Feedback Log & Score - Christopher Parrish Mar 31, 2020 8 - 09 PM PDF

9/18/2020 Feedback Log & Score — Christopher Parrish Mar 31, 2020 8:09 PM
Date of Completion
Mar 31, 2020 8:09 PM
Christopher Parrish
Age: 18 years
Diagnosis: Cystic Fibrosis
Score
1 
2  80%
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%3Da66cc821-5e7… 1/10
0:00 You reviewed the MAR.
0:00 You reviewed the orders.
0:00 You reviewed the intake and output.
0:10 Patient status - ECG: Sinus rhythm. Heart rate: 83. Pulse: Present. Blood pressure: 125/79
mm Hg. Respiration: 20. Conscious state: Appropriate. SpO2: 95%. Temp: 100°F (37.8°C)
 0:33 You introduced yourself. This was reasonable.
 0:41 You washed your hands. To maintain patient safety, it is important to wash your
hands as soon as you enter the room.
 1:58 You identified the patient. To maintain patient safety, it is important that you
quickly identify the patient.
 2:08 You asked the patient: Do you have any allergies? If so, what kind of reaction did
you have? He replied: 'No, I am not allergic to anything.'
 2:59 You asked the patient if he had any pain. He replied: 'Yes, I have some
pain.'
 3:09 You asked the patient if anything made the pain better. He replied: 'No, not
really.'
 3:19 You asked the patient if anything made the pain worse. He replied: 'Yes.
When I cough.'
 3:31 You asked the patient if he could describe his pain. He replied: 'It's
like I'm tender in my chest and back.'
 3:43 You asked: How would you rate your pain? He replied: 'Not too bad;
it's about a 3. '
3:56 You asked the patient: Where does it hurt? He replied: 'In my chest and
back.'
4:06 You asked the patient: Do you have chest pain? He replied: 'Yes, but not
only in the chest. I am tender in my chest and back, especially when I
cough.'
4:18 You asked the patient if he needed anything for the pain. He replied: 'No.
I'll manage.'
4:28 You asked the patient when the pain started. He replied: 'After my
coughing got worse.'
4:39 You asked the patient if he felt better. He replied: 'No, it's the
same.'
5:00 You asked the patient how he felt. He replied: 'I am tired.'
5:08 You asked what happened. He replied: 'My breathing got worse
again.'
5:16 You asked what happened. He replied: 'My breathing got worse
again.'
5:23 You asked the patient if he had trouble breathing. He replied: 'I'm a
bit out of breath, but it's better than before.'
 5:37 You asked the patient: Do you do any breathing exercises? He replied: 'I
take my breathing meds and use my airway clearance vest twice a day. I also try
to focus on deep breathing and good coughing.' Consider assessing the
patient's vital signs before doing this.
5:54 You asked the patient if he felt better. He replied: 'No, it's the
same.'
6:02 You asked the patient: How would you describe your coughing? Is it dry, wet, or
productive? He replied: 'There is a lot of mucus to cough up.'
6:16 You asked the patient: Are you dizzy? He replied: 'No.'
6:25 You asked the patient if he felt nauseated. He replied: 'No. I don't
have any nausea.'
6:50 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.'
7:06 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.'
7:20 You asked the patient: Do you follow a special diet prescribed by your doctor? He
replied: 'Yes. A high-fat, high-calorie diet.'
7:32 You asked the patient: Are you getting the meals you need on a daily basis? He
replied: 'Yes, I try to do that.'
7:51 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.'
8:17 You asked the patient if he could move his toes. He replied: 'Yes.'
8:26 You asked the patient if he could feel his toes. He replied: 'Yes. I think they
are fine.'
8:41 You asked the patient: Do you have any allergies? If so, what kind of reaction did
you have? He replied: 'No, I am not allergic to anything.'
8:53 You asked the patient what medication he was taking, if any. He replied:
'Yes, I take meds for my lungs and enzymes for digestion.'
9:04 You asked the patient if he had taken his medication, if any. He replied:
'Yes. This morning.'
9:12 You asked the patient if he had any medical problems. He replied: 'Yes, I
have cystic fibrosis.'
9:23 You asked the patient if he was a smoker. He replied: 'No, I don't
smoke.'
9:37 You asked the patient if he was awake. He replied: 'I'm

awake.'
9:45 You asked the patient what year it is. He replied: 'It is 2020.'
9:53 You asked the patient if he knew where he was. He replied: 'At the
hospital.'
10:02 You asked the patient what date it was. He replied: 'The 31st'
10:32 You performed a Mini-Cog™ assessment. The Mini-Cog™ score was 5 out of 5,
which is normal.
12:04 You checked the patient's pupillary response. The pupils were both round,
were 5 mm in size, and reacted equally to light with constriction to 3 mm.
12:22 You inspected the patient's neck. There was no vein distension or visible
pulsations. There was normal color and odor.
12:44 You checked the <Temperature>temperature<> at the ear. The
temperature was 100°F (37.8°C).


13:04 You inspected the patient's ears. There were no abnormal findings.
13:34 You inspected the patient's eyes. There were no abnormal findings.
 14:18 You inspected the patient's mouth. The mucous membranes and tongue
were a bit dry. Consider assessing the patient's vital signs before doing this.
 15:04 You inspected the patient's nose. There were no abnormal findings.
Consider assessing the patient's vital signs before doing this.
15:29 You checked eye opening as part of GCS. The patient had spontaneous opening
of eyes; 4 points were added to the GCS score.
15:51 You checked motor response as part of GCS. The patient's motor function
was observed. The patient obeyed verbal commands; 6 points were added to the
GCS score.
16:11 You checked verbal response as part of GCS. The patient conversed and was
oriented; 5 points were added to the GCS score. Total GCS score was 15.
16:38 You inspected the patient's skin on the upper arms. There were no lesions
or scarring. There was normal color, odor, and skin integrity.
 17:05 You measured the <Bloodpressure>blood pressure<> at 124/80 mm Hg.

It is appropriate to monitor the patient by measuring the blood pressure.
17:33 You inspected the patient's shoulders. There was no asymmetry, swelling,
or discoloration.
17:56 You palpated the skin on the patient's upper arms. It was smooth, warm,
dry, and mobile, with normal turgor.
18:22 You palpated the patient's shoulders. There was no pain, swelling,
masses, or heat.
18:46 You assessed the range of motion of the patient's arms. There was full
range of motion of the joints in the arms.
20:07 You assessed the patient's sensation on the upper arms. This was normal
for touch and pain.
20:35 You inspected the patient's skin on the lower arms. There were no lesions
or scarring. There was normal color, odor, and skin integrity.
 20:54 You assessed the patient's radial pulses. The rate was 85, and the
strength was +2.
21:18 You palpated the skin on the patient's lower arms. It was smooth, warm,
dry, and mobile, with normal turgor.
21:45 You inspected the patient's skin on the hands. There was an IV access in
the right hand.
22:11 You inspected the patient's skin on the hands. There was an IV access in
the right hand.
 22:42 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.
23:00 You measured the capillary refill time on the patient's fingers. It was less
than 2 seconds.
23:20 You palpated the skin on the patient's hands. It was smooth, warm, dry,
and mobile, with normal turgor.
 23:45 You inspected the patient's nails. The nails are clubbing. No cyanosis.
Consider assessing the patient's vital signs before doing this.
 24:07 You assessed the patient's IV. The site had no redness, swelling,
infiltration, bleeding, or drainage. The dressing was dry and intact. This is correct.
Assessing any IVs the patient has is always important.
 You should have used gloves during this procedure.
 24:31 You assessed the patient's IV. The site had no redness, swelling,
infiltration, bleeding, or drainage. The dressing was dry and intact. If you are in
doubt, it is always a good idea to reassess any IVs the patient has.
24:52 You assessed the patient's radial pulses. The rate was 85, and the
strength was +2.
 25:09 You looked for normal breathing. He is breathing at 19 breaths per minute. The
chest is moving equally.
25:36 You began auscultating the heart.
25:40 You auscultated the aortic area of the heart.
25:43 You auscultated the pulmonic area of the heart.
25:45 You auscultated the Erb's point of the heart.
25:46 You auscultated the triscupid area of the heart.
25:48 You auscultated the mitral area of the heart.
 25:50 You auscultated the heart. This was reasonable.
 26:07 You inspected the patient's skin on the thorax. There was mild subcostal
retraction. Other findings were normal.
 26:39 You palpated the skin on the patient's thorax. It was smooth, warm, dry,
and mobile, with normal turgor. The chest is a bit tender.
27:10 You inspected the patient's skin on the back. There were no lesions or
scarring. There was normal color, odor, and skin integrity.
27:24 You put on gloves.
27:46 You assessed the patient's sensation on the back. This was normal for
touch and pain.
28:06 You palpated the skin on the patient's back. It was smooth, warm, dry, and
mobile.
28:31 You began auscultating the lungs.
28:34 You auscultated the posterior left top area of the lungs.
28:39 You auscultated the posterior right top area of the lungs.
28:42 You auscultated the posterior left upper area of the lungs.
28:45 You auscultated the posterior right upper area of the lungs.
28:49 You auscultated the posterior left middle area of the lungs.
28:52 You auscultated the posterior right middle area of the lungs.
28:55 You auscultated the posterior left lower area of the lungs.
28:59 You auscultated the posterior right lower area of the lungs.
29:02 You auscultated the posterior left bottom area of the lungs.
29:05 You auscultated the posterior right bottom area of the lungs.
 29:08 You auscultated the lungs. You should auscultate the lungs on the front side of
the patient. Remember to auscultate the lungs on all areas. This was not correct.
Lung sounds were clear to auscultation.
29:56 You measured the capillary refill time on the patient's toes. It was less than
2 seconds.
 30:44 You educated the patient about activities, safety, and fall risk.
 31:20 You educated the patient about the steps in the assessment.
 31:53 You educated the patient about coughing.
 32:26 You educated the patient about diagnostics.
33:10 You educated the patient about diet.
 33:41 You educated the patient about improving venous return. This was reasonable.
 34:11 You educated the patient about intake and output.
 34:37 You educated the patient about improving venous return. This was reasonable.
35:11 You educated the patient about pain management.
35:36 You educated the patient about the plan of care.
35:58 You educated the patient about range of motion excercises.
 36:30 You assisted the patient into a high sitting position.
 37:46 You encouraged coughing.
38:04 You gave the patient a sip of water.
 38:18 You assessed the oxygen. It was set to 2 L/min.
 You should have inspected the sputum in order to see if it is colored or not.
38:45 You comforted the patient.
 38:47 A patient handoff was performed.
Cystic fibrosis (CF) is a chronic, progressive, inherited, incurable disease

affecting exocrine (mucus-secreting) glands. It is transmitted as an autosomal
recessive trait and is characterized by major aberrations in sweat gland,
respiratory, and gastrointestinal functions.[newline][newline]Almost half of all
people with cystic fibrosis in the United States today are adults. In addition to the
condition of CF, these individuals may also present with comorbidities associated
with the normal aging process, including CF-related diabetes and brittle bones
(osteoporosis or osteopenia). Collaboration with specialists in CF care centers
can help to prevent or lessen the impact of these and other health problems.
[newline][newline]The techniques for a CF-related respiratory assessment include
inspection, palpation, percussion, and auscultation. Patients should be in the
seated position during the assessment. Begin inspection by observing the
patient's chest for color, shape, or contour, breathing patterns, and muscle
development. The color should be even and consistent with the color of the
patient's face. The shape or contour should have a downward equal slope
at the rib cage. The chest should be symmetric, with the transverse diameter
greater than the anteroposterior diameter.[newline][newline]Palpation is used to
detect areas of sensitivity, chest expansion during respirations, and vibrations
(fremitus). Use the palmar surface of the hands to palpate the anterior and
posterior thoracic landmarks in a sequential pattern to assess temperature,
moisture, muscular development, tenderness, or masses. The skin should be
warm and dry, with symmetric muscular development. Abnormal findings may
include cool or excessively dry or moist skin, muscle asymmetry, tenderness,
masses, and vibrations.[newline][newline]Chest expansion is determined by
placing the hands over the posterior chest wall, with the fingers at the level of T9
or T10, pressing together a small skin fold. When the patient takes a deep breath,
observe the movement of your thumbs. The thorax should expand symmetrically.
[newline][newline]Auscultation is used to detect airflow within the respiratory tract.
Ask the patient to breathe slowly and deeply through the mouth. Place the
warmed diaphragm of the stethoscope over the thoracic landmarks and
auscultate breath sounds in the same sequential pattern used for palpation.
Normally, breath sounds result from the free movement of air into and out of all
parts of the bronchial tree. Listen for the duration, pitch, and intensity of the
sounds.[newline][newline]Normal breath sounds vary over different parts of the
lungs. Bronchial sounds heard over the trachea and thorax, are high-pitched,
harsh sounds, with expiration being longer than inspiration. Bronchovesicular
sounds are heard over the major bronchi and are moderate, mixed sounds, with
inspiration equal to expiration. Vesicular breath sounds are soft, low-pitched
sounds, heard best over peripheral lung fields, are longer during inspiration, and
are short with expiration.[newline][newline]Although stertorous respirations,
stridor, and wheezes can be heard without amplification, crackles and pleural
friction rubs are usually heard with a stethoscope. If a productive cough occurs
during assessment of the thorax and lungs, the sputum should be assessed for
color, consistency, odor, and amount.
You got 80%
https://simserver.wkhpe.com/debriefing/debrief.aspx?dss=https%3A%2F%2Fsso.wkhpe.com%2FDebriefingLog%2FSingle%3Fid%3Da66cc821-5e… 10/10

Feedback Log & Score - Christopher Parrish Mar 31, 2020 8 - 09 PM PDF

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Feedback Log & Score - Christopher Parrish Mar 31, 2020 8 - 09 PM PDF

Uploaded by

Copyright:

Available Formats

9/18/2020 Feedback Log & Score — Christopher Parrish Mar 31, 2020 8:09 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.

 0:33 You introduced yourself. This was reasonable.

9:37 You asked the patient if he was awake. He replied: &apos;I&apos;m

12:44 You checked the &lt;Temperature&gt;temperature&lt;&gt; at the ear. The

temperature was 100°F (37.8°C).

 17:05 You measured the &lt;Bloodpressure&gt;blood pressure&lt;&gt; at 124/80 mm Hg.

 22:42 You attached the &lt;Pulseoximeter&gt;pulse oximeter.&lt;&gt; It is a good idea to

 You should have used gloves during this procedure.

25:36 You began auscultating the heart.

25:40 You auscultated the aortic area of the heart.

25:43 You auscultated the pulmonic area of the heart.

25:45 You auscultated the Erb&apos;s point of the heart.

25:46 You auscultated the triscupid area of the heart.

25:48 You auscultated the mitral area of the heart.

 25:50 You auscultated the heart. This was reasonable.

27:24 You put on gloves.

28:31 You began auscultating the lungs.

 31:53 You educated the patient about coughing.

 32:26 You educated the patient about diagnostics.

33:10 You educated the patient about diet.

 34:11 You educated the patient about intake and output.

35:11 You educated the patient about pain management.

35:36 You educated the patient about the plan of care.

35:58 You educated the patient about range of motion excercises.

 36:30 You assisted the patient into a high sitting position.

 37:46 You encouraged coughing.

38:04 You gave the patient a sip of water.

 38:18 You assessed the oxygen. It was set to 2 L/min.

38:45 You comforted the patient.

 38:47 A patient handoff was performed.

Cystic fibrosis (CF) is a chronic, progressive, inherited, incurable disease

You got 80%

You might also like

9:37 You asked the patient if he was awake. He replied: 'I'm

12:44 You checked the <Temperature>temperature<> at the ear. The

 17:05 You measured the <Bloodpressure>blood pressure<> at 124/80 mm Hg.

 22:42 You attached the <Pulseoximeter>pulse oximeter.<> It is a good idea to

25:45 You auscultated the Erb's point of the heart.