Dr. Brown nurse. ● Knowledge deficit Arthur Thomason Use therapeutic communication/Active Listening demonstrates urine strain procedure. anxious and from the shift before is obviously worsened in overall condition. Check pedal capillary refill recovery. Click here to reset your password. 15. ● Health Change-increase ● Sensorium- increase, Tom Richardson, 46yr-old. His coughing, to clear his airway, appears ineffective. reluctance regarding walking on leg. Obtain vital signs machine family upset regarding dx. investigating bone marrow transplantation. Scenario two Dr Altace B. Do something!" pale, skin. Non-significant past medical Hx. ● readiness for enhanced immunizations status ● Patient states, "I need my water pitcher refilled." Carlos Mancia I have enjoyed great success using Swift River.”, “As a senior nurse with over 45 years of experience as both a direct care and academic professional, I want to share my thoughts regarding Swift River Virtual Clinical products – the Swift River suite of online virtual clinical products is the most realistic clinical simulations and case presentations that I have used as a nursing academic and clinical instructor. ● Hopelessness A. Recent Scenario four E. Document conversation Check monitor left forearm. Use therapeutic communication/Active Listening A. D. Adjust crutches C. Place patient on PCA pump E. You call his doctor to inform him the family has arrived. ● Health Change- increase ● Fall Risk-increase A. You explain that his condition has worsened and now he has been taken to ICU. Linda Yu Acuities Educational Needs Fall Risk Health Change Neurological Psychological Needs Nursing Concerns &nbsCourseMerit is a marketplace for online homework help and provide tutoring service. 2. Wound site clean, dry and intact NPO, NG-tube to low continuous suction. maintance fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in left forearm. D. Evaluate outcome of pietary plan Ordered: 6 mL over 12 hours. Scenario two C. Education of Foley Cath Procedure Keep the chart to show to the doctor, and start a fresh one for the next 24-hours. Use therapeutic communication/Active Listening ● Skin integrity C. Notify of doctor if condition is abnormal ● Fear ER Leadership Offer masks to visitors SWIFT 3 WAY . 15. IMPLEMENTATION OF SIMULATION-BASED PEDAGOGY IN YOUR INDIVIDUALIZED TEACHING AREA As experienced in other areas of clinical practice, pediatric clinical sites are becoming sparse in health care … ● LOC- increased acuity new consent. LOCATION--Lat 42°23'28", long 72°03'56", Worcester County, Hydrologic Unit 01080204, on left bank, below diversion dam at Ware River Intake Works, 2.7 mi downstream from Burnshirt River, 3 mi southeast of Barre, and at mile 29.1. DSD (dry sterile dressing), forehead laceration clean and dry intact. IV D5 1/2 NS @150ml/hr. B. No known allergies (NKA). She is with her physician. B. The scenarios are based on real-life situations and are accurate and evidence based. B. E. Reassure patient and help explain any new orders from physician to patient, a. If patient statement differs from the surgical consent she has signed, notify Replace O Evaluate caller understanding Virginia Smith, 57-year-old who has elected to have a total mastectomy based on Neuro WNL. A. Diet as tolerated. Present health assessment including B/P and LOC and dressing. 3. n/v. C. Apply restraint Wound clean dry and intact. Thus, the T-3 generator is at Shultz Electric being rebuilt with additional capacity to match Kiser Turbine's 849 kW capacity runner guaranteed capacity at 429 cfs hydraulic capacity at 26 feet … P 82, RR 20, SaO2 97%. B. for one week. A. ● disturbed energy field The urine output would be always slightly less than total water intake. A. c. Call Rapid Response protocol initiated A. ● Health Change-Increased 3) Breath / respiration. 20ga. Inspect Pain Location D. Contact head nurse or supervisor in the OR to evaluate new situation Prior to January 1937, 186 mi 2. D. Documentation Estelle Hatcher ● Fear and anxiety In order to maintain fluid balance, this intake must be met by fluid losses; on average, approximately 1.5 L of urine output, approximately 0.1 L of fecal water loss, and insensible water losses of approximately 0.9 L through the skin (including sweat) and lungs result in … Vital signs -Temp 98.4,BP 178/105, P 112, RR 28, SaO2 94%; Neuro- WNL's. A. Wash and glove hands B. Provide Operative summary of type of procedure, IV fluid and pain status. B. Validate NPO Status E. Request sitter/family member to bedside Tom Richardson Scenario four ... 3 Assess food computing and intake and output. c. Do not probe further Scenario three A. and vital signs q1 hr. ● Sensorium- Normal, John Duncan, 56yr-old male, Dx- Gastroenteritis, returned yesterday from Cancun, c/o B. Assess toe movement and capillary refilling cooperative. access and has received a small dose of Valium to reduce apprehension. in place on right lower leg. Dr. Roopes ● Nutrition ● Educational Needs- increase cooperative. Evaluate Understanding A. Elevate Extremity A. Remind physician to wash his hands before examining the patient ● Sensorium- increase, Robert Sturgess, 81yrs-old, Dx- Metastatic CA of Colon, Hx of diabetes. ● Educational Needs- Increased acuity cool to touch and appears pale. Explain HIPPA Protocol Note: Your body will always remind you when it needs water. B. ● Imbalanced nutrition Normal Sinus Rhythm on telemetry. The Swift River Virtual Hospital has proven to be a useful learning solution for many nursing programs across the country. minimal assistance. allergies (NKA); Vital signs - Temp 101.2, BP 108/74, P 92, RR 20, SaO2 99%, alert and ● Sensorium- normal, Lithia Monson, 93yr-old, c/o head injury, r/o subdural hematoma. ● Health Change- Increase C. Provide comfort and pain measures There is excretion of water in; 1) Stool. 23Have a second licensed nurse sign & verify the correct identification D. Perform circulatory evaluation o Request RN C. Provide emotional support A. Wash and glove hands C. Refer call to contact health department b. ● Acute pain Related Studylists. D. Insert foley catheter 2 Burner Cooktop, BBQ grill and roasting oven (that's the 3 ways) Full width griddle plate. B. ● Fall Risk- Increase patient and family. 2. ... and Burnett said they have set a target of increasing output to 200 gallons in the next five years. C. Assume role in response team of documenter ● Impaired urinary elimination, ● Risk for falls Oxygen in place. She has IV Reduced water intake will reduce feed intake and weight gain. Explain reason for asssessment and procedure D. Contact Social Services q 4 hours last dose at 0834. ● Sensorium- normal Scenario two No weight bearing today. E. Document Results ● Failure to thrive A. Wash and glove hands Pain and numbness in legs E. Document results Check input/ouput for possible dehydration You can know if your water intake is adequate by the color of your urine. ● Educational Needs- increase B. Printable Fluid Intake and Output Chart. B. Educate caller regarding HIPAA Dr. Jones. C. Encourage fluids and fiber diet B. She has arrived in pre-op and about to have C. Gown and mask E. Verify call light/bed safety precautions Richard Dominec, C. Evaluate understanding Skin warm dry, bruises on forehead with small laceration. View Swift River patients .pdf from CHEM MISC at West Coast University, Ontario. Scenario one family/visitors come, will need education to airborne precautions. Tap patient and ask "Are you ok?" A. No known allergies (NKA). ADA diet, Attempt to orient to person, place, time ● grieving C. Assist physician in physical exam of patient chest X-ray shows diffuse bilateral interstitial infiltrates in all lobes. C. Vital re-assessment Her husband and two grown children are also with her as she is ● Health Change-increase He is restless with slight confused, but is easily orientated with attempts from Scenario four, Scenario one ● Fall Risk-increase IV Morphine 2mg with little relief. WNL alert and cooperative. Robert Sturgess D. Evaluate understanding Scenario three C. Educate patient regarding condition B. ● Educational Needs- increase Increased fall ● Risk for fall ● Risk for constipation Neuro WNL, alert, and cooperative but worried about scarring and is Tina Kloepfer. ● Psychological Needs-increase Coke, coffee, tea and other drinks can be included in the fluid intake category. ... they don't have the number for this 24/7 helpline. ● compromised family comping Scenario two e. Document results, Scenario two Vital signs -BP 124/82, Temp 98.2, P 84, RR 22, SaO2 96%. Taking HIV Meds prophylaxis. most of axillary lymph nodes and chest muscles intact. 15. E. Obtain spanish signs & brochure Vital signs -Temp 98.8, BP How many mg will the patient receive after 6 hours? Therapeutic communication ● Psychological Needs- normal D. Evaluate understanding D. Connect telemetry. Release restraints/full range of motion ● Pain Level- increase IV maintance fluids with D5 1/4 NS @ 150 leaving the floor to make him more comfortable. So when you're looking at your total intake to see if the patient is staying adequately hydrated, you do not count the bladder irrigation. Use therapeutic communication/Active Listening Allergic to sulfa drugs. Dr. Rondeau Water Intake Chart Printable. A. Copyright © 2021 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Share your documents to get free Premium access, Upgrade to Premium to read the full document, DP ALT - Pneumonia - Active Learning Template, ALT - Nursing Skill - Active Learning Template. B. Provide verbal report to team members who respond to rapid response Educate patient of procedure E. Include patient condition change in shift report Dr Donofrio STAINLESS STEEL BBQ. B. B. Grain processing is essential. 10. ● Psychological Needs-increase D. Pain re-assessment Full assessment c/o headache- medicated with Lortab 5mg PO at 0900, takes Lomotil 10ml PRN C. Seek clarification E. Document results Ambulates with regular diet, intake 50%. ● Sensorium- Normal, Ann Rails, 38yr-old, c/o back pain, non-significant past medical history. happened, A. D. Notify lead nurse and doctor A. A. ● Acute confusion He is experiencing a new onset of shortness of breath and has a nasal cannula with 2L of D. Verify call light/bed safety precautions Dosage Calculation. PERIOD OF RECORD-- January 1928 to current year.Prior to October 1977, published as Ware River at Coldbrook. D. Re-assess patient Needs frequent reminding due to determination to do things herself without assistance. E. Document results and findings Scenario one Skin warm and dry, may sit up on edge of bed today. A. 7. Lithia Monson D. Obtain recent chest X-ray reports and recent ABG's for physician to review Discuss with patient identify home health needs available at ext: 61178. ● Risk for falls E. Provide comfort Scenario four A. Wash and glove hands Scenario two Scenario four E. Document Results 11. B. E. Notify family as to when they may come and visit. Use therapeutic communication/active listening E. Perform pain re-assessment Cardiovascular has pacer with rate of 82bpm on demand. o Request LPN ● Fall Risk- normal We have experts in subjects of maths, science and many more. Education patient Use therapeutic communication/Active Listening Skin moist, respiratory bilateral wheezes and rhonchi. Log in or create an account Strict I&O, Vital signs -Temp 97.2, BP 96/74, ● Fall Risk-increase 50% intake. o Request RN Clinical training for students and practicing nurses – available anywhere at any time. D. Document Results/Findings D. Notify Social Services C. Read PT report 45/12 = 3.75 mL/hr. Full assessment C. Provide emotional support D. Administer Diet Order Family at beside. The client had the following intake and output during your shift: 1900 4 ounces of coffee with 2 ounces creamer 10 mL IV flush 1 popsicle (40 mL) 8 ounces of vegetable broth 2000 1 can of ginger ale (12 ounces) 2100 24 ounces of ice chips 2300 16 ounces of ice chips 1650 mL urine 0000 20 mL saline flush 0200 30 ounces of ice chips 450 mL urine Emesis 80 mL What was … ● Psychological Needs-normal ● Self-care deficit The water intake of a 50-90 kg adult person is about 2500 to 3000 ml per day or 2 ml/kg/hour. B. Administer PRN constipation medicatons Crutches ● Powerlessness Apply nasal canula oxygen Scenario two E. Assist patient out of bed Available: 120 mg/4 mL. ", 1. D. Evaluate learning A. nursing home, fall one day ago. Overall Measurements (how big your space will need to be): 30W x 53D x 34H Teacher, Are You... Neuro- confusion to time and place, but oriented to self, speech D. Notify doctor B. Diet as tolerated. D. Notify doctor and charge nurse, A. ● Sensorium-normal, Viola Cumble, 92yr-old, second day post-op hip repair, Allergic to Penicillin. No known allergies (NKA). Abnormal left leg weakness, gait unsteady, 5/10 on numeric pain scale. ● Grieving The extent to which water intake requirements are determined by energy intake and expenditure is understudied but in the clinical setting it has long been practice to supply 1 ml per kCal administered by tube to patients unable to take in food or fluids [1]. D. Offer nutrition and/ or toileting Scenario two ● Educational Needs- Increase E. report and document results Lithia Monson ● Educational Needs- increase E. Explain to her family and provide contact information. Skin warm and dry, all vital signs in WNL except 115 pulse, which Manage Your Cables and Other Obstructions. GI WNL. e. Remain with patient and reassure, A. E. Provide a few chairs if possible for her family to also be comfortable A. Use Open Ended Questions ● Pain Level- increase Obstetric Nursing Care Plan 2006. D/C plan- Vertava Health of Massachusetts is looking for passionate, experienced and motivated individuals to join our team. Vital sign assessments Assessment of bowel movement A. Dr.Starks, Awaiting diagnostic labs. demonstrate falling PaO2 (hypoxemia) and increasing CO2 ( Hypocapnia). B. D. Re-assess patient A. ● Impaired physical mobility If the difference is alarming, consult your doctor. ● Pain Level- increased acuity In dehydrated patients the kidneys conserve water, producing urine that is dark, concentrated and reduced in volume (Scales and Pilsworth, 2008). Sarah Getts, 77 yr-old, Dx- Chronic Renal Failure, admitted with hyperkalemia (5.9, The thirst center is less responsive in older adults, so they need to be extra careful to consume enough water. Scenario five Notify Physical Therapy (PT) C. Assess food consumption and intake and output Scenario one DRAINAGE AREA--96.3 mi 2. Blood Glucose 85, 1 unit of insulin sliding scale for coverage. ● Bleeding E. Document results/findings Stools are decreasing but patient remains very weak. ● Educational Needs- increase The scenarios are based on real-life situations and are accurate and evidence based. Scenario four Pearls/Pitfalls Calculates urine output rate and fluid balance, comparing with normals, from total urine output and fluid intake. B. B. PT to educate patient ● Health Change- increase E. Retrieve cast removal tool Please sign in or register to post comments. A. C. Offer resource assistance to caller Scenario five attempt to locate physician for them. ● Chronic pain For more information or to reach our customer support team, please fill out the form below and we will get back to you promptly. A. A. 14. o Request LPN Website by Houston Design & Marketing Co. ● Patient in the next room states, "The TV is too loud." If you have experience working in the addiction treatment industry, we may have the perfect opportunity for you. consultation with her surgeon, a total mastectomy removes all breast tissue but leaves all or E. Document Conversation b. Elevate head of bed 3. Allow family to remain Renal diet. is normal for him. Dr Sangerstien C. Identify patient ... West Branch Swift River, Franklin County, Massachusetts, US on Tue Jan 19, 2021. C. tify doctor for pain medications o Request CNA 32Start a secondary IV line, 20 gauge cath with normal saline TKO (blood tubing).Best practice is to have a primary line dedicated to blood. B. E. Document teaching moment You explain that he is receiving a higher level of care and was he was sedated before Need frequent reminder to stay in room and maintain mask precautions. Include volume intake to get a net fluid balance calculation as well (assuming no other fluid losses), for both adult and pediatric patients. A. Presenting reality surgery this morning. 117 x 100 = 11700 mg. (11700/260)3 = 45 mL over 12 hrs. Student D. Evaluate PT Notify doctor for foley catheter Review Labs 10. No ● Sensorium-normal. Eq/L)/hyponatremia (128mEq/L). ● Patient tells family, "I need my urinal emptied." C. Provide supplies and needed instructions ● Psychological Needs- increase 9. Scenario three C. Encourage to ambulate with assistance to void if needed. B. C. Consult Social Service Scenario four 96, RR 20, SaO2 99%. 12. Feed processing. John Duncan ● Psychological Needs- Increase ● Pain Level- Increase Full Assessment Emergency intubation and assisted breathing is provided for Mr Thomason She also decrease pain and restore normal gait. Vital signs -Temp 99.1, BP 124/62, P 77, RR 20, SaO2 91%. C. Aquire daily weight and food intake prepared with gown and head cap awaiting transport to the operating room. Social worker with patient this D. Document results/findings Obtain urinary screen Our Virtual Clinicals are designed to help students and practicing nurses master their skills of Prioritization, Delegation, and Sequential thinking—without the requirement of being onsite—or even having to download software. Dosage Calculation ● Psychological Needs-Increased acuity The only number that they will give you is the intake number. ● ineffective coping Carlos Mancia, 48yr-old, Spanish speaking migrant worker with no known past medical Hx. ● Pain Level- Increase Medical-Surgical C. Offer bedpan Scenario three (NKA). 233CHAPTER 21 Pediatric Nursing Care Clinical Simulation Scenarios for Prelicensure Students Mary Ann Cantrell, Colleen H. Meakim, and Kathryn M. Reynolds A. Haven't received a confirmation email? Generalized weakness, blood tinged urine and severe pain upon urination, GI- Marcella Como Richard Dominec Alert and Disoriented to time and place, speech slurred. Family in room with patient very concerned. Inform and educate spouse of dietary orders Meanwhile, Swift River Operations crew were installing the T-1 Westinghouse generator in place of the T-3 generator because the new T-1 turbine will will require a higher capacity generator. ● Pain Level- Normal Patient morning. ● LOC- normal Use therapeutic communication/active listening repair. B. Scenario five Severe pain (10/10) medicated q 30 minutes x4 with Water troughs are usually cleaned a minimum of twice a week. r/o Tuberculosis. Educate patient regarding changes to POC ● Disturb body image, ● Family tell you patient in other room states,, "I can't catch my breath. Scenario three ● Anxiety Cracked grain gives approximately 15% better utilisation than whole grain, thereby increasing weight gains and reducing grain wastage. A. The sediment in urine can be due to; a) Less intake of water; some foods may require more food for digestion. ● Health Change- Increase Vital signs taken by automatic B/P Cuff q 15 minutes ● Educational Needs- Increase ● Pain Level- increase C. Contact Social Services for new consult Educate patient/family ● Risk for impaired fluid volume Side-mounted fans can be intake or exhaust, depending on the setup. C. Evaluate understanding ... Bondsville Road - Swift River Access, Hampshire County, Massachusetts, US on Tue Jan 12, 2021. Vital signs Temp 99.4, BP 106/72, P 96, RR 20, SaO2 91%. E. Document results C. Review Plan of Action Virginia Smith Room 312 Arthur Thomason, 56 year old MVA victim, fourth day post op with a splenectomy and femur Awaiting transport. D. Administer antipyretic medication Scenario five A. 1. … A. Assess for bowel sounds SLIDE OUT - STOW AWAY. chemotherapy, and hormone therapy post operatively. Hep-Lock in B. Assess C. Administer pain medications To schedule a demo, click the “Schedule a Demo” link in either the top or bottom right of the screen. Strict I&O and strain all urine, filters in bathroom. B. Evaluate/modify plan of care Generally, it’s best to have as few obstacles as possible between the intake fans on the front of the case and the exhaust fans on the rear and top of the case. ● Fall Risk- Increased acuity.