Chistopher Parrish JGClinical Replacement Packet PDF

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Download Chistopher Parrish JGClinical Replacement Packet PDF

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CONCEPT MAP/ PLAN OF CARE This activity creates an opportunity for you to organize the nursing care required for the patient care presented in your assigned vSim. Student Learning Outcome At the end of this activity, student will be able to: 1. Describe pathological events associated with the patient’s disease process or condition. 2. Create a plan of care and priori zed nursing interventions based on patient care needs. 3. Identify anticipated diagnostic and physical assessment findings related to the identified condition or disease process. Assignment 1. Log into thePoint and Launch the assigned vSim, following the instructions posted on your learning management system (LMS) or given by your clinical instructor. 2. Review the information contained in the patient information. 3. Review the smart sense links associated with the Nursing Care, Diagnostics, Pharmacology found in the suggested reading area. 4. Create the follow concept map. List pathophysiology associated with the patient’s disease process or condition, the anticipated physical assessment findings, vital signs, diagnostics, specific nursing interventions and other patient information on associated with the patient situation. 5. Utilize the smart sense links throughout the vSim to complete the worksheet. 6. Submit your concept map for review.

Concept Map Worksheet Describe Disease Process Affecting Patient (include pathophysiology of disease process) Cystic fibrosis affects the cell that produces mucus, sweat, and digestive juices. It causes these fluids to become thick and sticky. They then plug up tubes, ducts, and passageways. Symptoms vary and can include cough, repeated lung infections, inability to gain weight, and fatty stools. There is no cure for Cystic Fibrosis, but treatment can easily reduce symptoms and complications and improve quality of life. Close monitoring and early, aggressive intervention is recommended to slow the progression of Cystic Fibrosis, of life, which can lead to a longer life. End-stage lung disease is characterized by cystic abscesses, and fibrosis of lungs and airways. Causes: Cystic Fibrosis is an inherited disease caused by mutations In a gene called the cystic fibrosis transmembrane conductance regulator (CFTR) gene. The CFTR gene provides instructions for the CFTR protein. While cystic fibrosis is usually diagnosed at childhood, adults with no symptoms (or mild symptoms) during their youth can still be found to have the disease.

Diagnostic Tests (Reason for test and results)

Patient Information

Male who was admitted at 1900 today. His mother visited him at his college dormitory and was very concerned with his health; he seemed weak and had lost weight since she last saw him. Background: Christopher was diagnosed with cystic fibrosis as a child and has had frequent hospitalizations previously.

Christopher Parrish

18-year-old

Male

Anticipated Physical Findings Patient alert and awake. Pale skin. Blood pressure is 118/78 mm Hg. Rate and rhythm are regular at 80-85/min Respiratory rate at 18/min Temperature 97.5F He reports fatigue and has recently lost 6kg (13.2lbs) Pain 1 of 1 to 10 scale. His belly is flat and nontender, Bowel sounds are normoactive.

Anticipated Nursing Interventions Ordered a feed tube. I placed an 8-Fr, 42-inch feeding tube in his right nares about an hour age, and x-ray just called and confirmed placement in the stomach. He is up to the bathroom prn; otherwise bed rest. Obtain a fluid example from the tube. Check that the tube is not obstructed. Administer the medication is ordered by physician.

2 Adapted from vSim for Nursing Wolters Klewur

ISBAR ACTIVITY

This SBAR activity assists you in building the skill of communicating pertinent information when caring for a patient. Appropriate actions you should do to complete this activity include finding appropriate data to provide a thorough SBAR report. Student Learning Outcomes At the end of this activity, student will be able to: 1. Identify pertinent data from the patient information area of the vSim suggested reading section. 2. Communicate pertinent information for a patient using ISBAR. Assignment 1. Log into thePoint and launch the assigned vSim, following all instructions posted on your learning management system (LMS). 2. Review the information contained in the patient information area of the suggested reading section. 3. Review the smart sense links found within the Nursing Care, Diagnostics and Pharmacology areas of the suggested reading. 4. Navigate and fill out the data in the following document using the patient information provided in the suggested reading area. 5. Submit for review.

3 Adapted from vSim for Nursing Wolters Klewur

vSim ISBAR Activity

STUDENT WORKSHEET

Introduction

Jacqueline Gonzalez

Your name, position (RN), unit you are working on

Nursing Student Location: Inpatient Medical-Surgical Unit

Situation

Christopher Parrish, 18-year-old, Male

Patient’s name, age, specific reason for visit

Christopher was diagnosed with cystic fibrosis as a child and has had frequent hospitalizations previously.

Background

01/08/21 at 0815 Christopher was diagnosed with cystic fibrosis as a child and has had frequent hospitalizations previously. Order Access vital sign as protocol unit. Sitting when feeding. Recommend diet and reinforce patient education. The tube feeding 720 kilocalories over 8 hours. He is up to the bathroom prn; otherwise bed rest.

Patient’s primary diagnosis, date of admission, current orders for patient

Assessment

Patient alert and awake. Pale skin. Blood pressure is 118/78 mm Hg. Current pertinent assessment data using head to toe Rate and rhythm are regular at 80-85/min approach, pertinent diagnostics, vital signs Respiratory rate at 18/mm Temperature 97.5F He reports fatigue and has recently lost 6kg (13.2lb) Pain 1 of 1 to 10 scale. His belly is flat and nontender. Bowel sounds are normoactive. Recommendation Any orders or recommendations you may have for this patient

4 Adapted from vSim for Nursing Wolters Klewur

Orders Assess vital sign as protocol unit. Sitting when feeding. Recommend diet and reinforce patient education. The tube feeding 720 kilocalories over 8 hours. He is up to the bathroom prn; otherwise bed rest.

CLINICAL WORKSHEET This activity creates an opportunity for you to prepare for a virtual clinical experience. This activity provides you with the opportunity to manage patient care, prioritize interventions, and identify aspects of care that could be delegated. Student Learning Outcomes At the end of this activity, student will be able to: 1. 2. 3. 4.

Describe pathological events associated with the patient’s disease process or condition. Create a plan of care that is prioritized and is based on the patient’s care needs. Identifies path to healing or health and path to death or injury. Describes aspects of care that can be delegated and appropriate personnel to complete delegated tasks.

Assignment 1. Log into thePoint and launch the assigned vSim, following all instructions posted on your learning management system (LMS). 2. Review the information contained in the patient information. 3. Review the smart sense links associated with the Nursing Care, Diagnostics, and Pharmacology, found in the suggested reading area. 4. Complete all areas of the attached clinical worksheet. 5. Submit the completed worksheet.

5 Adapted from vSim for Nursing Wolters Klewur

Clinical Worksheet Date: January 9, 2019 Initials:CP

Diagnosis:Cystic Fibrosis

Student Name:Jacqueline Gonzalez HCP:

Isolation:

IV Type:

Fall Risk: Full

Location: Medical Surgical Unit 2315

Age:18-years-old M/F:Male

Length of Stay:2 days Consults:

Code Status:Full Allergies:None

GI, nutritionist

Assigned vSim: Christopher Parrish

Transfer:

Critical Labs:

Other Services:

None.

Fluid/Rate:

Consults Needed:

Psychology, Gastroentorolo gist

Why is your patient in the hospital? (Answer in your own words and include History of present illness) The patient has history of Cystic Fibrosis and was found by parent with a low weight related to the regular weight. Patient suffer fatigue. He mentions that he has no appetite.

Health History/ Comorbidities (that relate to this hospitalization): Patient was diagnosed with Cystic Fibrosis. Patient has had multiple hospitalizations.

Shift Goals/ Patient Education Needs: 1. Educating the patient on tube feeding 2. Educating the patient on BMI 3. Educating the patient on positioning 4. Path to Discharge: Patient will need to return regularly to have his condition monitored. Ask patient to write down questions so they can remember to ask during their next visit.

Path to Death or Injury: N/A

Clinical Worksheet Alerts:

Management of Care: What needs to be done for this patient today?

What are you on alert for with this patient? (Signs & Symptoms)

1. Monitoring vital signs

1. Weight Loss

2. Follow as ordered diet and medications

2. Fatigue

3. Observe symptoms and sign of infections

3. Weakness

4. Education is a priority 5.

What assessments will focus on for this patient? (How will I identify the above signs and symptoms?) 1. Vital Signs 2.Emphasizing fluids and dietary intake. 3. Support and advise.

6.

Priorities for managing the patient’s care today 1. Check vital signs 2. Feed patient as ordered on chart 3. Check intakes and outputs

List complications that may occur related to dx, procedure, comorbidities:

4. Check bowel movements

1. Respiratory infections 2.Digestive Chronic diarrhea 3. Weight loss

What nursing or medical interventions may prevent the above Alert or complications? 1. Severity and progression of the disease 2. Infections 3. General decay 4. Death

7 Adapted from vSim for Nursing Wolters Klewur

What aspects of the patient care can be delegated and who can do it? Vital signs while patient is stable

vSim Worksheets Grading Rubric (Not used for Clinical Worksheet) Criteria Content Knowledge

5 Points

4 Points

Follows all requirements for the assignment.

Follows all requirements for the assignment.

Conveys well-rounded knowledge of the topic. Content well organized, logical.

Major points of topic are mostly covered in the required assignment areas.

Easy to read and understand throughout all of worksheet.

Critical Thinking

Concisely explains each content area. Analyzes information, connects data points to provide accurate, concise information. Scholarly work.

Writing Composition (Spelling, Grammar, Sentence Structure)

An occasional spelling error present. Grammar, readability, and sentence structure is error free.

Content organized, logical flow. Easy to read and understand through most of worksheet.

3 Points Knowledge of topic is partially covered. Key information is missing from 2 or more assignment areas. Worksheet difficult to follow in two or more areas. Information is incomplete in two or more areas.

2 Points Knowledge of topic is general in more than three areas of the worksheet. 1 or more areas of worksheet left blank. Content unorganized throughout worksheet. Difficult to understand content of paper.

Few aspects of the content areas presented.

Explains each content area. Presents information about the topic. Some analysis, insight present, some data points threaded together.

Few insights presented, lacking analysis. Data points not connected to information provided.

Scholarly work.

Some minor errors (1-3 errors) with spelling, grammar and/or sentence structure, not consistent throughout worksheet. Errors do not interfere with the readability or comprehension of information.

Frequent errors (4-5 errors) with spelling, grammar and/or sentence structure. Errors effect ability to comprehend information present on worksheet and readability.

Little understanding gained from information presented. Numerous errors (5-6 errors) with spelling, grammar, and/or sentence structure throughout the worksheet Difficult to understand information presented due to numerous errors

1 Point

Total Points

Knowledge of topic is general throughout entire worksheet, and/or does not cover all the required assignment areas. Two or more areas left blank on worksheet. Unable to follow flow of worksheet.

Information is basic. No aspects of the content present in the worksheet. Lacks insight, analysis, and conclusions. No understanding from the content presented.

Excessive errors (>6 errors) occur with spelling, grammar and/or sentence structure, throughout worksheet. Unable to understand information presented in the worksheet.

Total Points: __________________

8 Adapted from vSim for Nursing Wolters Klewur

Rubric for Grading vSim Clinical Worksheet 5

3

1

0

Patient Information: Demographics, Diagnosis, Allergies, Provider, Consults, Isolation, Fall Risk, Intravenous Therapy, Critical Labs, Services and Needed Consults Medical History: Why patient is in the hospital, History of present Illness, Past Medical/Surgical History, Comorbidity Factors Patient Education/Goals: Shift Goals, Patient Education Needs

Disease Progression: Pathway to Death or Injury Pathway to Health

AACIP: Alerts, Assessments, Complications, Interventions and Prevention

Nursing Care Plan: Management of Care, Priorities for Patient Care, Delegation

All documented areas 100% complete and provide thorough information.

Three listed areas completed OR documented areas 75% complete.

Less than three listed areas completed OR documented areas less than 50% completed.

Patient information area blank.

100% of HPI, Past Medical/Surgical History and Comorbidity Factors completed with thorough, relevant information.

75% of HPI, Past Medical/Surgical History and Comorbidity Factors completed. Information relevant to scenario.

50% of HPI, Past Medical/Surgical History and Comorbidity Factors completed. Information basic and lacks relevancy.

25% of HPI, Past Medical/Surgical History and Comorbidity Factors completed. Information not relevant, or content areas left blank,

Thorough and detailed patient education. Patient shift. goals are SMART, relevant, and detailed goals. 100% of worksheet area is complete.

Provides patient education but lacks thoroughness or details. Patient shift goals missing 1-2 components of SMART goals. 75% of information needed for worksheet area present.

Patient education lacks thoroughness and details. Patient shift goals missing 3 – 4 components of SMART goals. 50% of the information needed for worksheet area present.

Missing patient education and/or patient shift goals. Patient shift goals lack all components of SMART goals. 25% of the information needed for worksheet area present.

Pathway to death and health is identified with detail. Information is concise, relevant, accurate and portraits appropriate timeframe for occurrence. 100% of the information needed for worksheet present.

Pathway to death and health is identified. Information is relevant and accurate. Missing timeframe for occurrence. 75% of information needed for worksheet area present.

Missing over 50% of needed information for worksheet area present. Pathway to death and health identified but content either not relevant or accurate for situation present in scenario.

Pathway to death and health contains information not relevant or accurate to the scenario or section left blank.

Alerts, Assessments, Complications and Interventions/Preventions identified thoroughly. Answers relevant to scenario. 100% of the information needed is present.

Alerts, Assessments, Complications and Interventions/Preventions identified. Most answers relevant to scenario. 75% of the information needed for worksheet area present.

Missing 2 – 3 areas on worksheet. Answers not relevant to scenario. 50% of the information needed is present.

Missing 4 or more areas on worksheet. Answers not relevant to scenario. 25% of the information needed for worksheet area is present.

Management of Care relevant to case scenario and detailed. Priorities for scenario identified. Identifies all aspects of care that can be delegated and identifies appropriate personnel to delegate activities to. Answers detailed; Critical thinking evident.

Management of Care, Priorities or delegation sections relevant to scenario. Answers generic to situation. Some evidence of critical thinking present.

Missing relevant data in one or more categories (management of care, prioritization, delegation). Answers basic without detail. Little to no evidence of critical thinking present.

Information provided not relevant to scenario. Answers are basic without detail. No evidence of critical thinking. Missing answers in one or more area.

9 Adapted from vSim for Nursing Wolters Klewur

Total Points:

10 Adapted from vSim for Nursing Wolters Klewur...