Madison word - Vsim PDF

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Title of Student Activity:

Plan of Care Estimated Time (hr): 1-hour 30min Description of Activity :

This activity creates an opportunity for you to organize the nursing care of a pediatric patient who is dehydrated. It allows you to put the different data pieces collected during the shift head to toe and throughout the nursing shift together in a meaningful manner. Student Learning Outcomes

The student explains the nursing care related to the dehydrated pediatric patie nt. The student identifies data that identifies a critical change in patient condition.

Assignment

all readings assigned to you by instructor. Open Eva Madison' s electronic health record in Lippincott DocuCare and review : Demographics Assessments C. Notes Vital Signs Orders Medication Administration Record Create the following concept map by physical assessment and nursing interventions required when caring for the dehydrated pediatric patie nt. Submit for review.

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PLAN OF CARE WORKSHEET Respiratory Data

Answer Auscultate breath sounds using the diaphragm of you stethoscope. Eva’s Oxygen is at a 94% on room air, no form of sputum, no symptoms of difficulty breathing, cough, or deformity, all breath sounds are clear on all four quadrants, respiration is regular at 30bpm. Administer nasal canula oxygen, teach breathing exercises, teach relaxation techniques

Physical Assessment

Nursing Interventions

Cardiovascular Data Physical Assessment

Answer Auscultate the heart, auscultate for carotid bruits, carotid artery pulse, jugular venous pulse, palpating the heart sounds for murmur. Eva’s pulse is beating at 185 every minute and it is strong and regular. rhythm and heart rate is regular without any murmurs. I could here the s1 and s2 sounds, heart tones were regular, pulses were a strength of 2, no edema present, capillary refill was less than 3 seconds, skin color is appropriate for ethnicity, Monitor vital signs, oxygen therapy, diet modification.

Nursing Interventions lntegumentary Data

Answer inspection and palpation of the skin, hair, scalp, and nails. Palpate skin for texture, temperature, and the turgor of the skin. Eva’s skin is clean, dry, and intact Assess the risk for pressure ulcers, Use Braden scale or Norton scale for pressure ulcer risk assessment.

Physical Assessment Nursing Interventions

GI/GU

Data

Answer Auscultate bowel sounds, ask patient about digestive or nutritional issues, ask patient about family history of GI and GU disease. Eva’s abdomen is round, soft and non-tender, patient has anorexia, vomiting, and its clear, she has diarrhea, abdominal pain, and has lost weight. Bowel sounds are hyperactive. She has oliguria, yellow urine color, she voids with difficulties. Assess for pain, cramping, frequency, hyperactive bowel, evaluate pattern of defecation, get a stool and urine culture, ask about meal pattern, get strict I&O.

Physical Assessment

Nursing Interventions

Pain Data

Answer Using the pain scale “FACES” to ask the patient about pain. Eva rated her pain a 4 on a scale of 1-10, she said it’s around her stomach, it hursts when she moves, it’s aching, frequency is intermittent, pain is acute. Perform comprehension of pain, assess the location of pain, perform history assessment of the pain, determine perception of pain, check pain every 4hours,

Physical Assessment

Nursing Interventions

Neurological Data

Answer

Eva’s behavior and affect is appropriate, anxious, and crying. Her stressors are condition, hospitalization, and diagnosis. She is coping fairly. Monitor neurologic status, observe signs for intracranial pressure, monitor ABGs, administer oxygen as needed

Physical Assessment Nursing Interventions

Fluid & Electrolytes Data Physical Assessment Nursing Interventions

Answer Check for edema, skin turgor, perform serum electrolyte test. Perform a serum electrolyte test, monitor stict intake and output, measure patient weight daily,

Title of Student Activity:

"5 Whys" Estimated Time (hr): 1 hour Description of Activity:

This activity asks you to consider a patient situation related to dehydration and its management. It builds critical thinking and clinical judgement by encouraging you to ask the question "why" when Student Learning Outcomes

The student describes the clinical manifestations of dehydration. The student discusses nursing management of a patient experiencing dehydration. The student identifies abnormal findings that indicate a change in the patient condition. implementing interventions and evaluating respond Assignment

Complete all readings assigned to you by instructor. Review the following areas in Eva Madison's EHR: Patient Information Notes Orders Vital Signs Diagnostics Complete the following handout answering the "5 Why's". Remember to use green smart sense links in EHR. Submit for review.

"5 WHYS" WORKSHEET Why Data Why is this patient dehydrated? (Be specific and include pathophysiology)

Answer The patient is dehydrated due to diarrhea and vomiting. In diarrhea, the large intestine absorbs water from food and prevents diarrhea from this. The body excretes water and causes symptoms of dehydration too. Vomiting cause fluid loss and make it difficult to change fluids when drinking.

Why Data Why does this patient need immediate treatment?

Answer If left untreated, severe dehydration can be severe and cause convulsions brain damage, and death.

Why Answer Data Why would the nurse choose one administration It is advantageous because the medicine can be effectively applied with the clinical effect desired by the doctor. route over another? {Intravenous fluids versus oral fluid replacement)

Why Data Why should the nurse monitor the patient's perfusion status and electrolyte levels closely?

Answer Drugs administered intravenously develop faster because their effects are more pronounced than drugs administered by other routes

Why Data Why is the normal saline intravenous fluid ordered as a bolus and the DS ½ NS ordered at 62ml/hr?

Answer

When rapid fluid infusion is required, this approach is usually used in emergency care settings.

Title of Student Activity:

Pharm 4 Fun: Case Study Estimated Time (hr): 1 hour Description of Activity:

This activity presents you with a patient scenario where you are required to navigate through an electronic health record (EHR) using Lippincott DocuCare and provide information regarding the safe administration of normal saline intravenously. Student Learning Outcomes

pertinent nursing considerations regarding safe administration of intravenous fluids in the pediatric patient. The student calculates intravenous fluid bolus amounts and hourly maintenance fluid rates both based on the patient's weight. The student analyzes assessment/vital sign data to determine the effectiveness of the intravenous fluid boluses and need to contact the healthcare provider.

Assignment

thePoint and launch DocuCare, following all instructions posted on your learning management system (LMS). Locate and open Eva Madison's EHR . Review Eva Madison's patient information, notes, vitals, and electronic medical record (EMA R). Complete the following handout. Use the smart sense links in Eva Madison's EM AR. 5 .Submit for review.

Title of Worksheet Pharm 4 Fun Case Study I

Scenario Data 5-year-old Caucasian female presenting with a 3-day history of vomiting and diarrhea. Mom reports that she is unable to keep fluids down, has not voided since 8 p.m. yesterday, and appears to have "lost weight.'' She has vomited twice since arrival to the floor, small amounts of clear fluid. No new foods, no fever, and no medications given. Several kids in kindergarten class have had the "stomach bug" per mom. The patient responds to questions with one word answers, appears pale and fatigued, and has dry mucous membranes.

Answer Stool culture for yersinia

Check for appendicitis

What medications does Eva Madison have ordered to treat her dehydration? Do you feel safe administering this medication? If so, support your answer What are the nursing considerations regarding this medication?

She was ordered an Infusion Dextrose 5% in 0.45% normal saline at 62ml/hr.

The patient's vital signs after finishing the normal saline fluid bolus are BP 79/35, HR 140, RR 30, Sats 95% on room air, Temp 100.5 axillary. Was the normal saline bolus effective? What steps do you need to take now? The healthcare provider orders a 20ml/kg normal saline bolus to infuse over 15 minutes. Eva weighs 45Ibs, how many mls of fluid will you administer? What will you program the infusion pump to run at (ml/hr)? What assessment data would demonstrate the fluid volume bolus was effective?

The normal saline bolus was effective because Blood pressure improved, heart rate improved, respiration improved,

Yes I do feel safe administering this medication because Eva is dehydrated and needs it to rehydrate Close monitoring for patients with heart failure Educate patients and families Observe for signs of fluid overload Document baseline data Monitor for manifestations of fluid volume deficit Warning on excessive infusion

408.234ml will be administered

Therefore, infusion pump program will run for 6.8039ml/hr

The heart rate will be improved. Blood pressure improved, heart rate improved,...