Question

9:00 AM: The physician has not come in to see Mr. S. Mr. S is alert but experiencing increasing shortness of breath, cough, and nausea and complaining of blurred vision. His pulse oximetry result is 88%. P 116 and irregular, R 34 and short and shallow, BP 152/100. Skin cool, color with slight cyanosis. Aside from the K+ of 3.0 mEq, Mr. S’s Na+ is 135+ mEq, and his digoxin level is 2.4 ng/mL. You call the physician and learn that he is in surgery and will call you back within 30 minutes. At 0930 the physician calls you back. Using the ISBAR sheet, write how you will communicate with the physician over the phone.

I	Identify	Self – name , position, location Patient – name, age, gender
S	Situation	Explain what has happened to trigger this phone call conversation
B	Background	Admission date, diagnosis, relevant history, investigations, what has been done so far
A	Assessment	Give a summary of the patient’s condition or situation. Explain what you think the problem is (if you can)
R	Request / Recommendation	State your request or recommendation

Answer 1

Identity;
hello Doctor, This is staff nurse X , from Intensive medical unit. Here's my patient detail sir,
patient name is Mr.S and he is 62 years old.

Situation;
Sir, patient vitals had become changed from 9.00 am onwards. Now he is experiencing imbalanced vital sigtns.Further he has a symptoms of shortness of breath, cough, nausea and a complaint of blurred vision.

pulse oximeter shows O2 saturation of 88% , his pulse rate is 116 beats/ mins and it is regular, his respiratory rate is 34 breath/mins which is short and shallow sir, his BP is 152/100, his skin feels cool and slightly he had a sign of cyanosis Sir,..

Background;
Here's the patient history sir. Mr.S got admitted two days ago with the complaint of difficulty in breathing, chest pain and nausea. He had undergone some appropriate investigation and physician diagnosed him as COPD. In his investigation the lab values shows 3.0 mEq of k+ and 135+mEq of Na+ and digoxin level is 2.4ng/ml.

So far, he was taking some bronchodialators such as albuterol and levabuteral. Also he is taking some corticosteroid drugs such as fluticason and prednisolone. he is taking these drugs by orally sir.Thats the patient background sir.

Assessment;
After taking these medication his health condition was slightly improved but today morning it all got reversed and seems so woresn sir. I think patient needs heavey dose in his medication, In our side I'm maintaining proper position to him, so I think it will help him for better breathing.

Request;
please come and visit as soon as possible sir. If this condition get further worsen, We need to assist him with artificial ventilation sir, So please have a look sir, thank you,...