RESPIRATORY Distress

· Students at the end of this virtual simulation will be able to discuss how communicating a critical change in health status using SBAR is important.

· Prioritize interventions using assessment data to prevent further deterioration of the patient’s condition.

Link to Virtual simulation (copy this URL into browser and play):

http://www.can-sim.ca/games/respiratorype/story_html5.html

Instructions: The following is a series of questions to guide your reflection on your experience. These questions will help you express your reactions, analyze issues, and reflect on your performance, while making connections to future clinical practice.

 

1. List presenting symptoms of the patient that led the nurse to suspect a pulmonary embolism? Include pathophysiology.

2. What would the nurse need to document regarding finding the heparin drip was not infusing?

3. Discuss the communication between the nurse and patient, and the nurse and family member, would you have communicated differently and why?

4. If you were the nursing manager, how would you evaluate the nurse’s respiratory assessment to improve performance?

Sample Solution

RESPIRATORY Distress

Pulmonary embolism refers to the obstruction of the pulmonary artery or one of its branches by a thrombus that originates somewhere in the venous system or in the right side of the heart. A series of happenings occur inside a patient`s body when he or she has emboli: impairment-the area receives little to no blood flow and gas exchange is impaired; constriction-various substances are released from the clot and surrounding area that cause constriction of the blood vessels and results in pulmonary resistance. Dyspnea is the most frequent symptom; the duration and intensity of the dyspnea depend on the extent of embolization.

The North and South had opposite views in the National Economic System, the North was more of capitalist. The North practiced the work of the Wealth of Nations, the North was more industrialized, they had more of a commercial agriculture. Thomas Jefferson was from the South (Virginia) and Alexander Hamilton was from New York. Jefferson was more about he concerned of the farming republic and the virtue of the yeoman farmer. He’d paid more attention to Commercial Agriculture. Whereas, on the other side you have Alexander Hamilton, the English industrial model, he believes in the National Bank such as the Tariffs and Internal improvements. Tariff was not favor by the South because it made buying their goods more difficult. The Compromise Tariff of 1833 Gradual reduction of tariff. The Southern planters and slave owners invoke rights of the state.

Dealing with the division of the States, the first adopted idea was the Mason- Dixon line of 1779, this line was the first dividing slave and free states. The division was the answer to the dispute about Pennsylvania and Maryland, these states were divided in the 40-degree parallel. The free states were North of the Dixon line and the slave states South of the Dixon line, the slave holding South was known as the “Dixie”.

Right after the Mason-Dixon line division, the United States took another step towards trying to solve the tension between the states, the Great Compromise of 1787. This was supposed to give an equal representation for the states for Congress, such as the Senate and for the House of Representatives. The equal representation was in great importance to the House mainly, because house based number amount of members on population of the States. Which was under the compromises 1 representative per 40,000 people. However, the conflict in the House was the fact that it was under a 3/5 clause which made the Southerners disproportional in power. After the Great Compromise the states were not equal in Congress, which led to Cold War. With the settling of new territories bought by the Louisiana Purchase in 1803, the United States started moving West. It came to question rather or not the new Western states bought by the purchase should be counted as free or slave states. Louisiana was thereby admitted as a slave state in 1812, slave territories were Arkansas and Missouri. When Missouri applied for statehood there was a concern that Missouri would u

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