Medical Case 3: Vincent Brody Guided Reflection Questions 1. How did the scenario make you feel? The first time I felt ready for it, and thought I knew what to do. Then the patient started complaining of chest pain during the nebulizer and I started panicking. 2. When a patient develops a rapid ons...
Medical Case 3: Vincent Brody
Guided Reflection Questions
1. How did the scenario make you feel?
This scenario was interesting because the patient developed a left-sided pneumothorax.
It made me feel more pressured than the sims prior because I had to react and think
what was happening and how I could help my pt. and his vital signs. The pt. was steadily
deteriorating creating concern and making me think critically in a short amount of time.
2. When a patient develops a rapid onset of shortness of breath, what are the nurse’s
immediate priorities?
Assess the patient’s airway and breathing is the number one priority. Provide oxygen if
needed and call the provider to discuss what is taking place. You will also need to figure
out why he is short of breath. Listen to the lungs for crackles, wheezing, absent breath
sounds, etc. Place a pulse oximeter to monitor his oxygen levels. Sit the patient upright
and indicate deep breaths can help. Constant reassessments are important to determine
whether interventions are working.
3. What assessment findings would indicate that the patient’s condition is worsening?
Some assessment findings that would indicate that the patient’s condition is worsening
would be wheezing when listening to breath sounds, fever, shallow or rapid breathing,
confusion, low oxygen saturation, increase in mucous production or changes in the color,
cyanosis of lips or fingernail beds, and drowsiness. Diminished breath sounds, decreased
SaO2, increased respiration/heart rate, patient reporting feeling anxious/doomed. The
biggest indication would be the patient complaining of chest tightness or shortness of
breath.
4. Review Vincent Brody’s laboratory results. Which results are abnormal? Discuss how
these results relate to his clinical presentation and chronic disease process.
The patient’s ABG came back with an elevated HCO3 and PCO2 and a pH within normal
range. Since the PCO2 was outside of normal range and on the alkalotic side Mr. Brody
was in respiratory alkalosis. Some symptoms of respiratory alkalosis are heart
palpitations, shortness of breath, and chest pain which is what the patient is presenting.
Mr. Brody also had a high hematocrit with is commonly found in patients with COPD.
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