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.
...
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]
