*NURSING > VSIM for NURSING FUNDAMENTALS > Feedback Log & Score; Josephine Morrow. Diagnosis: Venous Stasis Ulcer. Includes Feedback Log. Score (All)
You reviewed the MAR. 0:00 You reviewed the orders. 0:00 You reviewed the intake and output. 0:06 You washed your hands. To maintain patient safety, it is important to wash your hands as soon ... as you enter the room. 0:10 Patient status - ECG: Sinus rhythm. Heart rate: 95. Pulse: Present. Blood pressure: 121/80 mm Hg. Respiration: 20. Conscious state: Appropriate. SpO2: 94%. Temp: 98 F (36.6 C) 1:10 Patient status - ECG: Sinus rhythm. Heart rate: 95. Pulse: Present. Blood pressure: 120/80 mm Hg. Respiration: 20. Conscious state: Appropriate. SpO2: 94%. Temp: 98 F (36.5 C) 1:18 You introduced yourself. This was reasonable. 1:32 You identified the patient. To maintain patient safety, it is important that you quickly identify the patient. 1:41 You asked if the patient was <Allergy>allergic<> to anything. She replied: 'Yes, I am allergic to penicillin.' 1:48 You asked the patient how she felt. She replied: 'I get tired easily.' 1:55 You asked what happened. She replied: 'I have this wound on my leg; it does not seem to heal.' 2:02 You asked the patient if she needed anything. She replied: 'I need help with my legs; they are swollen and hurt. I easily get ulcers.' 2:10 Patient status - ECG: Sinus rhythm. Heart rate: 95. Pulse: Present. Blood pressure: 122/81 mm Hg. Respiration: 20. Conscious state: Appropriate. SpO2: 94%. Temp: 98 F (36.4 C) 2:13 You put on gloves. 2:23 You examined the patient's legs. There is moderate edema and hyperpigmentation of the skin from the knees and down on both sides. There is a dressing covering the skin lesion on the lower leg. There is normal elasticity of the skin. Her color is normal, and she is not sweating. 2:58 You educated the patient about wound care. This was reasonable. 3:10 Patient status - ECG: Sinus rhythm. Heart rate: 95. Pulse: Present. Blood pressure: 123/81 mm Hg. Respiration: 20. Conscious state: Appropriate. SpO2: 94%. Temp: 97 F (36.3 C) 3:21 You assessed the patient's dressing. This is correct. Assessing any dressings the patient has is always important. 3:36 You removed the dressing. This was reasonable. However, make sure to dress the area appropriately again when possible. 3:46 You assessed the patient's ulcer. This was reasonable. The ulcer is shallow, 1 inch in width, and looks mostly pink to red, with no signs of necrosis or infection. [Show More]
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