Eva Madison .,WELL EXPLAINED WITH VERIFIED ANSWERS 100% CORRECT.

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Gastroenteritis is inflammation of the lining of the stomach and small and large intestines. Most cases are infectious and acquisition may be foodborne, waterborne, or via person-to-person spread. ... DIAGNOSTIC TESTS (REASON FOR TEST AND RESULTS) Patient Information ANTICIPATED PHYSICAL FINDINGS Urinalysis, stool culture and blood panel Eva Madison, Female, 5 years old Physical symptoms include nausea, vomiting, diarrhea, and abdominal discomfort. ANTICIPATED NURSING INTERVENTIONS - Maintain adequate fluid intake - Monitor vital signs and capillary refill - Assess cardiovascular status - Prevent infection transmission - Monitor I/O - Administer medications vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Amanda Morejon, RN in the pediatric floor Your name, position (RN), unit you are working on SITUATION Patient is Eva Madison, 5 years old, has had vomiting and diarrhea for the past 3 days Patient’s name, age, specific reason for visit BACKGROUND Gastroenteritis, was admitted this morning at 7:00am, current orders are to monitor cardiorespiratory status, continuous pulse ox, continuation of fluids, urinalysis and stool culture. Patient’s primary diagnosis, date of admission, current orders for patient ASSESSMENT Patient is pale, lethargic and mucous membranes are dry. Is complaining about abdominal pain. Current pertinent assessment data using head to toe approach, pertinent diagnostics, vital signs RECOMMENDATION Order pain medication for abdominal pain and continue fluids. Any orders or recommendations you may have for this patient PHARM-4-FUN PATIENT EDUCATION WORKSHEET NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE MEDICATION: Dextrose CLASSIFICATION: Glucose PROTOTYPE: Sugar SAFE DOSE OR DOSE RANGE, SAFE ROUTE Parenteral route, 10 mL - 2,000 mL PURPOSE FOR TAKING THIS MEDICATION Used to treat hypoglycemia PATIENT EDUCATION WHILE TAKING THIS MEDICATION - Explain need for supplement to patient and family, and answer any questions - Tell patient to report any adverse effects, especially severe dizziness or syncope. PHARM-4-FUN PATIENT EDUCATION WORKSHEET NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE MEDICATION: Sodium Chloride CLASSIFICATION: Sodium electrolyte PROTOTYPE: Salt SAFE DOSE OR DOSE RANGE, SAFE ROUTE Injection: 0.45% saline solution 25mL-1,000mL, 0.9% saline solution 25mL-1,00mL, 3% sodium chloride solution 500mL, 5% sodium chloride solution 500mL PURPOSE FOR TAKING THIS MEDICATION Used to treat and prevent sodium loss caused by dehydration and vomiting. PATIENT EDUCATION WHILE TAKING THIS MEDICATION - Explain the use and administration of the drug to the patient and family - Tell patient to report any adverse reactions Clinical Worksheet Date: Student Name: Amanda Morejon Assigned vSim: Initials: E. M. Age: 5y Diagnosis: Gastroenteritis HCP: Consults: Isolation: Contact Fall Risk: IV Type: Periphera l line Location: Left arm Critical Labs: K & Na Other Services: Consults Needed: Length of Stay: M/F: F Transfer: Fluid/Rate: Code Status: Full code Allergies: NKDA Why is your patient in the hospital (Answer in your own words and include the History of present Illness)?: Patient is in the hospital because she has had vomiting and diarrhea for the past 3 days. There is no previous history of present illness. Health History/Comorbities (that relate to this hospitalization): No previous health history that relates to this hospitalization Shift Goals/ Patient Education Needs: 1. Reduce patients pain from a 2 to a 0 on the faces pain scale 2. Monitor I/O 3. Monitor weight 4. Collect urine and stool Path to Discharge: Assess patient, administer fluids as ordered, monitor urine output, monitor labs, obtain urinalysis and stool culture, perform proper infection control, continue fluid administration, educate patient and parent on diagnosis. Path to Death or Injury: If not treated promptly and appropriately, the patient can go into hypovolemic shock due to dehydration. This is life threatening because of a decrease in blood pressure due to low blood volume and a drop in oxygen in the body. Alerts: What are you on alert for with this patient? (Signs & Symptoms) 1. Lethargy 2. Dehydration 3. Oliguria What Assessments will focus on for this patient? (How will I identify the above signs &Symptoms?) 1. Cardiovascular 2. Gastrointestinal 3. Respiratory List Complications that may occur related to dx, procedure, comorbidities: 1. Hypovolemic shock 2. Urinary and Kidney issues 3. Seizures What nursing or medical interventions may prevent the above Alert or complications? 1. Assess vital signs every 15 minutes 2. Administer intravenous fluids as ordered 3. Monitor lab values 4. Strictly monitor I/O Management of Care: What needs to be done for this Patient Today? 1. Monitor vital signs 2. Administer intravenous fluids as ordered 3. Auscultate bowel sounds 4. Collect stool culture 5. Strictly monitor I/O 6. Monitor cardiorespiratory function Priorities for Managing the Patient’s Care Today 1. Monitor vital signs 2. Monitor urine output 3. Monitor lab values 4. Maintain continuous fluids What aspects of the patient care can be Delegated and who can do it? Vital signs and weighting the patient are tasks that can be delegated to a nurse assistant. Clinical Worksheet Opening Questions Reflection Questions Paste your reflection questions in the box below How did the simulated experience of Eva Madison's case make you feel? - I enjoyed Eva’s case, it was straight forward and educational. Describe the actions you felt went well in this scenario. - I felt like I did well in assessing Eva’s symptoms and monitoring her vital signs, specifically her oxygen saturation. Scenario Analysis Questions* EBP List in order of priority your initial nursing actions identified for Eva Madison based on physical findings and family interaction. - Wash hands, verify patient and guardian, check vital signs, asses pain, administer fluids, comfort her and educate her and her parent. EBP When initiating a fluid bolus for a dehydrated child, what type of fluid should be given and why? - Isotonic fluids should be given bolus because it increases circulating fluid to help restore and maintain blood pressure. EBP What complications might Eva Madison face if her symptoms are not recognized and treated in a timely manner? - She could become severely dehydrated and go into hypovolemic shock and eventually death. PCC What measures should be initiated to decrease anxiety in Eva Madison's mother while simultaneously caring for Eva? - It is important to keep Eva’s mother educated and aware of what is going on, what is being done, and why we are doing what we are doing. S/QI Reflect on ways to improve safety and quality of care based on your experience with Eva Madison's case. - Triple check the medications and dosages prescribed before administering them and practice good infection control to prevent complications. S/QI What infection control measures should be taken in this case and why? - In this case, the patient should be put under contact precautions until the cause of her diarrhea and vomiting is discovered. Any visitors need to wear a gown, a mask and gloves at all times while around the patient. T&C/I What key elements would you include in the handoff report for this patient? Consider the situation-background-assessment-recommendation (SBAR) format. - I would explain the situation, give the patients name and age, provide the latest vitals, state the medications that were administered and provide information on the patients current status. Clinical Judgement Components Exemplary = 4 point Scoring: Accomplished = 3 points Beginning = 1 point Developing = 2 points Noticing: Score: vSim 1 Score: vSim 2 Score: vSim 2 Focused Observation: Recognizing Deviations from Expected Patterns: Information Seeking: E A D B E A D B E A D B E E E Total for category: 12 Interpreting: E E 8 Prioritizing Data: E A D B Making Sense of Data: E A D B Total for category: Responding: Calm, Confident Manner: E A D B Clear Communication: E A D B Well-Planned Intervention/Flexibility: E A D B Being Skillful E A D B E E E E Total for category: 16 Reflecting: E E 8 Evaluation/Self-Analysis: E A D B Commitment to Improvement: E A D B Total for category: [Show More]

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