Use the following format to reflect on the Week 4 iHuman Neurovascular Assessment. This was the Athena Washington case.
Paragraph One: What went well for you in the simulation? Provide examples of when you felt knowledgeable and confident in your skills. Do you feel the scenario was realistic? Why or why not?
Paragraph Two: What would you do differently next time if you were caring for a patient similar to Ms. Washington? Describe at least one area you identified where improvements could be made, specific to Ms. Washington’s assessment. Were you surprised by any of the feedback you were provided by iHuman? If yes, please explain.
Paragraph Three: What did you learn from this simulation that you could apply to nursing practice? Or, what did this simulation reinforce that you found valuable? Do you have any questions related to the scenario?
– Mrs. Washington, an African American woman 48 years old with a history of hypertension (HTN) and cardiac problems, is being treated for stroke-like symptoms that began with a severe headache
B – The client went to sleep after taking Tylenol for her headache, which is a common practice for her due to hypertension. She awoke with partial paralysis, stiffness on her left side, bewilderment, and a severe gag reflex, but she was unable to swallow. A stroke was suspected; therefore, EMS was contacted. Mrs. Washington also has uncontrolled hypertension and hyperlipidemia. For type 1 diabetes, she is taking antihypertensive and cholesterol-lowering drugs.
A – Mrs. Washington is aware and oriented to herself and her surroundings, but she is confused about time, according to her assessment. She has hypertension, left-sided stiffness, facial droop, mouth deviation, and a severe gag reflex yet is unable to swallow. The swallow test came out negative. She has an NIH Stroke Scale (NIHSS) score of 11, as well as other symptoms such as dysarthria, vomiting, headache, and palpitations. CTA found no substantial arterial blockage; however, a CT scan suggested a possible acute right cerebellar infarction. There is no evidence of subarachnoid or hemorrhagic bleeding.
R – 1. Continue to give the required drugs.
2. Titrate oxygen via nasal cannula as directed by your doctor.
3. Every 15 minutes, check vital indicators.
4. Every hour, put yourself to bed.
5. Every hour, perform NIH Stroke Scale (NIHSS) assessments.
6. Keep your NPO status (nothing by mouth).
7. Monitor and limit fluid intake and outflow.
8. Monitor pulse oximetry and vital signs at the same time.
9. To improve respiratory function, raise the head of the bed to 30 degrees.