Competency-Based Assessments
A forty-five-year-old male is admitted to the emergency department following a motor vehicle accident. He has multiple lacerations and significant blood loss. Upon arrival, his vital signs are:
- Blood pressure: 85/55 mmHg
- Heart rate: 130 beats per minute
- Respiratory rate: 28 breaths per minute
- Skin is cold and clammy, and the patient is anxious.
1
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Based on the patient’s presentation, discuss the pathophysiology of hypovolemic shock and identify three risk factors and three clinical manifestations seen in this patient.
2
.
The same patient is undergoing diagnostics to confirm hypovolemic shock. The health-care team orders a complete blood count (CBC), blood chemistry, and arterial blood gases (ABGs). Describe the key diagnostic tests and expected laboratory findings for a patient in hypovolemic shock.
3
.
The patient’s condition is deteriorating, and you are the nurse responsible for managing their care. Develop a nursing care plan for this patient, incorporating key nursing concepts for managing hypovolemic shock.
Jamal visits his grandmother once a week to take her grocery shopping. Today when Jamal arrives at her home, she does not answer the door. Jamal uses his key to let himself in and finds his grandmother lying on the bed. She is very confused and weak. Jamal calls 911 for assistance. She is transported to the local emergency department where you are the nurse assigned to care for the patient. Upon admission, the patient is disoriented to time, place, and person and manifests these vital signs:
- Blood pressure: 78/58 mmHg
- Heart rate: 122 beats per minute
- Respiratory rate: 26
- Temperature 39 °C
4
.
Using the scenario preceding, develop a plan of care identifying the patient’s quick Sequential Organ Failure Assessment (qSOFA)?
5
.
Considering the progression for the preceding scenario, the provider orders a broad-spectrum antibiotic for the patient because sepsis is suspected. Prior to administering the antibiotic, the nurse validates that the patient has no allergies to the ordered medication. Develop a list of other steps the nurse must take prior to administering the antibiotic.
6
.
Early diagnosis and treatment of sepsis is key to patient survival. The nurse is aware of the recommended implementation of a one-hour bundle in the treatment of a patient who is suspected of having sepsis. Develop a presentation for your peers explaining what the one-hour bundle includes.