VCE Med Surge 1 End of life Exercise 1 - Virtual Hospital Activity. 21 QnA. 99% Pass Rate.

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Questions 1. Exercise 1 - Virtual Hospital Activity This exercise will take approximately 30 minutes to complete. Sign in to work at Pacific View Regional Hospital for Period of Care 3. (Note: If ... you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get to the sign-in window.) From the Patient List, select Pablo Rodriguez (Room 405). Click on Emergency Department and review the record. Exercise 1 - Question 1 Why was Pablo Rodriguez admitted to the hospital? 2. Exercise 1 - Question 2 What are Pablo Rodriguez’s primary and secondary diagnoses? 3. Click on Admissions. 4. Exercise 1 - Question 4 Which are guidelines included in the Patient Self-Determination Act of 1991? Select all that apply. Patients admitted to health care agencies must be asked if they have executed an advance directive (AD). For those patients who have not executed an AD, health care agencies must provide them with the opportunity to complete the state-required forms. The patient must have written permission from the attending physician to enact a presented AD. ADs require an attorney for completion. AD laws vary by state. 5. Exercise 1 - Question 5 To retain health care decision-making responsibilities, which criteria must be met by the patient? Select all that apply. The patient must be alert and oriented x 4. The patient must be able to receive information provided by health care providers. The patient must be able to communicate treatment choices. The patient must have the cognitive ability to evaluate treatment options. 6. Click on Return to Nurses’ Station. Click on Kardex. Click on 405. Exercise 1 - Question 6 What is Pablo Rodriguez’s code status? Is this appropriate based on the reason for this admission? Explain. 7. Click on Return to Nurses’ Station. Click on 405 at the bottom of your screen. Click on Patient Care and then on Nurse-Client Interactions. Select and view the video titled 1530: Decision—End-of-Life Care. (Note: Check the virtual clock to see whether enough time has elapsed. You can use the fast-forward feature to advance the time by 2-minute intervals if the video is not yet available. Then click again on Patient Care and Nurse-Client Interactions to refresh the screen.) Exercise 1 - Question 7 What is Pablo Rodriguez telling the nurse? 8. Exercise 1 - Question 8 What therapeutic communication techniques is the nurse using? Are they effective? What other technique(s) might have been used? 9. Exercise 1 - Question 9 What would you do if Pablo Rodriguez asked you to administer a lethal dose of morphine to “stop my pain and help me die with dignity"? What legal term would apply to this request?. 10. Exercise 1 - Question 10 How do passive euthanasia and active euthanasia differ? 11. Exercise 2 - Virtual Hospital Activity This exercise will take approximately 45 minutes to complete. Sign in to work at Pacific View Regional Hospital for Period of Care 1. (Note: If you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then Restart the Program to get to the sign-in window.) From the Patient List, select Pablo Rodriguez (Room 405). Click on Go to Nurses' Station. Click on 405 at the bottom of your screen. Read the Initial Observations. Exercise 2 - Question 1 What physical symptom of distress is Pablo Rodriguez displaying? 12. Exercise 2 - Question 2 Identify interventions you would use to alleviate Pablo Rodriguez’s symptoms. Provide rationales for your interventions. (Hint: You may need to go to the patient’s chart to review physician orders and/or use the Drug Guide to provide rationales.) Give ordered medication: Metoclopramide 10 mg IV every 2 hours PRN for the nausea. Give Morphine for pain Educate the patient regarding the side effect of morphine which includes nausea, vomiting and respiratory depression which can be withheld if the RR i less than 12 cpm. Advise the patient to move slowly as he is taking high doses of morphine which can induce orthostatic hypotension. Patient is already on oxygen at 3 lpm with oxygen saturation of 98% 13. Click on EPR. Click Login. Choose 405 from the Patient drop-down menu and Vital Signs from the Category drop-down menu. Find the vital signs assessment documented at 0700. Exercise 2 - Question 3 Describe Pablo Rodriguez’s pain assessment. 8/10 located at left leg and lower back , characterized as constant sharp and shooting, groaning, furrowing of brow relieved by morphine 14. Click on Return to Room 405. Click on MAR and then on tab 405. Exercise 2 - Question 4 What pharmacologic interventions would be appropriate to relieve this pain? What nonpharmacologic interventions would you suggest? 15. Now let's check the patient's current vital signs. Click on Return to Room 405. Click on Take Vital Signs. Exercise 2 - Question 5 Based on the EPR data and Pablo Rodriguez's current pain rating, is the morphine providing effective relief? Explain. The current pain scale is 2/10 and the goal is to be on minimum pain(kardex). The goal is met. 16. Click on Patient Care and then Physical Assessment. Click on Abdomen (yellow button). Click on Gastrointestinal (green button). Exercise 2 - Question 6 Document your assessment findings below. What is the significance of these findings? How do they relate to Pablo Rodriguez’s diagnosis and/or treatment? 17. Click on MAR and then on tab 405. Exercise 2 - Question 7 What pharmacologic and nonpharmacologic interventions would you implement to prevent potential complications related to the above findings? 18. Click on Return to Room 405. Select and view the video titled 0730: Symptom Management. (Note: Check the virtual clock to see whether enough time has elapsed. You can use the fast-forward feature to advance the time by 2-minute intervals if the video is not yet available. Then click again on Patient Care and on Nurse-Client Interactions to refresh the screen.) Exercise 2 - Question 8 Now that his pain has been controlled, what two physical symptoms of distress does Pablo Rodriguez complain of? For each of his symptoms, identify interventions you could use to relieve these discomforts. 19. Click on Patient Care and then on Nurse-Client Interactions. Select and view the video titled 0735: Patient Perception. (Note: Check the virtual clock to see whether enough time has elapsed. You can use the fast-forward feature to advance the time by 2-minute intervals if the video is not yet available. Then click again on Patient Care and Nurse-Client Interactions to refresh the screen.) Exercise 2 - Question 9 Describe Pablo Rodriguez’s emotional distress as displayed in this video. 20. Exercise 2 - Question 10 What nursing interventions would be appropriate to help Pablo Rodriguez cope? For him to cope with emotional stress: 21. Exercise 2 - Question 11 Describe the nurse's role in end-of-life care. How does this compare with the care being provided for Pablo Rodriguez? Explain. [Show More]

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