Pharmacology Scenario 9: Juan Carlos Guided Reflection

• I felt a little bit unprepared at first, but after reading the orders I realized I was really familiar for the treatments of hypoglycemia. After a while, I felt relatively in control.

Tell me the actions you felt went well within this scenario.

• I gave insulin correctly. I treated hypoglycemia when it occurred. All assessments were performed correctly and as needed.

Reflecting on Juan Carlos’s case, were there any actions you would do differently if you were to repeat this scenario? If so, how would your patient care change?

-I was supposed to assess for pain, but I missed it on this attempt. I would go back and add pain assessment with the vital signs assessment.

Scenario Analysis Questions^[1]

PCC/EBP What priority problem(s) did you identify for Juan Carlos? Did your priorities change during the scenario? Why?

• In the beginning, his priority problem was his ulcer on his toe and maintaining his blood sugar level. It then changed to hypoglycemia, so I had to readjust my interventions.

EBP/S What data that was presented to you or that you gathered indicated a need for more education for Juan Carlos in regard to diabetes management?

• Juan Carlos needs to be educated on the importance of checking his blood glucose regularly. He also needs to be educated on frequent foot assessments since he developed an ulcer. He should be taught how to maintain a healthy lifestyle as well to help manage his diabetes.

PCC/T&C List and discuss the importance of patient education on proper diabetic control.

• They should be educated on checking their blood glucose frequently. They should know what to do for high blood glucose and low blood glucose. They should make sure to check before and after giving insulin.

T&C/S What other interprofessional team members should be involved in Juan Carlos’s care?

• Endocrinologist
• Primary care provider
• Maybe even a podiatrist if his foot issues worsened.
• Dietician or nutritionist to teach about healthy lifestyle

Concluding Questions

Describe some specific strategies you would use to apply the knowledge and skills that you obtained in Juan Carlos’s case to an actual patient care situation.

• I would know how to respond if a patient became hypoglycemic. I would know the signs and symptoms of hypoglycemia. I would know the assessments to make in a similar situation. I would do everything that I did in this scenario, but I would make sure to assess pain the next time.

[1]The Scenario Analysis Questions are correlated to the Quality and Safety Education for Nurses (QSEN) competencies: Patient-Centered Care (PCC), Teamwork and Collaboration (T&C), Evidence-Based Practice (EBP), Quality Improvement (QI), Safety (S), and Informatics (I). Find more information at: http://qsen.org/