Critical thinking case study —with using Bubblier.us

Read the following case study:
You are a staff nurse working in an intensive care unit and assigned to care for a 75-year-old man who had
coronary artery bypass graft surgery four days ago. The patient has a history of chronic obstructive pulmonary
disease exacerbated by heavy smoking. His postoperative course has been difficult, and he has suffered a
number of setbacks. Staff members, despite their diligent efforts, have not been able to wean him off the
ventilator since the surgery. He has required frequent suctioning throughout the shift, and he is being evaluated
for the development of ventilator-associated pneumonia.
Today, when returning from lunch, you observed an experienced nurse was suctioning your patient. His
secretions were thick, and you observed that the nurse was instilling saline into the patient’s endotracheal tube
as she was suctioning him. The patient turned red and began coughing, and it was obvious he was in distress.
You asked the nurse why she was instilling saline into his endotracheal tube. She replied this was being done
to loosen the secretions. You told her this was no longer an acceptable practice. She stated that she has many
years of critical care experience and she did not care what anyone said, that the only way you could loosen the
patient’s secretions would be to instill saline. She also said that would be the last time she would do something
for one of your patients while you were at lunch.
Determine a plan of care for the patient using the nursing process.
Define each step of the nursing process, and align each step to critical thinking and clinical decision-making
processes.

Sample Solution

ACED ESSAYS