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Decision Tree Case Study Assignment

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Decision Tree Case Study Assignment


Directions: Use the copy of the Decision Tree while answering the questions associated with this case vignette

You are the nurse on a med/surg unit and have just received a new admission from the emergency room.  The patient is a 60-year-old male with COPD who was admitted with an exacerbation of COPD.  Your quick assessment reveals that he has a slight increase in his work of breathing Decision Tree Case Study Assignment and mild expiratory wheezes.  He is anxious and frequently asking to be repositioned and wants the head of the bed elevated at all times.  He is wet from being incontinent of urine while on the ER stretcher and needs vital signs in addition to being cleaned up.

You speak to the UAP and ask that he obtain vital signs, clean the patient and remove the wet sheets from underneath the patient.  His response is “ok, no problem”.  About 20 minutes later you realize that the UAP has not brought you the vital signs, but when you look in the computer, you note that they have been charted. The vital signs are as follows: BP 150/80, HR 120, RR 20 and PO Sat 90%.  You are concerned that the UAP did not report the elevated HR and decreased PO Saturation.  You are also not convinced that the documented respiratory rate is correct.


Discussion question one:

  1. Using Step two in the Decision-Making Tree (Communication) as your guide, describe your perception of the effectiveness of the communication between yourself and the UAP. Identify the issues/limitations with the way the request was communicated (delegated) to the UAP and acknowledge by the UAP? Decision Tree Case Study Assignment


Discussion question two:

You go the patient’s room and find the UAP changing the sheets with the patient on their side with the head of the bed down.  The patient is now in moderate distress.  After settling the patient more appropriately and stabilizing him, you need to talk to the UAP about what happened with the patient.

  1. Review the information in step one of the Decision-Making Tree (Assessment and Planning), and using that, identify missteps made in this delegation to the UAP.


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