SCENS Simulations for Clinical Excellence in Nursing Services

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SCENS Gastrointestinal: Abdominal Assessment and Labs

SCENS 1. 2. 3. 4. Learning Objectives Demonstrate appropriate infection control measures when caring for the patient with hepatitis C Perform a focused abdominal assessment Demonstrate appropriate steps required to obtain and handle lab specimens Communicate effectively when performing an abdominal assessment and obtaining lab specimens for the patient with hepatitis C

SCENS • Overall statistics • Statistics for Veterans • VHA Directive 1300. 01 –VHA Viral Hepatitis Program –https: //www. hepatitis. va. gov • National Patient Safety Goals Why?

SCENS • • • Hepatitis C Most common bloodborne infection in the United States Transmission Infection control practices Centers for Disease Control and Prevention (CDC) Standard Precautions – Hand hygiene – Personal protective equipment – Safe injection practices – Appropriate aseptic techniques

SCENS Complication of Hepatitis C • Cirrhosis –Ascites • Albumin production • Drop in hydrostatic pressure • Assessment –Respiratory status –Fluid wave –Abdominal girth –Daily weights

SCENS • Inspection • Auscultation • Palpation • Percussion Abdominal Assessment

SCENS • Orders • Scope of practice • Patient identification • Equipment • Hand hygiene • PPE • Joint Commission requirements Specimen Collection Labeling of the specimen Packaging Delivery of the specimen Follow-up to ensure the specimen was received • Who is ultimately responsible? • Safety measures • •

SCENS • Psychosocial • Equipment or supplies • Positioning of the patient • Difficulty obtaining the specimen Potential Issues ? … F I T A H W

SCENS 1. 2. 3. 4. Summary Reviewed appropriate infection control measures when caring for the patient with hepatitis C Performed a focused abdominal assessment Demonstrated appropriate steps required to obtain and handle lab specimens Discussed communication when performing an abdominal assessment and obtaining lab specimens for the patient with hepatitis C

SCENS

SCENS Kenneth Green Gastrointestinal: Abdominal Assessment and Labs Sixty five (65) year-old male with a history of Hepatitis C presents with complaints of abdominal discomfort (3/10 scale) for three (3) days and unintentional twenty (20) pound weight loss. He has a history of alcohol (ETOH) abuse and has been refusing to take his medication. He was admitted with ascites, weight loss, and malnutrition. Past Medical History: Medications: • Hepatitis C, alcohol (ETOH) abuse, and benign • Ledispavir 90 mg/Sofosbuvir prostatic hypertrophy (BPH) 400 mg daily Past Surgical History: Allergies: • Transurethral Resection of the prostate (TURP) • Penicillin