- Information
- AI Chat
Edith Jacobson vSim
Foundations of Professional Nursing (NUR 3130)
Nova Southeastern University
Recommended for you
Preview text
Diagnostic Tests (Reason for Test and Results
Patient Information Anticipated Physical Findings
Anticipated Nursing Intervention
CONCEPT MAP WORKSHEET
DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS)
Osteoporosis = a bone disease caused by loss of calcium and phosphate from bones, resulting in decreased bone density o Causes weakened bones and increased vulnerability to fractures o Pathophysiology: The rate of bone resorption accelerates as the rate of bone formation decelerates Decreased bone mass results, and bones become porous and brittle o Causes: Primary cause: estrogen deficiency; changes associated with aging Secondary causes: underlying disease of agent
CBC w/ differential Electrolyte levels Thyroid studies Blood glucose levels Drug and alcohol levels X-ray, CT and MRI: shows any abnormalities of fractures and determines if surgical interventions are needed
Edith Jacobson - 85 years old - White, female - Weight: 47 kg - Height: 152 cm - Allergies: NKA - History of osteoporosis - Admitted 03/11/2021 for a hip fracture
- Displacement of the extremity due to fracture
- Patient will have limited mobility
- Patient will not be able to move or bear weight on affected leg
- Bed rest (due to fracture)
- Patient will have limited ROM
Treat the patient’s pain, as needed and order o Use nonpharmacologic, pharmacologic, or a combination of approaches Give prescribed drugs o Enoxaparin sodium 40mg SUBQ daily o Docusate sodium 100mg PO daily o Morphine Sulfate 4mg IV q 4hrs prn for pain Use intermittent pneumatic compression devices or antiembolism stockings, as ordered, to VTE Assess neurovascular status of the affected extremity and compare it with unaffected extremity Reposition patient every 2 hours o Use logrolling techniques to turn the patient in bed Assist w/ ambulation Encourage careful positioning, ambulation, and participated in prescribed exercises Patient and family education Encourage a diet high in calcium and vitamin D Encourage patient to participate in physical therapy sessions Consult with PT and Dietary Nutritionist Prepare patient for surgery
vSim ISBAR ACTIVITY STUDENT
WORKSHEET
INTRODUCTION Hi, my name is Jonelle and I’m a student nurse from Nova Southeastern University rotating the Orthopedic unit 15 55 Your name, position (RN), unit you are working on
SITUATION Edith Jacobson White female 85 years old Admitting DX: hip fracture – admitted last evening after falling and fracturing her hip. X-rays have been taken and show left intertrochanteric hip fracture. Mrs. Jacobson is scheduled for surgery tomorrow
Patient’s name, age, specific reason for visit
BACKGROUND Admitting date: 03/11/ Primary diagnosis: hip fracture Has a 10-year history of osteoporosis Patient’s daughter reported Mrs. Jacobson has been having dizzy spells recently Current orders: - Vitals - Labs - Medication - Call orders
Patient’s primary diagnosis, date of admission, current orders for patient
ASSESSMENT Vitals performed: BP: 136/82 mmHg (LUE sitting), T: 99 (ear, slightly elevated), Pulse: 90 bpm (left arm, radial and pedal), RR: 15 bpm (equal, bilateral movement), Pulse Ox: 97% (on room air) Listened to the lungs. The breath sounds are clean and equal bilaterally Examined the patients’ legs
- Tenderness in the left hip area
- Left leg is a bit shorter than the right
- Normal elasticity of the skin
- Her color is normal Assess the patient’s neurological status
- No neurological deficit
Current pertinent assessment data using head to toe approach, pertinent diagnostics, vital signs
RECOMMENDATION Reposition patient every two hours Antiembolism socks to prevent VTE (on both legs) Nothing by mouth after midnight the night before surgery Check patient’s vitals every 4hrs Activity: bed rest After surgery encourage ROM exercises Consult: - PT - Dietary nutritionist - Elderly living/ Rehab center Assess patient for any self-care deficits Fall risk precautions (bed rails up x2, call light within reach, only ambulate if need) Patient education – activities, safety, fall risk, and positioning Pressure ulcer precautions – compromised skin integrity, skin breakdown
Any orders or recommendations you may have for this patient
Clinical Worksheet
Date: Student Name: Assigned vSim:
Initials
: EJ
Age:
83
M/F: F
Code Status: Fall
Diagnosis: Fractured hip
Length of
Stay: 1 days
Allergies:
NKA
HCP: Blount Memorial Hospital
Consults: MP
Isolation: Standard
Fall Risk: fall risk precaution
Transfer
: N/A
IV Type Location : right hand
Fluid/Rate: 84 mL/hr
Critical Labs: N/A Other Services: PT Dietary Nutritionist
Consults Needed: PT Therapies
Why is your patient in the hospital (Answer in your own words and include the History of present Illness)?: - Mrs. Jacobson is an 85-year-old white female who was admitted last night after falling which resulted in a hip fracture. Mrs. Jacobson has a 10-year history of osteoporosis.
Health History/Comorbities (that relate to this hospitalization): - Osteoporosis
Shift Goals/ Patient Education Needs: 1. Pain management – patient will verbalize a lowered pain level (Goal: 4/10) by the end of the shift.
2. Impaired Comfort – patient will be able to verbalize feelings of comfort upon discharge
3. Risk for infection – the patient will show no evidence of infection by the end of the shift (patient at risk for skin breakdown, impaired skin integrity, and pressure ulcers)
4. Patient education – ROM exercises, self-care behaviors, possible rehab
Path to Discharge: - Collaborative teamwork: bedside nurse, care manager, primary care physician, PT therapist, Diet Nutritionist – all members work together to plan patient’s discharge - Teach patient and family how to care for wound while at home - Patient/family teaching – patient will be able to verbalize an accurate understanding of diagnosis, treatment, follow-up, and warnings signs for when to seek medical attention - Assess the patient’s ability to obtain medications; identify the party responsible for obtaining medications - Ensure the patient or caregiver receives contact info for any medical and psychological support - Document discharge planning evaluation in the patient’s clinical record, including who was involved in discharge planning and teaching, patient’s understanding of the teaching provided and any need for follow-up teaching Path to Death or Injury: - Evaluate how the patient’s current illness will affect independence - Inadequate care of osteoporosis - Pulmonary embolism – complication of hip fracture - Provide patient with contact information in case of emergency
progress toward pain management goals
Reflection Questions
Paste your reflection questions in the box below
Opening Questions: - How did the simulated experience of Edith Jacobson’s case make you feel? It made me feel anxious. I’ve interacted with older adults in a job setting and when working with older adults I always feel so anxious. There is always a lot to consider with any patient however, with older adults there always a lot to consider plus more. - Talk about what went well in the scenario.
Reflecting on Edith Jacobson’s case, were there actions that you would do differently if you were to repeat this scenario? If so, how would your patient care change?
What feelings were you experiencing during your interaction with Edith Jacobson?
Scenario Analysis Questions - T&C : Discuss the role of teamwork related to Edith Jacobson’s care.
T&C : List some ways that teamwork and collaboration can be improved. Discuss how you would implement your suggestions.
S : Describe your role in ensuring Edith Jacobson’s safety.
EBP : Discuss two evidence-based practices that you incorporated into your care of Edith Jacobson and how these practices impact patient outcomes.
Concluding Questions
- Describe how you would apply the knowledge and skills that you obtained in Edith Jacobson’s case to an actual patient care situation.
Clinical Judgement Components
Scoring:
Exemplary = 4 point Accomplished = 3 points Developing = 2 points
Beginning = 1 point
Noticing:
Focused Observation: E A D B
Recognizing Deviations from
Expected Patterns: E A D B
Information Seeking: E A D B
Total for category :
Score: vSim 1 Score: vSim 2 Score: vSim 2
Interpreting:
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
Total for category :
Reflecting:
Evaluation/Self-Analysis: E A D B
Commitment to Improvement: E A D B
Total for category :
Edith Jacobson vSim
Course: Foundations of Professional Nursing (NUR 3130)
University: Nova Southeastern University
This is a preview
Access to all documents
Get Unlimited Downloads
Improve your grades
