Cledis Brown 10/31/XX 81yo (AX: NKDA Dx: UTI Scenario: Mr. Brown is an 81 yo client c/o of burning urination. Urinalysis results indicate a large amount of bacteria, leukocytes, nitrites and blood. Urine | culture is pending. He is diagnosed with a urinary tract infection and the provider writes ordersto treat this condition. Skill: Reconstitute and administer IM ceftriaxone 16 Cues: burning urination, dark cloudy urine in urinal, UA: dark yellow, cloudy, large blood, +nitrites, bacteria. UC: pending. WBC: elevated. Elderly. No family at bedside. ‘Analyzing cues: WBC elevated indicates some type of infection. Dark, cloudy urine is abnormal. Should cue us to ask deeper questions about the urinary tract. All cues should lead us to think about a urinary tract infection. Prioritize hypothesis: infection Generate Solutions: Hydration (increase oral intake). Monitor VS (potential for fever). Antibiotics to treat | the infection. Is this a bacterial or a viral issue?? Can we use antibiotics to treat viral infections? Take actions: Educate and administer antibiotics. Educate about how to prevent future UTIs. Evaluate: Urine will return to baseline. WBC will return to baseline. Frequency and burning will subside. No worsening of symptoms. Has on wrong armband. Sim Expectations: Hand hygiene Introduction to client Identify client using 2 identifiers Check orders Obtain vs. Brief Focused Assessment Check chart for abnormal values Prepare and administer ceftriaxone 1G IM Provide teaching for 1* dose of medication Instructor Notes:Cleo Threadgoode 10/31/XX 80 yo AX: NKDA, Dx: T2DM Scenario: Mr. Threadgoode is an 80 year old client who is diabetic. He takes metformin orally with breakfast and dinner for diabetes control and has recently had Regular Insulin added at meal times. It is currently lunch time (he had his metformin with breakfast) and his blood has been checked and the result is in the chart. ‘Skill: Administer subcutaneous Regular Insulin. Cues: Elevated glucose in chart, Analyzing cues: Elevated glucose is indicative the metformin is not enough to control the glucose level. Prioritize hypothesis: Uncontrolled diabetes. Generate Solutions: Education related to diet, exercise, and weight loss. Administer metformin and Insulin as ordered by the provider. Evaluate: Glucose will remain in a normal range. Has wrong diet on food tray. Sim Expectations: Hand hygiene Introduction to client Identify client using 2 identifiers Check orders Obtain VS Brief Focused Assessment Check glucose in chart Prepare and administer Regular Insulin Provide teaching r/t diabetic diet Instructor Notes:Chris Kringle 10/31/XX 67 year old Instructor Notes: AX: ACE Inhibitors Dx: HTN/Glaucoma Scenario: Client presents for HTN, and has glaucoma. Skill: Administer timolol, call MD regarding Li Cues: BP slightly elevated, allergic to ACI Analyzing cues: Allergy to ACE inhibitors Prioritize hypothesis: Generate Solutions: Evaluate: Has Lisinopril ordered but is allergic to ACE inhibitors. ‘Sim Expectations: Hand hygiene Introduction to client Identify client using 2 identifiers Check orders Obtain VS Brief Focused Assessment | Recognize allergy and call provider | Receive orders | ‘Administer timolol eye dropCody Wynn 10/31/XX 5 years old ‘AX: NKDA Dx: Influenza Scenario: 5 year old child with Influenza. He is 40 inches tall and 41 Ibs (18.6kg). Parent is with him, Skill: Administer liquid PO acetaminophen. Cues: Flu +, Covid -, peds patient, fever 102.0 ‘Analyzing cues: Fever and Flut Prioritize hypothesis: Reduce Fever Generate Solutions: Administer acetaminophen Evaluate: Recheck temperature Order is for acetaminophen 500mg PO q4h prn for in Lippincott is 240mg qh4 prn gah. With max of 5 doses in 24 hours. ‘Sim Expectations: Hand hygiene Introduction to client Identify client using 2 identifiers Check orders Obtain VS Brief Focused Assessment Call MD for new dose of acetaminophen Receive orders Prepare and administer acetaminophen Instructor Notes: