vrijdag, juli 13, 2007

Voorbeeldje

Vandaag even een lui en gecopieerd stukje blog: in een van de lessen van vorig semester was de opdracht om uit te leggen aan een leek wat een verpleegkundige zo allemaal doet op een dag en welk kritisch denken er bij komt kijken. Ik had het fout begrepen en schreef maar een klein stukje, anderen hadden hun hele dag opgeschreven, wat ook de bedoeling bleek te zijn. Als ik tijd en zin heb zal ik dat nog een keer doen. Maar hier dan dat kleine stukje uit een dag;

An example of what a nurse does, and what critical thinking skills a nurse has.

A patient was admitted with syncope (fainting) and had been observed on telemetry (heart monitor) for 2 days. No changes in her heart rhythm were noted, and the patient was being discharged. While the cardiologist was writing the discharge instructions, the heart monitor alarmed and the patient was noted to have a “pause” (a long period between 2 heart beats). I went in to check on the patient and she was sitting on the edge of the bed. I asked her how she felt. She said “Good”. I asked if she was dizzy at all, and she said “A little bit”. I knew this patient was very eager to go home, and might not be telling about all of her symptoms if this prevented her from going home. I checked her blood pressure; it was 74/50. I helped her to lie down in bed, checked her blood pressure again, and it was up to 110/70, and she no longer felt dizzy. I showed the rhythm strip to the cardiologist; the discharge was canceled and the next day the patient got a pacemaker.

The critical thinking skills used here are:
• Assessment: assessing the patient when a heart monitor alarms, checking the blood pressure
• Evaluation of the information obtained: the patient is symptomatic with dizziness and a low blood pressure
• Action taken: preventing syncope by putting the patient in bed, re-evaluation by checking the blood pressure, notifying the cardiologist

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