unstable vital signs require emergent care H e a l t h M e d i c a l

Initial Post

Describe how you achieved each course competency including at least one example of new knowledge gained related to that competency.

Describe how you achieved the transferable skill, Critical Thinking, including at least one example of new knowledge gained related to the transferable skill

Describe how this new knowledge will impact your nursing practice.

Course Competencies

• Apply strategies for safe, effective multidimensional nursing practice when providing care for clients with neurological disorders.
• Outline appropriate nursing strategies for providing care to perioperative clients.
• Compare nursing interventions for clients with complex disorders.
• Identify strategies for safe nursing practice of the client with multi-system organ failure.
• Prioritize nursing interventions for clients with medical emergencies.
• Summarize the nurse’s role and care strategies for clients during disasters.

Transferable Skills

• Critical Thinking (Application)

Responses

You are required to give a minimum of two responses and follow the criteria listed below:

• Review how your classmates achieved each course competency and transferable skill.
• Identify new knowledge others gained you had not considered.
• Describe how this new knowledge could impact your nursing practice.

Please make your initial post by midweek, and respond to at least two other students’ posts by the end of the week. Please check the Course Calendar for specific due dates.POST TO RESPONS TO

POST 1

Course Competencies

• Apply strategies for safe, effective multidimensional nursing practice when providing care for clients with neurological disorders.

In modules 01 the student nurse learned about caring for clients with dementia. The student nurse learned that memantine is the drug of choice for these clients as it delays deterioration. The student nurse also learned that in the early stage of dementia the nurse should reorient the client as needed. In the late stages the nurse should focus more on validation therapy. The student nurse will use validation therapy in their practice as a way to avoid increased agitation and help the client feel heard.

• Outline appropriate nursing strategies for providing care to perioperative clients.

In module 04 the student nurse learned about caring for perioperative clients. The major takeaway was the surgical checklist. The nurse must accurately complete this checklist before the client can undergo surgery. The student nurse will likely participate in completing the checklist. Understanding the importance of completing this checklist and the detrimental effects if done incorrectly will stay with the student nurse in their future practice.

• Compare nursing interventions for clients with complex disorders.

In module 05 the student nurse learned about caring for clients who need endotracheal intubation. Early recognition for the need for intubation is key. The nurse knows how to assess the airway and to perform manual ventilation until the provider can insert the ETT. The student nurse will use this information when quick action is needed in an emergent situation.

• Identify strategies for safe nursing practice of the client with multi-system organ failure.

A full assessment is needed in a client with multi-system organ failure. The nurse will then treat based what specific organ needs the support. The nurse must also think ahead about preventing further complications. The student nurse will know in future practice to assess the airway and apply airway management up to mechanical ventilation as needed.

• Prioritize nursing interventions for clients with medical emergencies.

The nurse learned about triage in medical emergencies. Triage is split into emergent, urgent, and non-urgent. The student nurse will know that respiratory distress, chest pain, stroke, and unstable vital signs require emergent care. This will also help the future nurse with prioritizing clients.

• Summarize the nurse’s role and care strategies for clients during disasters.

The nurse may work as triage or they may work as part of the response team. The student nurse learned the importance of being prepared for disasters and to understand what your roll will be. This prevents inaction and uncertainty when nurses need to be acting quickly. The student nurse will make sure they are up-to-date on their facilities disaster preparedness plan.

POST 2Apply strategies for safe, effective multidimensional nursing practice when providing care for clients with neurological disorders.

I learned in this quarter that I need to watch for autonomic dysreflexia in patients who have suffered a neurological disorder that had made them paralyzed. It is important to know the clinical manifestations of that and to treat it we need to find the underlying cause such as pressure, a full bladder, restrictive clothing, or the inability to pass bowel.

Outline appropriate nursing strategies for providing care to perioperative clients.

It is most important in the preop phase to be a witness for the signing of that informed consent prior to the procedure. It is important to advocate for your patients if they are unsure or still have questions about anything pertaining to the procedure that is answered by the provider prior to beginning the procedure. Safety and infection control are the most important thing during intraoperative. For post-op, it is most important to monitor for airway and breathing, signs of infection, and proper wound care.

Compare nursing interventions for clients with complex disorders.

Respiratory disorders were definitely one of the more complex subjects this quarter. Knowing what respiratory condition they are in determines the correct nursing intervention. Interventions such as chest tube for pneumothorax, needle thoracotomy for tension pneumothorax, PEEP and Prone for ARDS, and the complications of PEEP. Assessing the patient first is always the priority if they are on a ventilator, assessing the machines goes to respiratory therapy, as nurses we do never touch the ventilator machines.

Identify strategies for safe nursing practice of the client with multi-system organ failure.

It is important to provide interventions before progressing to multi-system organ failure. At the earliest signs of the patient going into shock, intervention should be implemented because if it is not, as the patient progresses through each of the stages, there will be a decrease in the amount of available oxygen circulating within the body system and eventually important organs will start to fail and can result in death.

Prioritize nursing interventions for clients with medical emergencies.

I learned how to triage using the triage color system. Those with airway and breathing issues are always emergent and need to be seen right away. This type of triage is different from disaster triage. Also know what is a medical emergency such as

Summarize the nurse’s role and care strategies for clients during disasters.

The nurse’s role is to triage as fast as possible to get everyone the care they needed in an emergent manner. Sometimes we will need to make the difficult call during a disaster recovery situation and leave patients who will not make it through and move on to the next person who has a higher chance of survival. We may have to make that call about caring for a 2-year-old or 35 year old, or a 95-year-old in a mass casualty disaster. In a smaller scenario such as a fire disaster in a building we work in, we need to be prepared to implement emergency protocols such as RACE.

Critical Thinking

Through this course, I really had to put on my thinking hat and use my critical knowledge skills to break down what is important and pertains to the situation. I have to use my best judgment to prioritize patient care when they are all equally important. I have to learn to be a leader and make decisions about people’s lives.