Hansen_Reflection

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Medicine

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Apr 3, 2024

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docx

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Medical Case 5: Skyler Hansen Guided Reflection Questions 1. How did the scenario make you feel? The scenario was different to me because I had to act fast before the patient started to deteriorate. I wasn’t used to the patient not being to answer questions and relying solely on the physical assessment of the patient to determine what to do next. I liked the challenge of this scenario. 2. What management options would have been appropriate if Skyler Hansen had been alert and could swallow? If Skyler would have been alert and could swallow, I could have given him an oral glucose pill or fast acting carbohydrates like fruit juice or soda to help his blood sugar rise. 3. If Skyler Hansen’s acute hypoglycemic episode had not have been treated immediately, what could have happened? If Skyler’s acute hypoglycemic episode was not treated immediately, it could have led to a life-threatening emergency. Some of the more severe symptoms are changes in vision, slurred speech, loss of consciousness, confusion, seizures, coma, and death. 4. If too much glucose were administered to Skyler Hansen while the health care team was trying to correct his blood glucose level, what could occur? If too much glucose is given to Skyler, he could experience rapid fluctuation hyperglycemia. Some manifestations are headache, fatigue, blurred vision, increased hunger and thirst, and frequent urination. These can lead to serious problems like ketoacidosis, diabetic retinopathy, and diabetic neuropathy. 5. What key elements would you include in the handoff report for this patient? Consider the SBAR (situation, background, assessment, recommendation) format. Situation: The patient is Skyler Hansen. His friend brought him to the hospital after he started “acting weird” while playing basketball. Background: Skyler Hansen in an 18 y/o male recently diagnosed with Type 1 diabetes. He has no known allergies. A: Patient was acting irrationally with slurred speech. His initial blood glucose was 56 mg/dL. Patient responded well to administration of 50 mL of 50% Dextrose in water. After administration of 50 mL of 50% Dextrose in water, his blood glucose was 110 mg/dL. He stated he had breakfast this morning, but had not eaten anything recently. He was provided with carbohydrates and protein snack to eat. He is now alert and oriented x 4. R: Follow up with provider regarding plan for further treatment. Monitor vital signs and blood glucose every hour as ordered. Follow up on patient education regarding Type 1 Diabetes management and medication management. 6. Describe age-appropriate patient teaching for Skyler Hansen and resources that may be helpful to him. Age-appropriate teaching for Skyler Hansen are educating him on symptoms of hypoglycemia and hyperglycemia, teach him to monitor his blood glucose in his Notes app © Wolters Kluwer Health | Lippincott Williams & Wilkins
on his cellphone if that is easier for him to manage, teach him how to administer insulin, teach him to carry rapid-acting glucose to treat hypoglycemia quickly, and educate him on how exercise can affect glucose (exercise usually lowers glucose). Educate him on eating healthy, avoiding smoking, and using the “teachback” method to make sure he understands how to manage his diabetes. 7. Discuss confidentiality and legal empowerment of 18-year-old patients such as in Skyler Hansen’s case. Skyler is legally an adult, so he is fully autonomous in making his own decisions in his medical treatment. His treatment will not be discussed with his parents unless he consents to it and his medical records will remain confidential information. 8. What would you do differently if you were to repeat this scenario? How would your patient care change? I would try and act faster in attaining the patient’s vitals and make sure to act on the provider’s orders faster, so the patient does not deteriorate. I was able to do this on the second attempt and became more comfortable working at a faster pace. © Wolters Kluwer Health | Lippincott Williams & Wilkins
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