CHF Sim-Case Study—Learning Objectives for PNS—Ivan Emoto

1. Describes the pathophysiologic changes that result in right-sided heart

failure and left-sided heart failure. (understanding) (PLO #3--Evidence-based
Practice--The PN student will deliver optimal health care by integrating best current
evidence with clinical expertise and integrating evidence-based practice with
patient/family preferences and values.) (CLO #2)

2. Uses history information and assessment data to plan and provide care for
the patient with acute exacerbation of chronic heart failure. (applying) (PLO #
6 Patient-centered Care--The PN student will be able to provide patient-centered care by
recognizing the patient as a source of control and full partner in providing compassionate
and coordinated care based on respect for patient’s preferences, values, and needs.)
(CLO #3)

3. Performs a full physical assessment and focused cardiovascular and

peripheral vascular assessments on a patient with chronic heart failure.
(applying) (PLO #3, CLO #2)

4. Anticipates diagnostic orders and therapies, including medications, for the

patient with acute exacerbation of chronic heart failure. (understanding) (PLO
#3, CLO #3)

5. Prioritizes the implementation of and approach to caring for a patient with

an exacerbation of chronic heart failure. (analyzing) (PLO #2 Safety--The PN
student will demonstrate safety measures by engaging in system effectiveness and
applying individual safety measures.) (CLO #3)

6. Evaluates effectiveness of treatment plan and revises as necessary.

(evaluating) (PLO #1—Quality Improvement--The PN student will improve the quality
and safety of health care systems by evaluating data to monitor the outcomes of care
processes and using improvement methods to design and test changes.) (CLO #3)

7. Analyzes the situation and determines appropriate delegation duties.

(analyzing) (PLO #5—Teamwork and Collaboration-- The PN student will demonstrate
teamwork and collaboration by functioning effectively within nursing and inter-
professional teams, engaging in open communication and mutual respect, and applying
shared decision-making to achieve quality patient care.) (CLO #5)

8. Documents all orders, assessments, and interventions in the chart. (PLO #4

—Informatics-- The PN student will employ informatics to communicate with care teams,
manage knowledge, mitigate error, and support decision-making.) (CLO #4)
CHF Sim--Preparation Questions and Notes for LPN Students
1. List the risk factors for CHF related to coronary artery disease (CAD).

2. Describe the manifestations and effects of right-sided and left-sided heart failure.

3. Fill out information about the medications that are ordered:

Drug Name Drug Class Why Prescribed Side Effects Nsg Implications

digoxin

captopril

metoprolol

furosemide

potassium

docusate

nitroglycerin

morphine

4. What priority assessments would you need to perform?

5. List the goals in the interdisciplinary care of a patient with chronic heart failure
6. What nursing diagnoses would be appropriate for most CHF patients?

7. What priority interventions would be needed possibly?

8. Can you give Lasix IV push?

9. How long will it take for diuresis to begin with IV furosemide?

10. Why might a urinary catheter be ordered?

11. What lab needs to be monitored for a patient receiving furosemide?

12. What atrial arrhythmia is common in chronic heart failure patients?

13. Explain the difference in pathophysiology between fluid retention due to CHF
(pulmonary edema and/or peripheral edema) and urinary retention (in the
bladder).

14. What are patient education needs of CHF patients?