A nurse is contacting the on-call healthcare provider about a patient who underwent a hysterectomy two days ago and is experiencing pain that is not alleviated by the prescribed opioid pain medication. Which statement constitutes the “Background” portion of the SBAR format for communication?
“I would like you to prescribe a different pain medication.”
“This patient underwent a vaginal hysterectomy two days ago.”
“The patient, D.A. Smith, has an aversion to nonsteroidal anti-inflammatory medications.”
“This patient has allergies to morphine and codeine.”
The Correct Answer is B
Choice A rationale:
This statement belongs to the "Request" portion of the SBAR format. It articulates a specific action the nurse wants the healthcare provider to take.
It's not part of the Background because it doesn't provide any historical or contextual information about the patient's condition.
Choice B rationale:
This statement is the correct choice for the "Background" portion of the SBAR format.
It provides essential background information about the patient's recent medical history, specifically the recent hysterectomy.
This information is crucial for the healthcare provider to understand the context of the current situation and make informed decisions about pain management.
Choice C rationale:
This statement provides additional patient information, but it's not the most relevant for the Background section in this context.
The patient's aversion to NSAIDs might be important for medication choices, but it doesn't directly address the current issue of pain management after a hysterectomy.
Choice D rationale:
This statement provides important information about the patient's allergies, but it's not the most relevant for the Background section in this context.
Allergies are crucial for medication safety, but they don't directly address the current issue of pain management or provide context about the patient's recent surgery.
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Correct Answer is C
Explanation
Rationale for Choice A:
Documenting and continuing to monitor is a crucial aspect of nursing care; however, in this scenario, it would not be the first action to take. The significant drop in blood pressure warrants immediate intervention to prevent potential complications.
While monitoring is essential, it does not actively address the underlying cause of the hypotension. Relying solely on monitoring could delay necessary interventions and potentially compromise patient safety.
It's important to balance monitoring with timely interventions to ensure optimal patient outcomes. In this case, calling for assistance takes priority over documentation and continued monitoring.
Rationale for Choice B:
Repeating the blood pressure in 15 minutes could delay critical interventions if the hypotension is severe. Timely action is crucial to maintain adequate tissue perfusion and prevent organ damage.
Waiting to recheck the blood pressure could potentially worsen the patient's condition and lead to adverse outcomes. It's essential to act promptly when a significant change in vital signs occurs.
Rationale for Choice D:
While notifying the primary healthcare provider is an important step, it may not be the most immediate action in this situation. The Rapid Response Team is specifically trained to handle acute patient deterioration and can provide timely interventions.
The Rapid Response Team can initiate life-saving measures, such as administering fluids or medications, while the primary healthcare provider is being notified. This ensures that the patient receives prompt and appropriate care.
Rationale for Choice C:
Calling the Rapid Response Team is the most appropriate first action in this scenario because it ensures a rapid and coordinated response to the patient's hypotension.
The Rapid Response Team can quickly assess the patient, initiate interventions, and potentially prevent further complications. They can also facilitate communication and collaboration among healthcare providers.
Early activation of the Rapid Response Team has been shown to improve patient outcomes in various clinical settings, including postoperative care.
Correct Answer is B
Explanation
Choice A rationale:
Plague is a highly contagious and often fatal disease caused by the bacterium Yersinia pestis. It is transmitted to humans through the bites of infected fleas or by direct contact with infected animals or their tissues.
Plague can cause severe illness and death, even with prompt treatment. The mortality rate for untreated plague is 50-60%. Therefore, it is incorrect to state that plague produces a mild illness and generally has a low mortality rate.
Choice C rationale:
Smallpox is a highly contagious and deadly disease caused by the variola virus. It was eradicated in 1980, but there is still a risk that it could be used as a bioweapon.
Most people under the age of 40 have not been vaccinated against smallpox and therefore have no immunity to the disease. Therefore, it is incorrect to state that the majority of Americans have adequate innate immunity to smallpox.
Choice D rationale:
Safer food preparation practices have helped to decrease the incidence of foodborne illnesses.
However, foodborne illnesses can still be spread through international travel. Travelers can be exposed to contaminated food or water in other countries.
Therefore, safer food preparation practices do not eliminate the risk of foodborne illnesses being spread through international travel.
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