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(Solved): SBAR Case Studies Scenario 1 You have started your morning rounds on the medical unit when you fin ...



SBAR Case Studies Scenario 1 You have started your morning rounds on the medical unit when you find your patient, Mrs. Smith, aged 67 yrs., in room 7, SOB. She was admitted with pneumonia and is a full code status, no allergies. You find her struggling to breath when you enter the room. She has 3-word dyspnea and states “help me, I am dying”. You assess her RR to be 43, her SPO2 to be 77 on r/a, BP 120/70 & HR 65. You raise the head of bed and apply 2L O2. You have her on continuous SPO2 monitoring and notice her SPO2 improves with oxygen to achieve a saturation of 98%. Her WOB also improves with her RR now 22. You need to call the MRP to update them of Mrs. Smith’s situation. Write an SBAR for your communication with the physician . Scenario 2 Patient Tom Brady, aged 35 years, arrives to ER with complaints of chest pain. He is a full code status and allergic to Penicillin. He tells you he has had this pain for 3 days and that he first noticed it after bench pressing at the gym. He is sweaty and his skin is pale. You check his vital signs: BP 116/89, HR 120, SPO2 98% on R/A, Temp 36 & RR 24. He denies any heart history. He states, “this is terrible, I think I am going to die”. You do an ECG and show it to the doctor. The doctor informs you that the ECG is normal and advises you to let him know when the blood work results are back. The doctor runs out of the department to another call. Mr. Brady calls and says that the pain is really bad and is there anything he can have for it? You then check the doctor’s orders to find that he has not ordered the patient any medication for pain. You call the doctor to obtain an order for analgesic. Write an SBAR for your communication with the doctor. Scenario 3 You are making your rounds at the start of the shift on the respiratory unit when you notice that Lucy Dally aged 62, is very short of breath. She is a DNR status, allergic to Ibuprofen. Her resp rate is 27/min, and she is only able to speak 2-3 words at a time. She is normally on O2 at all times for chronic COPD but you find her sitting on her walker without her O2 on as the tank is empty. You immediately refill the O2 tank and attach it to her at her regular 2l/min. When you check her O2 sat is only 76%. You notify a colleague overhead that you need help in room 12. When she arrives she advises you to call the doctor. Write an SBAR for your communication with the doctor. Scenario 4 Milly Smith is an 85-year-old female in The Meadows nursing home. She is a DNR status and has no allergies. You are currently a nurse working on the home area she is living. Milly has a history of Alzheimer’s disease and has had 3 falls in the past few weeks. When you go in to check on her you find her on the floor. Milly has sustained a laceration on her right forearm but no other injuries are noted and she is crying and holding her arm. Milly is also on blood thinners and is not able to tell you whether she hit her head. You need to call the on-call doctor about Milly’s current situation. Write an SBAR for your communication with the doctor. Scenario 5 Alan Edwards is 48-year-old on the surgical unit where you work. He is a full code status and has no allergies. He has recently had a below knee amputation and has been on Dilaudid for pain. When you go in to see Alan he complains that he is very constipated and has not has a bowel movement for 4 days. Alan is currently on a laxative BID but it does not seem to be working. You assess his abdomen and note it to firm and distended with hypoactive bowel sounds. You need to call the doctor to request an order for a suppository or enema. Write an SBAR for your communication with the doctor. Scenario 6 You are the night nurse on the medical unit and at 0700 hrs you are ready to hand over your patient Mary Smith to the nurse coming on days. Mary Smith is a 96 yr old lady who was admitted overnight from a nursing home where she lives. She is a DNR status and has allergies to Erythromycin and Codeine. She was admitted for IV antibiotic treatment of urosepsis. Overnight she was febrile, 38.7 degrees and received Tylenol prn. She has an IV running and is on IV ampicillin, and has received 2 doses so far. Currently she is afebrile and her VSS. Her family still needs to be informed of her admission and there needs to be follow up on her urine culture. Write an SBAR for your communication with the oncoming nurse.



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