Question

Please help answer these question

Patient information

Patient name

: Maria Gonzales

Diagnosis: Severe necrotizing

pancreatitis

Age: 64

Ht: 5 ft 2 in

Wt: 175 lbs (79.5 kg)

Gender: female

Medications

:

X IV access

X IV fluid: D5.45%NS with 20

meq/L at 100 ml/hour

IV medication:

Esomeprazole 20 mg IV

X Hydromorphone 0.5 mg IVP/

2 hours

X Promethazine 25 mg IVP/6

hours

Sliding scale insulin

X BS>200 call PCP

X BS < 60 give Dextrose 50%

50 ml IVP

General orders

:

X Advanced directives: Full

Code

X Diet: NPO

_ Fall precautions:

_Restraints:

_Isolation precautions:

Unit

: Progressive ICU

Family: Daughter Rosanna

Phone: xxx xxx xxxx

Immunizations: up to date

Medication from home: none

Monitoring

:

X I & O every hour

X Vital signs every 15 minutes

until stable then every hour

X ECG monitor

X Sp02 monitor

Diagnostics

:

X Lab: BMP, Calcium,

Magnesium, CBC, Amylase,

lipase

X ABG

X X ray: CXR

Respiratory

:

X Incentive spirometer every

hour

02 titrate to keep Sp02>92%

X Cannula

_Oxygen mask

X Non-Rebreather mask

_Bag-mask ventilator

_Nebulizer

Social history

:

Daughter next of kin

+history smoking 20 years ago

+history ETOH moderate

Employed: sales manager

Ethnicity: Hispanic

Religion: Catholic

Maria Gonzales Simulation learning Objectives

OBJECTIVES:

1. Identifies the primary nursing diagnosis

2. Identifies relevant patient history information

3. Implements patient safety measures

4. Explains physical assessment findings and diagnostics related

to patient condition specifically pancreatitis and septic shock

5. Implements clinician’s orders appropriately

6. Implements nursing interventions based on patient care

needs

7. Prioritizes nursing interventions

8. Identifies indications, contraindications, and potential

adverse effects of prescribed mediations

9. Demonstrates correct medication administration

10. Implements a focused cardiac and respiratory assessment

11. Explains clinical findings and critical lab values relating to

pancreatitis and sepsis

12. Summarizes potential complications for patients with acute

pancreatitis

13. Demonstrates appropriate nursing interventions for a patient

with pancreatitis and sepsis

14. Provides relevant patient/family education and teaching

15. Demonstrates therapeutic and confidential communication

16. Demonstrates direct and accurate communication with

interprofessional team member

17. Demonstrates effective teamwork

Groups will be divide according to clinical groups

2. The staff (students) will be divided accordingly:

a.

Leader ARNP/charge nurse

b. RN-assessment/documentation/ retrieving and

communication of lab results

c.

RN- meds and IV administration/ safety and

procedures

d. family member (may periodically assist instructor)

e. Remaining students will be observers, then we flip

roles

3. For this scenario, patient has been in ICU for 3 days and

condition has taken suddenly taken a turn for the worse

Please answer these questions below base on this patient

1. Explain what type of patient will be involved in today’s simulation

2. Predict one priority action that you might anticipate for this simulation today

3. Can you delegate the central line dressing change to the UAP? Why or why not?

4. What does MEWS stand for?

5. What does CAM stand for?

Answer 1

1. The types of patient involved in today's simulation are those who are sick and admitted in ICU with chronic pancreatitis .

2. One priority action that i would expect for this simulation today is that the patients who are shown to the students are not affected in any way because of the simulation going on . There treatment and others needs are up to the mark and not delayed .

3. No, we can't delegate the central line dressing change to the UAP because Unlicensed assistive personnel (UAP) are paraprofessionals who assist individuals with physical disabilities, mental impairments, and other health care needs with their activities of daily living like assistance in ambulation , hygiene , feeding etc .

4. MEW's - Modified early warning scores are the scores for clinical deterioration . Determines the degree of illness of a patient . It is a tool designed to identify patients with declining condition .

5. CAM stands for complementary and alternative medicine . It is not the part of the conventional medicine