Exam (elaborations)
VSIM REFLECTIVE QUESTIONS SEM 1
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VSIM REFLECTIVE QUESTIONS SEM 1
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VSIM REFLECTIVE QUESTIONS SEM 1What priority problem(s) did you identify for Christopher Parrish - ANSWERS-1)
Nutritional status related to cystic fibrosis (CF);
2) Safe medication administration in a patient with CF;
3) Safety related to tube feeding
What potential problems could arise due to Christopher Parrish's identified Vitamin D
deficiency? - ANSWERS-Hypocalcemia, bone demineralization, and osteoporosis
Discuss the relationship between pancreatic enzymes, malabsorption, and CF -
ANSWERS-Patients with CF experience a loss of pancreatic enzymes. This results in a
pancreatic inability to absorb fat and fat-soluble vitamins, including vitamin D. Thus,
patients with CF experience malabsorption and a loss of a positive nutritional state,
including a vitamin D deficiency (among other vitamin deficiencies). Therefore,
nutritional needs for Christopher Parrish (and all patients with CF) include a high calorie,
high fat, and high protein diet.
What are important assessments related to administration of enteral feedings -
ANSWERS-Assessment of placement of enteral feeding tube by checking tube
placement (gastric pH is less than 5; observe routine chest x-ray to verify placement;
check residual prior to administration of enteral feed while following agency protocol
regarding reinstallation or withholding of feeding.) If medications need to be
administered via enteral feeding tube, the tube should be flushed with 15-30 mL of
sterile or tap water (depending on hospital protocol) before and after medications are
administered. If the patient has more than one medication to be administered at a time,
they should be administered one at a time with the tube flushed inbetween
Using Erikson's developmental stages, discuss the importance of peer
relationships/support group with other young adults with cystic fibrosis - ANSWERS-
Christopher Parrish is in Erikson's stage late adolescence/early adulthood. During this
phase, it is important for an individual to develop and maintain healthy and social
relationships. Therefore, it is vital to encourage Christopher Parrish to reach out for
psychosocial support options provided to CF patients by the medical team.
Identify potential patient safety issues related to nutritional status in the care of
Christopher Parrish. - ANSWERS-Pancreatic enzymes are necessary for the digestion
and absorption of proteins and fats. CF patients have pancreatic insufficiency causing
inadequate enzyme secretions. Therefore, pancreatic enzymes must be taken prior to
eating to enhance adequate digestion and absorption of nutrients.
What other interprofessional team members should be involved in Josephine Morrow's
care - ANSWERS-Nursing, medicine, physical therapy, dietary, and wound specialists.
Prior to discharge, the hospital health care team should discuss and review treatment
with the health care team from Josephine Morrow's current nursing home.
, What priority problem(s) did you identify for Kim Johnson - ANSWERS-Kim Johnson's
priority problem is urinary retention related to paraplegia due to a complete spinal cord
injury at the T8 level.
Identify safety hazards in Kim Johnson's patient care situation - ANSWERS-The safety
hazard that occurred was contamination of the urinary catheter by the nurse
Identify potential complications from using improper sterile technique during intermittent
catheterization. - ANSWERS-Contamination of the urinary catheter can lead to urinary
tract infection (UTI). Urinary tract infection can be very serious and possibly lead to
systemic complications if it goes unrecognized and is not treated.
How would you would correct the nurse's actions specific to the contamination of the
sterile field? - ANSWERS-1. Make an opening
Q. Are you aware you just contaminated the sterile field?
2. State the concern
A. I am concerned that you may not know the difference between sterile and clean.
3. State the problem
A. By touching a sterile catheter with your bare hands, the potential for infection
increases.
4. Offer a solution
A. Let me demonstrate the procedure with a new sterile urinary catheter kit. After I am
finished, we will review the procedure steps.
5.Reach an agreement on next steps
A. Let's save the contaminated kit for you to practice your sterile technique on a
manikin.
Which federal and state programs offer benefits to support Kim Johnson's care -
ANSWERS-Centers for Medicare & Medicaid Services
What priority problem(s) did you identify for Rashid Ahmed? What information led to
identification of the priority problems? - ANSWERS-1) Fluid and electrolyte imbalance
related to dehydration; 2) Decreased cardiac output related to fluid loss; 3) Safety
related to dehydration and decreased cardiac output.
What potential problems could arise if the identified fluid and electrolyte imbalances are
not corrected? - ANSWERS-Complications that could occur if the identified fluid and
electrolyte imbalances are not corrected include vascular collapse, renal insufficiency,
and potential life-threatening arrhythmias.
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