Critical thinking exercise

make sure its connected to the source................

Make sure the O2 is on..many times the resp therapist turns the O2 off while giving a treatment...:) Erin

Hee hee... nothing like nasal cannula in situ... with the oxygen tubing not connected or kinked or not turned on..... and a pale bluish-looking patient.....

I get lost in translation re. USA and Australian medical terms..... PVC's? Is that Pre-Ventricular Contractions?

Is the pulse ox attaqched to his finger correctly?

Noney

scream at the top of my lungs

oh my god there is no urine

:rotfl:

duh, assume she hasn't urinated???? :chuckle

seriously,

check for kinks in the tubing first!!

Look at the patient, if he looks sick then turn up O2, vitals, full assessment- if he looks the same ask him how he feels and check connections and moniters.

scream at the top of my lungs

oh my god there is no urine

lol first thing wake her and ask her if she feels the urge to relieve her bladder and then palpate her bladder, then check for kinks and then see when her bag was emptied.

in keeping with ccu's assessment of scenario number 1..on number two, i would perform an emergency trach using one of the 200 bic pens in my pocket...sorry, just couldn't resist!! :rotfl:

Make sure O2 is turned on, check pulse ox, try another finger...talk to the patient-are they coherent, are they SOB, are they in pain? If all that is normal get a mask.

Great thread!!! I, too, would check to see if O2 was turned on--and check if pulse ox was on finger (ear) whatever correctly. Then I would check vitals- lung sounds etc. and take it from there.

Reminds me of when I was a NA and one of the night nurses comes running out of pt room at 4am screaming because patient's temp was 106. When we all went down to room patient was sitting up in bed rubbing eyes and looking quite healthy (this was in Nursing Home) wondering who was screaming. Turned out nurse took temp with thermometer that had been cleaned under hot water!! :angryfire :angryfire She never shook down thermometer. :uhoh21: :uhoh21:

(this was many many years before we had digital)

Remember--you can teach all the facts you want and offer all the critical thinking skills you have--but you can't give away common SENSE. :chair:

by saying she is sleeping, i hope that as I observe that I also notice how she is breathing..listen to the heart/lung sounds..which would be far more important than urine...what is her rhythm, other vitals..I find it hard to believe that she would be in distress with her breathing (as most are anxious, and obvious) and be sleeping...i also find it hard to believe that her bladder would be about to explode and she would be sleeping...

and yes check the foley for kinks..

oh, by the way, first questions kill me..I do look, listen and feel at the same time..see the effort while listening to lungs, check perifpheral pulses, is she cold, move the foley tubing around and see if it is kinked..further actions as neccessary

Remember--you can teach all the facts you want and offer all the critical thinking skills you have--but you can't give away common SENSE. :chair:

You aint kidding, Zumalong! :) Once worked with an Rn in an Ob/gyn office who had a couple of kids at home. She actually asked me how many trimesters there were in a pregnancy? :uhoh21: Uh, Hello?! Doncha have a couple of kiddies at home and work in an OB/gyn office and you DON"t know this? Scary.....very scary.....

FIRST I would try to rouse the patient - see if she is simply napping, or if there has been a decline in consciousness (scenario says nothing about level of consciousness). SECOND I would check the foley to make sure it is clear and able to drain.

This would be a start, at least.....

John