*NURSING > CASE STUDY > VSIM Christopher Parrish Diagnosis: Cystic Fibrosis feedback log - Scored 100% (latest 2022- 2023) (All)

VSIM Christopher Parrish Diagnosis: Cystic Fibrosis feedback log - Scored 100% (latest 2022- 2023)

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Nursing G130: vSim Grading Rubric Name: Oanh Dang (Amy Dang) Clinical Instructor: Eva Potts Components 0 Points 1 Point Pre-simulation Quiz Score < 75% Score > or = 75% vSim Scenario Score < 80% S... core > or = 80% Post-vSim Quiz Score < 100% Score 100% Documentation Assignment including worksheet/activity as posted on Canvas All questions not answered completely All questions answered completely Guided Reflection Questions Opening questions, Scenario Analysis Questions, and Concluding Questions not answered completely. Opening questions, Scenario Analysis Questions, and Concluding Questions answered completely. Total Points Earned = points out of 5 points Christopher Parrish Documentation Assignments 1. Document your focused gastrointestinal and dietary assessment of Christopher Parrish. Focused GI assessment: - Inspect, ascultate, palpate and percuse the abdomen for any abnormal shape of the adominal area and abnormal bowel sounds - Ask the patient if he has abdominal pain - Ask the patient the last time he had bowel movement, how many bowel movements he has a day, the characteristic and quantity of stool. Check for any sign of mucous, greasy stool. - Ask the patient if he has any difficulty passing stool - Ask the patient if he has any nausea, vomiting - Any difficulty swallowing - Check placement of NG tube, residual, monitor patient regularly for any aspiration Focused dietary assessment: - Ask about his appetite, his daily diet - Ask if he is following any prescribed nutritional diet - Ask if he is taking any vitamins and supplement - Ask if the patient has any allergy with food 2. Document two nursing diagnoses for this patient. - Malnutrion: + related to: fatigue and has recently lost 6 kg (13.2 lb) + AEB: low albumin, protein level and vitamin D on lab results - Risk for aspiration 3. Document your priorities for care of this patient. - Check NG tube regularly - Check the amount of food patient has taken by checking residual every 4 hours and document - Maintain adequate nutrition by giving 3 meals/day and snacks during the day with high calories foods - encourage the patient to cough 2-3 times a day on an empty stomach, avoid lying down for too long, encourage patient to change position regularly 4. Describe the age-related considerations you will use when caring for Christopher Parrish. At this age, the patient may experience withdrawal or isolation because of peer pressure and influences. The patient is a young man and is likely to expect himself to be a strong, independent person like any other adolescent at his age. So mentally support from family, school or friends and a therapist may be helpful if he has any sign of withdrawal. 5. Referring to your feedback log, document the nursing care, including patient education about nutritional needs and therapy, which you provided to Christopher Parrish. Include his response. Patient education about nutrional needs: - educate the patient about body mass index (BMI) and the patient asked what he can do to gain weight and keep his BMI up since he does try to eat a lot. The BMI decrease is the result of his weight loss, the patient has to continue on his high calories diet and overnight NG tube to gain weight faster. - educate patient about diagnostics: the patient asked what the numbers in the labs mean. So, the patient’s albumin is low, which could be because he has not been eating well. The vitamin D is really low, which is also because his body has difficulty absorbing vitamin D, so it’s really important to tell the patient to take vitamin supplement because vitamin D helps strengthen bones. - educate the patient about diet: in his situation, it is very important not to skip meals and to follow a high callories diet. Remind the patient to take enzyme before eating. - educate patient about intake and output: we are recording his fluid intake and urinary output, let the patient know that it is important to let the nurse know when he drinks and urinates. - educate patient about risk of aspiration: the patient asked if he is at risk of that. So, since the patient is having NG tube feeding, it is important to keep the head of the bed up so the patient does not bring up any of the feeding. - education patient about tube feeding: since the patient are not used to being fed overnight, he may feel nauseated or painful when the stomach gets pretty full. So it is important to tell the patient to let us know if that happens so we can slow down the feeds or turn it off for a short period to give his stomach a break. Therapy: According to Erikson’s theory, the adolescent tries out different roles, personal choices, and beliefs in the stage called identity versus role confusion. Self-concept is being stabilized, with the peer group acting as the greatest influence. It is difficult for an adolescent to deal and accept his chronic disease. As a nurse taking care for this patient, I should educate him about the disease and the cure is not trully impossible at the present date. The nurse’s attention should be the patient, let him know that he could enjoy life and have any activity like other peers. Support the patient and encourage him to self-manage. Encourage seeking for family and friends’support as well. [Show More]

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