Melissa Murray-Smith

Daily Journal

December 9, 2020

RN Adult Medical-Surgical Urinary Tract Infection

The second Real Life 3.0 simulation involved a female patient suffering from urinary

tract infection. She is 78 years old and was recently diagnosed with the condition. I worked

through the scenario and identified the additional information that could help in treating her.

They include her WBC levels, mobility, status, temperature, vital signs, and urinalysis. I noticed

the patient’s restlessness and her difficulty in breathing when the nurse entered her room. This

enabled me to consider a rapid focused assessment as the recommendable approach for the

patient examination. Besides, I correctly identified that applying the oxygen per NC at 2l per

minute was the best intervention to control the situation. It would be right to increase the oxygen

application to 4l per minute if the patient did not stabilize. Also, auscultating lung sounds for the

patients would serve well, but the process would interfere with the overall diagnosis and

treatment of the primary illness that the patient is suffering from. Finally, upon receiving the

patient’s medication, I realized the importance of discussing it with the pharmacist. The rationale

behind the decision is to ensure that a comparison is made with her preadmission medicine.

My weakness in the simulation emerged after the patient began exhibiting exacerbation of heart

failure. The increased respiratory distress was quite confusing considering the medication and

interventions she was subjected to earlier. However, I realized that my strength was the ability to

determine the medication and necessary emergency procedures to assist the patient. Using
observation and the available data, I managed to make sound clinical decisions that assisted the

patient.