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Designed to simulate real nursing scenarios, vSim® for Nursing, co-developed by Laerdal Medical http://www.laerdal.com/us/ and Wolters Kluwer http://www.nursingeducationsuccess.com/nursing-education-solutions/ allows students to interact with patients in a safe, realistic online environment. Online interactive virtual simulations with integrated curriculum resources provide a full simulation learning experience for every student. vSim® for Nursing Fundamentals includes 10 fundamentals patient scenarios, authored by the National League for Nursing.
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Guided Reflection Questions. Mona Hernandez – Stuvia
1. Exam (elaborations) – Documentation assignments. mona hernandez · 2. Exam (elaborations) – Vsim isbar workheet mona hernandez · 3. Exam ( …
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Mona Hernandez – DocsBay
Mona Hernandez. Gued Reflection Questions. Concluding Questions. How d the simulated experience of Mona Hernandez s case make you feel?
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Patient Introduction Mona Hernandez Assessment Answers
Gued Reflection Questions. Opening Questions. 1. How d the simulated experience of Mona Hernandez’s case make you feel? -The Mona Hernandez made me feel …
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Mona Hernandez. Diagnosis: Pneumonia. Includes Feedback …
Mona Hernandez. Diagnosis: Pneumonia. Includes Feedback Log. 94% Score. (Mona Hernandez. … Medical Case 5: Skyler Hansen Gued Reflection Questions 1.
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SOLUTION: Guided reflection q mona – Studypool
Mona Hernandez Gued Reflection Questions Concluding Questions How d the simulated experience of Mona Hernandez’s case make you feel?
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Guided Reflection Questions. Mona Hernandez
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Patient Introduction Mona Hernandez Assessment Answers
Patient Introduction Mona Hernandez (Pneumonia)
Location: Medical Unit 1600
Report from day shift nurse:
Situation: Mrs. Hernandez is a 72-year-old Hispanic female who was admitted to the medical unit yesterday afternoon with a diagnosis of pneumonia in her right lobe. Chest X-ray shows infiltrates in right lower lobe, indicative of pneumonia. She was started on antibiotics after a sputum specimen for Gram stain culture was obtained. We are monitoring her respiratory status closely.
Background: Mrs. Hernandez was experiencing symptoms of dry cough, fever, and malaise, and was diagnosed with influenza 10 days prior to admission. Her symptoms got progressively worse, and yesterday she had a temperature of 38.4 °C (101.2 °F), shaking, chills, and a productive cough of rust-colored sputum. Her primary care provider saw her yesterday and decided to admit her for treatment of pneumonia.
Assessment: Mrs. Hernandez is alert and oriented ×3, but appears tired. She reports sharp chest pain with coughing and shortness of breath with activity. She rated the pain as a 6 on a scale of 0–10 and was given acetaminophen 650 mg at 1400. Vitals signs were taken at 1200. Her temperature has been elevated since this morning and was 38.1 °C (100.6 °F). Pulse is 104/min, respirations 24/min, and blood pressure 112/72 mm Hg. Her saturation was 95% on nasal cannula with oxygen at 3 L/min. Her respirations were labored when she came back from the bathroom, but improved when she settled back in bed.
Recommendation: You should make sure to maintain saturation levels above 94%. Mrs. Hernandez needs encouragement to cough and deep breathe, and to use incentive spirometry. She only uses her incentive spirometer after much encouragement. You should also start patient education on disease process and management. Please also perform a head to toe assessment with a focused respiratory assessment.
Documentation Assignments
1. Document your focused assessment of Mona Hernandez.
My focus assessment was on the Lung due to her dx of Pneumonia.
-Auscultated lungs
-O2
-Respiratory Rate
-Encouraged to cough and observed emesis basin for Sputum
-Assessed for difficulty breathing
-Temperature
2. Document your assessment findings and any nursing interventions related to Mona Hernandez’s oxygenation.
Patient status – ECG: Sinus tachycardia. Heart rate: 119. Pulse: Present. Blood pressure: 142/86 mm Hg. Respiration: 22. Conscious state: Appropriate. SpO2: 87%. Temp: 101 F (38.2 C)
Due to her O2 saturation being so low and her verbalizing her she is having shortness of breath, Patient was assisted to a high sitting position and oxygen therapy was started via nasal cannula at 2L to begin, and ultimately ending in 4L.
3. Document your education to Mona Hernandez regarding the purpose of, and how to use, the incentive spirometer.
Patient used an incentive spirometer. This was indicated by order.
Incentive spirometer provides visual reinforcement for deep breathing. It encourages the patient to maximize lung inflation and prevent or reduce atelectasis. In addition, it helps to support optimal gas exchange, and clearing and expectoration of secretions. Before using incentive spirometry equipment, the patient needs instructions on using the equipment properly. Validate the correct use of this equipment and encourage use every 1-2 hour.
4. Referring to your feedback log, document the nursing care you provided to Mona Hernandez and her response.
Asked the patient if she had any difficulty in breathing. She replied: “Yes, for many days, but now it is worse.”
Assisted the patient into a high sitting position.
Asked the patient how she felt. Patient replied: “I am feeling short of breath.”
Attached the Pulse oximeter
Placed a nasal oxygen cannula, turned the oxygen on to 2 L. Started giving the patient warm, humidified oxygen.
Asked the patient if she felt better, patient stated “No, its the same”
Asked the patient: How would you describe your coughing? Is it dry, wet, or productive? She replied: “There has been quite a lot to cough up the last couple of days. It is worse in the morning.”
Encouraged coughing. This was indicated by order.
The patient used an incentive spirometer. This was indicated by order.
Gave patient sip of water
Listened to the lungs of the patient. There are reduced breath sounds at the right lung base.
Listened to the heart of the patient. There were regular heart sounds without murmurs.
Asked the patient if she had any difficulty in breathing. She replied, “It is better now. Thanks”
Educated the patient about coughing.
Educated the patient about pneumonia
Educated the patient about positioning
Educated the patient about use of incentive spirometer
Checked patient temperature, Temperature 101.
Checked patients Orders and administered 650 mg dose of acetaminophen
Measured patients blood pressure, 132/80
Asked patient if she was experiencing any pain, patient stated, “No, I’m ok”.
Assessed for normal breathing. She is breathing at 18 breaths per minute. The chest is moving equally.
Examined the patient’s skin. There is normal elasticity of the skin. She appears flushed and her skin is warm and dry.
Reassessed patients status: Patient status – ECG: Sinus tachycardia. Heart rate: 109. Pulse: Present. Blood pressure: 134/79 mm Hg. Respiration: 18. Conscious state: Appropriate. SpO2: 94%. Temp: 101 F (38.1 C)
Phoned provider.
Guided Reflection Questions
Opening Questions
1. How did the simulated experience of Mona Hernandez’s case make you feel?
-The Mona Hernandez made me feel prepared and unprepared all at the same time. It was a little overwhelming to try and remember everything and try and keep a particular order. However, over all it was pretty exciting to learn from this simulated experience.
2. Talk about what went well in the scenario.
-Over all, I did enjoy being able to see a patient’s full history, medications, labs, and all that jazz. It was exciting to see the patients O2 saturations get better while administering O2. It was nice to see that the patient was improving, and great to see how many interventions we can make to help this patient.
3. Reflecting on Mona Hernandez’s case, were there any actions you would do differently if you were to repeat this scenario? If so, how would your patient care change?
– If I were to repeat this scenario again, I think I would try and keep a better order of what I am doing, as well as educating the patient right after so that I am not missing key steps in the treatment for this patient. I believe that if the patient is educated right after the treatment, such as a spirometer for example, the patient will remember more easily and therefore use these tools at home to help prevent further issues. If I am more organized in how I assesse the patient, the patient will sense that and possibly take my recommendations more seriously.
Scenario Analysis Questions
1. What priority problem(s) did you identify for Mona Hernandez?
Going into the simulation the first observed symptoms was the clear dyspnea at rest, so the first step was to sit the patient up. The next step was to take a full set of vitals: Tachycardia, Heart rate: 119.
Blood pressure: 142/86 mm Hg.
SpO2: 87%.
Temp: 101 F (38.2 C)
The next priority was to administer oxygen due to the low O2 saturation.
2. What potential problems could arise due to pneumonia?
Due to pneumonia, several problems can arise, like Mona, difficulty breathing and needing oxygen therapy, cough and even as serious has septic shock caused by the bacteria spreading to the bloodstream. Have to make sure to continue to use the incentive spirometer as well as making sure she ambulating regularly.
3. Discuss the importance of support from her health care team in Mona Hernandez’s care.
Without the support of her health care team, Mona will be left without treating her pneumonia, and this could drastically take a turn for the worst. Mona needs encouragement to continue to utilize her incentive spirometer, encouragement to cough and keep up these interventions to get better.
4. Identify potential patient safety issues related to oxygenation and specific to Mona Hernandez’s
Fall Risk
Increased HR
Confusion
Cyanosis
5. What other interprofessional team members should be involved in Mona Hernandez’s care?
Social Worker
R.T
O.T
Concluding Questions
1. Describe how you would apply the knowledge and skills that you acquired in Mona Hernandez’s case to an actual patient care situation.
I believe this simulation helped tremendously in that I’ve learned to organized my actions better and also have made sure to educate the patient accordingly. The feedback given helped give a better understanding why we should/shouldn’t do things. I was actually able to use my skills learned here with one resident in the long-term care facility I am currently in. We had a patient who was experiencing dyspnea at rest, and the first the CNA and I did was sit the patient up and take vitals as we notified the RN. It was a pleasant surprise to have gained so much from a virtual simulation.
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Mona Hernandez. Diagnosis: Pneumonia. Includes Feedback Log. 94% Score. (Mona Hernandez. Diagnosis: Pneumonia. Includes Feedback Log. 94% Score)
Mona Hernandez. Diagnosis: Pneumonia. Includes Feedback Log. 94% Score. (Mona Hernandez. Diagnosis: Pneumonia. Includes Feedback Log. 94% Score)
Document Content and Description Below
Feedback Log 0:00 You arrived at the patient’s side. 0:00 You reviewed the patient information. 0:00 You reviewed the patient log. 0:00 You reviewed the diagnostics. 0:00 You reviewed the cl inic… al observations. file/65527510/Feedback-Log-Score-Mona-Hernandezpdf/7/22/2020 Feedback Log & Score — Mona Hernandez Jul 11, 2020 08:35 AM https://simserver.wkhpe.com/debriefing/debrief.aspx?dss=https%3A%2F%2Fsso.wkhpe.com%2FDebriefingLog%2FSingle%2Fec381809-11da-462c-a… 2/5 0:00 You reviewed the MAR. 0:00 You reviewed the orders. 0:00 You reviewed the intake and output. 0:06 You washed your hands. To maintain patient safety, it is important to wash your hands as soon as you enter the room. 0:10 Patient status – ECG: Sinus tachycardia. Heart rate: 119. Pulse: Present. Blood pressure: 148/88 mm Hg. Respiration: 22. Conscious state: Appropriate. SpO2: 87%. Temp: 101 F (38.2 C) 1:10 Patient status – ECG: Sinus tachycardia. Heart rate: 119. Pulse: Present. Blood pressure: 147/88 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 88%. Temp: 101 F (38.1 C) 1:26 You introduced yourself. This was reasonable. 1:41 You identified the patient. To maintain patient safety, it is important that you quickly identify the patient. 1:51 You asked the patient how she felt. She replied: ‘I am feeling short of breath.’ 2:10 Patient status – ECG: Sinus tachycardia. Heart rate: 119. Pulse: Present. Blood pressure: 149/89 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 88%. Temp: 101 F (38.1 C) 2:32 You attached the
pulse oximeter.<> It is a good idea to monitor the saturation and pulse here. This will allow you to reassess the patient continuously. 2:34 You asked the patient if she had any difficulty in breathing. She replied: ‘Yes, for many days, but now it is worse.’ 2:50 You assisted the patient into a high sitting position. This was indicated and the correct response to the patient’s condition. 3:10 Patient status – ECG: Sinus tachycardia. Heart rate: 119. Pulse: Present. Blood pressure: 147/88 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 88%. Temp: 101 F (38.1 C) 3:50 You asked the patient what other symptoms she had. She replied: ‘I feel tired and have some chest tightness.’ 3:58 You asked the patient: How would you describe your coughing? Is it dry, wet, or productive? She replied: ‘There has been quite a lot to cough up the last couple of days. It is worse in the morning.’ 4:10 Patient status – ECG: Sinus tachycardia. Heart rate: 119. Pulse: Present. Blood pressure: 149/89 mm Hg. Respiration: 21. Conscious state: Appropriate. SpO2: 88%. Temp: 101 F (38.1 C) 4:35 You educated the patient about oxygen therapy. This was reasonable. /:6556527510Y/Foeeudbpalcak-cLeodg-Saco&rel-tM;Nonaas-Haelr_noanxdyezgpedfn/>nasal oxygen cannula.<> This was part of Show Less [Show More] Last updated: 1 year ago
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Guided Reflection Questions. Mona Hernandez
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SOLUTION: Guided reflection q mona
From vSim for Nursin g | Fun damentals. © Wolters Kluwer.
Mona Hernande z
Guided Reflection Q uestions
Concluding Ques tions
How did the simulated experience of Mona Hernandez ’s case make you feel ?
Talk about what w ent well in the sc enario.
Re flecting on Mona Hernandez ’s case, were there any acti ons you would do diff erently if you were to
repeat this scenario ? If so, how would your patient ca re change?
Scenario Analysis Q uestions
PCC What priority proble m(s) did you id entify for Mona He rnandez? Pneumonia and difficulty
breathing.
PCC What potential proble ms could arise du e to pneumon ia? Septicimia, bacteri a, kung abcess,
respiratory proble ms
PCC /T &C Discuss the imp ortance of supp ort from he r health care tea m in Mona Hernandez ’s care . Its
important that all heal thcare work ers collalborate in order to avoid medication er rors and
ensure all part of her care being done. Assessment and carev are an ongoing pro cess.
S Identify potential patient safety issues related to oxyg enation and specific to Mona Hernandez’ s
pneumonia. Loss of no rmal drive for br eath, skin irrita tion from nasal cannula, she could get
dizzy or light headed ness.
T&C What oth er interprofessional t eam members should be invol ved in Mona Hernan dez ’s care?
Respiratory therap y and ra diology
T&C/I Provide Mona Hernand ez with education on the importance of smoking cessati on and the role
that smoking has on respiratory health. As part of this educati on, provide her wit h a list of
smoking cessati on support group s. Smoking cessation is the most important int ervention in
COPD. It irritates the trachea and laryn x reduces lung function and breal essness due to swellin g
and narrowing of th e airway and excess mucus in the l ung. The American lung ass ociation,
National Cancer institu te and American Cancer Societ y.
The Scenario An alysis Questions a re correlated to the Quality and Safety Educa tion for Nurses (QSEN)
competencies: Patient-Centered Care ( PCC), Teamwo rk and Collaboration (T&C), Evid ence-Based Practice
(EBP), Quality Improve ment (QI), Safety (S), and Infor matics (I). Find more info rmation at:
http://qsen.org /
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