Learner Response Summary

Successful
Scenario: Assessment of the Post-Operative Patient (026)
Started On July 30, 2023

How do you respond to this report?

Your Choices:
- Clarify report

Patient arrived. What is the priority?

Your Choices:
- Assess patient first

Which option best describes what you heard during auscultation?

Your Choices:
- Diminished sounds in the bases

What was Lena’s calculated apical rate?

Your Choices:
- 90

What vitals would you act on?

Your Choices:
- SpO2 92

What intervention would be most appropriate?

Your Choices:
- Deep breathing / Incentive spirometry

Document your admission of Lena and the assessment findings using a narrative note style.

Your Response:
patient is a 58 female, . post op right total knee arthroplasty. PMHx DM2, asthma, and depression. NKDA. BG was 7.0. is
the patent is on a PCA pump, patient has demonstrated how to use it correctly. pain well controlled at this time.
upon arrival the patient was sleeping but early awaken. patient is A+Ox3, able to follow commands appropriately. HR
90, decreased air entry to bases bilaterally, Pedal pulse present , used doppler for right foot. foley catheter insitu,
draining clear amber urine. right knee dressing intact with moderate sanguineous drainage, Hemo vac to right knee with
150ml of fluid.

in site healthy, BP 112/64, P 69, R15, o2 at 92% on RA, T 36.8 . patient ale to demonstrate incentive spirometer.

How do you proceed with Lena's concern about pain medication?

Your Choices:
- Assess pain using a numerical pain scale (0-10)

When considering a patient using a PCA pump, what health teaching would you provide related to pain, dosing and
potential side effects of the medication?

Your Response:
The PCA pump is programmed to only allow a limited number of doeses that your are safely allowed to administer per
hour. the less pain you have the better you will be able to heel.
if you notice yourself get lightheaded, shortness of breath, §or dizzy it is important to let us know. constipation can be a
side effect of the pain medication.

What would you do next after explaining the PCA pump use?

Your Choices:
- Ask Lena to restate the information about PCA pump

When should you return to check on Lena?

Your Choices:
- 15-30 min

Document on your latest interaction with Lena.

Your Response:
patient is awake and A+Ox3. able to follow commands. patient states 7/10 for pain, but worries about using the PCA
pump. additional education provided regarding staying onto of pain . health teach about sign and symptoms to report .
patient able to repeat information and will recheck in 15-30 min
List the cues Lena has presented in the previous interaction.

Your Response:
increase BP
Increase RR
increase HR

What do the cues suggest/infer?

Your Choices:
- Allergic reaction

What is your next action in response to Lena's allergic reaction?

Your Choices:
- Remove the Morphine and call the MRP

Prepare SBAR

Your Response:
S - hi this is gaby, calling from the surgical unit. I am calling you regarding your patient lena F . she is a 58 year old
female who was admitted following a total right knee arthroplasty.

B - she has a history of DM2, asthma, and depression for 3 years. she currently is taking metformin, and Zoloft, Ventolin,
and atrovent prn.

A - Lena is alert and orientated x3. her vitals are BP 136/76, P 108, RR 20, Spo2 97% on RA, and T 36.7, RL running at
125 with RL, also on a PCA pump with morphne for pain, Foley catheter draining and Hemo Vac drain. she is reporting
pain 7/10 and utilizing the PCA pump. upon reassessment within 15 min patient is experiencing itching, raised red rash
on her neck and chest. feeling nauseous, denies SOB, I am concerned she is having a allergic reaction and have stoped
the PCA pup at this time .

R - hoping for order of antihistamine and for you to assess patient for pain management.

What might be contributing to Lena feeling so dizzy? Answer - all apply.

Your Choices:
- Lying supine
- Analgesic
- Dehydration
- Pain
- Hypovolemia
- Fatigue

Can you describe in one or two sentences how you felt after playing the virtual game?

Your Response:
the stimulation was quick and effective. I was able to build some confidence with expelling information about the pump.

What were you proud of? What went well during the game and why do you think it went well?

Your Response:
I am proud to be able to give a effective report. I am building on my communication SMART goal.

What challenged you during the game? What was the most difficult decision point and why was it difficult for you?

Your Response:
my PCA pump knowledge was challenging for me. but I was able to learn more about them as I went through the
simulation.

Were you satisfied with your ability to care for Lena Futris? If a similar situation arose in the future, what would you
take away from this simulation to incorporate into your clinical practice?

Your Response:
I was satisfied with my ability to care for lena. for future practise iw ill take what I learned and health teach the patient
more on how to use the PCA pump for effectively in order to promote healing.

What were your key learning points regarding post-opertaive assessment?

No response submitted.

What would you do differently next time?

Your Response:
next time what I would do differently is look at her past medical history and do more health teaching.

Is there anything else you would like to discuss?

No response submitted.
Session ID: 675879