:44 You examined the patient's abdomen and pelvis. There is normal elasticity
of the skin. His color is normal, and he is not sweating. There is nothing else to
find on examination of the abdomen and pelvis.
8:00 You examined the patient's arms. There is normal elasticity of the skin. His
color is normal, and he is not sweating. There is nothing else to find on
examination of the arms.
8:17 You examined the patient's legs. There is normal elasticity of the skin. His
color is normal, and he is not sweating. There is nothing else to find on
examination of the legs.
 8:44 You assessed the mucous membranes. This was reasonable.
 9:20 You listened to the lungs of the patient. The breath sounds are clear and equal
bilaterally.
 9:41 You listened to the heart of the patient. This is reasonable. There were regular
heart sounds without murmurs.
10:10 You listened to the abdomen of the patient. Normal bowel sounds were heard.
10:16 You looked for normal breathing. He is breathing at 12 breaths per minute. The
chest is moving equally.
 10:45 You attached the <Pulseoximeter>pulse oximeter.<> It is a good idea to

monitor the saturation and pulse here. This will allow you to reassess the patient
continuously.
10:49 You disconnected the <Pulseoximeter>pulse oximeter.<>
 11:00 You checked the radial pulse. The pulse is strong, 85 per minute, and regular. It is
correct to assess the patient's vital signs.
 11:48 You checked the <Temperature>temperature<> at the ear. The

temperature was 99 F (37.2 C).
 12:05 You checked the <Temperature>temperature<> at the ear. The

temperature was 99 F (37.2 C).
 12:27 You measured the <Bloodpressure>blood pressure<> at 120/72 mm Hg.

It is appropriate to monitor the patient by measuring the blood pressure.
 13:08 You checked the pedal pulse. The pulse is strong, 85 per minute, and regular.
 13:32 You checked the radial pulse. The pulse is strong, 85 per minute, and regular.
13:59 You checked the capillary refill time. The capillary refill time was less than 2
seconds.
14:22 You checked the eye movements. Extraocular movements within normal limits.
14:40 You checked the patient's pupils, and they were 4 mm and reactive.
 15:09 You checked the placement of the nasogastric tube. This was reasonable.
 16:05 You tried to assess an ulcer, but the patient did not have one. This was not
necessary here.
 16:38 You educated the patient about activities, safety, and fall risk.
 17:05 You educated the patient about body mass index.
 17:46 You educated the patient about diagnostics.
 18:27 You educated the patient about diet. This was reasonable.
 18:54 You educated the patient about improving venous return. This was reasonable.
 19:21 You educated the patient about intake and output.
19:47 You educated the patient about medication.
20:11 You educated the patient about risk of aspiration.
 20:43 You educated the patient about tube feeding. This was reasonable.
21:36 You assisted the patient into a sitting position.
 22:02 You encouraged coughing.
 22:30 You aspirated on the nasogastric tube. This was reasonable.
 22:54 You flushed the nasogastric tube. This was reasonable.
 23:56 You checked the placement of the nasogastric tube. This was reasonable.
 24:47 You compared the medication label with MAR. This was reasonable.
 24:57 A 5-tablet dose of pancrelipase was given orally. It is important to use the basic
rights of medication administration to ensure proper drug therapy. This was
indicated by order.
 28:20 You compared the medication label with MAR. This was reasonable.
 28:31 You started a 720 mL tube feeding of fluid nutrition 1.5 kCal/mL at 2 mL/hr.
Ordered rate for {fluidnutritionnasogastricinfuse} was 60 mL/hr. The administered
rate was too low. The ordered volume was 480 mL. The administered volume
was too high.. You should have used the basic rights of medication administration
to avoid improper use of drugs.
 28:49 You phoned the provider in order to discuss the patient.
 30:01 A patient handoff was performed.
This patient has been hospitalized for management of cystic fibrosis and
associated weakness and weight loss. He reports fatigue, and he has had a
recent 6 kg (13.2 lb) weight loss. He was diagnosed with cystic fibrosis as an
infant and has had multiple hospitalizations for respiratory and nutritional support.
A nasogastric (NG) tube has been placed for feedings. Students are expected to
assess his nutritional status, assess vital signs, administer oral medications,
begin tube feeding, and educate the patient about his nutritional needs. The steps
for administering feedings are similar regardless of the tube used. Feeding can
be provided on an intermittent or continuous basis. Position the patient with the
head of bed elevated at least 30 to 45 degrees or as near normal position for
eating as possible. This position minimizes the possibility of aspiration into the
trachea. Assure correct placement of the feeding tube before administering the
feedings. The nurse should ensure proper placement of the NG tube by relying
on multiple methods and not on one method alone.
You got 92%

Feedback Log & Score - Christopher Parrish Apr 01, 2020 8 - 53 PM

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9/18/2020 Feedback Log & Score — Christopher Parrish Apr 01, 2020 8:53 PM

Diagnosis: Cystic Fibrosis

0:00 You reviewed the patient information.

0:00 You reviewed the patient log.

0:00 You reviewed the diagnostics.

0:00 You reviewed the clinical observations.

0:00 You reviewed the MAR.

0:00 You reviewed the orders.

0:00 You reviewed the intake and output.

 1:24 You introduced yourself. This was reasonable.

 1:51 You asked if the patient was &lt;Allergy&gt;allergic&lt;&gt; to anything. He replied:

don&apos;t think so.&apos;

6:14 You asked the patient if he was awake. He replied: &apos;I&apos;m

6:45 You put on gloves.

 7:24 You examined the patient&apos;s chest. He is breathing at 12 breaths per

 8:44 You assessed the mucous membranes. This was reasonable.

 10:45 You attached the &lt;Pulseoximeter&gt;pulse oximeter.&lt;&gt; It is a good idea to

10:49 You disconnected the &lt;Pulseoximeter&gt;pulse oximeter.&lt;&gt;

 11:48 You checked the &lt;Temperature&gt;temperature&lt;&gt; at the ear. The

 12:05 You checked the &lt;Temperature&gt;temperature&lt;&gt; at the ear. The

 12:27 You measured the &lt;Bloodpressure&gt;blood pressure&lt;&gt; at 120/72 mm Hg.

 17:05 You educated the patient about body mass index.

 17:46 You educated the patient about diagnostics.

 19:21 You educated the patient about intake and output.

19:47 You educated the patient about medication.

20:11 You educated the patient about risk of aspiration.

21:36 You assisted the patient into a sitting position.

 22:02 You encouraged coughing.

 22:30 You aspirated on the nasogastric tube. This was reasonable.

 22:54 You flushed the nasogastric tube. This was reasonable.

 28:49 You phoned the provider in order to discuss the patient.

 30:01 A patient handoff was performed.

You got 92%

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 1:51 You asked if the patient was <Allergy>allergic<> to anything. He replied:

don't think so.'

6:14 You asked the patient if he was awake. He replied: 'I'm

 7:24 You examined the patient's chest. He is breathing at 12 breaths per

 10:45 You attached the <Pulseoximeter>pulse oximeter.<> It is a good idea to

10:49 You disconnected the <Pulseoximeter>pulse oximeter.<>

 11:48 You checked the <Temperature>temperature<> at the ear. The

 12:05 You checked the <Temperature>temperature<> at the ear. The

 12:27 You measured the <Bloodpressure>blood pressure<> at 120/72 mm Hg.