MD1
\nSIM DAY 1
\n(Turing a patient with a hip fracture-Edith Jacobson)<\/p>\n
THE BELOW ACTIVITIES ARE REQUIRED TO BE COMPLETED BEFORE YOU ARRIVE TO THE SIMULATION.
\nIf this is not completed, you will not be allowed to participate in the simulation (please be advised that simulations are limited, so make-up is not guaranteed. If the simulation is not completed for this course NUR2356 Multidimensional Care 1, you will fail to meet the objectives and not pass this course-both lecture and clinical).
\n1.\tGo To “My ATI” \uf0e0 Apply \uf0e0 Skills Modules 3.0 \uf0e0 Mobility (1hr)
\na.\tComplete the pretest (if you have not taken it yet), review the lesson, and finish with the posttest for Mobility (screenshot posttest results showing 95% or greater and showing 1 hour spent in module).
\ni.\t (place screenshot here)<\/p>\n
2.\tComplete the Osteoporosis Pathophysiology diagram below by using the ATI Med\/Surg ebook, [“My ATI” \uf0e0 Learn \uf0e0 RN eBook Library\uf0e0 RN Adult Medical Surgical Nursing Edition 11.0 (this is the ebook you will need to complete the below diagram) start on page 463]) (1hr)<\/p>\n
3.\tComplete the table below (1hr)
\nComplete the table below on medications using a Drug eBook. You can use any drug book, the below picture is an example of one book. You could use Rasmussen Library to search for a drug book.<\/p>\n
Drug Name\tIndications\tPharmacokinetics\tContraindications\/Precautions \tNursing Implications\tImplementation\tPatient\/family teaching
\nAssessment
\nEnoxaparin \t\u2022\tAcute coronary syndromes such as ST-elevation myocardial infarction, Non-ST elevation myocardial infarction, and unstable angina.
\n\u2022\tDeep venous thrombosis (DVT) treatment.
\n\u2022\tDeep venous thrombosis (DVT) prophylaxis.
\n\u2022\tTreatment for pulmonary embolism (PE)
\n\u2022\tVenous thromboembolism secondary to malignancy.
\nThe absorption of enoxaparin is proportional to the dose, demonstrating linear absorption. The average maximum plasma anti-Xa activity is reached 3 to 5 hours after a subcutaneous injection.\t\u2022\tKnown hypersensitivity to enoxaparin (urticaria, anaphylactic reactions) or any heparin products.
\n\u2022\tActive major bleeding such as gastrointestinal bleed.
\n\u2022\tHistory of heparin-induced thrombocytopenia within the past 100 days.
\n\u2022\tActive gastric or duodenal ulcers.
\n\u2022\tHemorrhagic cerebrovascular accident.
\nAssess for signs of bleeding and hemorrhage, including bleeding gums, nosebleeds, unusual bruising, black\/tarry stools, hematuria, and a fall in hematocrit or blood pressure. Notify physician or nursing staff immediately if enoxaparin causes excessive anticoagulation.\tEnoxaparin is used to prevent deep venous thrombosis, a condition in which harmful blood clots form in the blood vessels of the legs. \tMake sure your patient recognizes the significance of informing their healthcare providers, including dentists, that they are taking Lovenox. Instruct them to check with their physician if they notice any possible side effects such as: Bruising or bleeding, especially prolonged bleeding. Bloody or black, tarry stools.
\nDocusate Sodium\tDocusate is often used when straining to have a bowel movement should be avoided (e.g., after a heart attack or surgery). Docusate is a stool softener. It works by increasing the amount of water the stool absorbs in the gut, making the stool softer and easier to pass.\tDocusate sodium is a laxative and an anionic detergent that supposedly promotes incorporation of water and fats into stool through a reduction in surface tension, resulting in softer fecal mass 6,4. Docusate’s onset of action is 6-72 hours orally and 2-15 minutes rectally 6,7.\t\u2022\tHypersensitivity reaction to any of the docusate ingredients.
\n\u2022\tAvoid concomitant use of mineral oil. …
\n\u2022\tNausea or vomiting. …
\n\u2022\tIntestinal obstruction, symptoms of appendicitis, acute abdominal pain, fecal impaction, especially in children.
\nEvaluate therapeutic response (decreased constipation). – Drug should be discontinued if cramping, rectal bleeding, nausea or vomiting occur. – Administer alone for better absorption. – Do not administer within one hour of other drugs, antacids or milk\tDocusate is a type of medicine called a laxative. It helps to soften your poo and makes your bowel movements easier if you have problems pooing (constipation).\tSwallow tablets whole, do not chew them. – Health education: other possible means of avoiding constipation. – Inform that normal bowel movements do not always occur daily. – Do not use in the presence of abdominal pain, nausea, vomiting.
\nMorphine Sulfate \tMorphine sulfate injection is indicated for the relief of moderate to severe pain. Morphine sulfate injection is used especially in pain associated with cancer, myocardial infarction and surgery. Morphine also helps to relieve the anxiety and insomnia which may be associated with severe pain.\tAfter an oral dose, about 60% is excreted in the urine in 24 hours, with about 3% excreted as free morphine in 48 hours. After a parental dose, about 90% is excreted in 24 hours, with about 10% as free morphine, 65 to 70% as conjugated morphine, 1% as normorphine and 3% as normorphine glucuronide.\tmorphine may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. \tMonitor patient’s respiratory rate prior to administration. Reassess pain after administration of morphine. Monitor for respiratory depression and hypotension frequently up to 24 hours after administration of morphine. Place call light signal close to patient.\tThis medication is used to treat severe pain. Morphine belongs to a class of drugs known as opioid analgesics. It works in the brain to change how your body feels and responds to pain.\t\u2022\tinstruct patient on how and when to ask for and take pain medication.
\n\u2022\tMay cause drowsiness or dizziness. Caution patient to call for Helpance when ambulating or smoking and to avoid driving or other activities requiring alertness until response to medication is known.
\n\u2022\tAdvise patient that morphine is a drug with known abuse potential. Protect it from theft, and never give to anyone other than the individual for whom it was prescribed. Store out of sight and reach of children, and in a location not accessible by others.<\/p>\n
4.\tComplete the table below (1hr)
\nComplete the table below on lab values using the Lab and diagnostic ebook (example below).<\/p>\n
Lab Name\tRationale\tNormal Range (Adult)
\nHgb\tIf a hemoglobin test reveals that your hemoglobin level is lower than normal, it means you have a low red blood cell count (anemia)\tFemale : 12 or higher
\nMale : 13 or higher
\nHCT\tA hematocrit test is needed to check for the proportion of red blood cells.\tFor men, 38.3 to 48.6 percent. For women, 35.5 to 44.9 percent
\nWBC\tThese cells help fight infections by attacking bacteria, viruses, and germs that invade the body. White blood cells originate in the bone marrow but circulate throughout the bloodstream.\t 4,500 to 11,000
\nPlatelets\tPlatelets stop bleeding by clumping and forming plugs in blood vessel injuries.\t from 150,000 to 450,000 platelets per microliter
\nSodium (Na+)\tSodium is essential for cellular homeostasis and physiological function.\t135 and 145 milliequivalents per liter
\nPotassium (K+)\tPotassium is an electrolyte that’s essential for proper muscle and nerve function. Even minor increases or decreases in the amount of potassium in your blood can result in serious health problems.\t3.6 to 5.2 millimoles per liter (mmol\/L).
\nChloride (CL)\telectrolyte that helps balance the amount of fluid inside and outside of cells. It also helps maintain blood volume, blood pressure, and the pH of body fluids.\t96 to 106 milliequivalents per liter (mEq\/L)
\nBUN\tA BUN test can reveal whether your urea nitrogen levels are higher than normal, suggesting that your kidneys may not be working properly.\t6 to 24 mg\/dL (2.1 to 8.5 mmol\/L )
\nHCO3\ta byproduct of your body’s metabolism. Your blood brings bicarbonate to your lungs, and then it is exhaled as carbon dioxide.\t22 to 28
\nCreatinine\tHigh levels of creatinine may indicate that your kidney is damaged and not working properly\tmen, 0.74 to 1.35 mg\/dL (65.4 to 119.3 micromoles\/L) For adult women, 0.59 to 1.04 mg\/dL (52.2 to 91.9 micromoles\/L)
\nGlucose\tGlucose is either metabolised to produce energy or is stored in the muscles and liver as glycogen\tless than 140 mg\/dL (7.8 mmol\/L)
\nProthrombin time\tThe most common reason for PT tests is to monitor your blood levels if you are taking the blood-thinner warfarin.\t10 to 13 seconds
\nINR\tThe INR test helps balance the risk of internal bleeding against the risk of blood clotting.\t2.0 to 3.0
\naPTT\tIt measures how long it takes your blood to form a clot.\t20 to 35<\/p>\n
YOU HAVE NOW COMPLETED THE PREP WORK FOR SIM
\nSTOP HERE! DO NOT UPLOAD
\n(I will be looking at the above as you walk into the classroom, so please have it ready for me to review)
\nYou will hand in the worksheet at the end of the SIM day. This is why the due date is on the course calendar
\nSimulation: This is the rotation for the SIM day, keep as a reference for the SIM day
\nTime\tSIM (Room1)\tChart\/EHR (Room2)\tSkills (Room3)\tActivity (Room4)
\n0900-0945\tGroup A\tGroup D\tGroup B\tGroup C
\n0945-1030\tGroup D\tGroup A\tGroup C\tGroup B
\n1030-1115\tGroup C\tGroup B\tGroup D\tGroup A
\n1115-1200\tGroup B\tGroup C\tGroup A\tGroup D
\nGroup Debrief
\n1200-1230
\nLUNCH
\n(bring your lunch)
\n1230-1315\tGroup A\tGroup D\tGroup B\tGroup C
\n1315-1400\tGroup D\tGroup A\tGroup C\tGroup B
\n1400-1445\tGroup C\tGroup B\tGroup D\tGroup A
\n1445-1530\tGroup B\tGroup C\tGroup A\tGroup D
\nGroup Debrief<\/p>\n
Student Instructions\/Worksheet for SIM Day<\/p>\n
Room Number\tActivity
\nRoom 1-SIM \tCaring for Edith Jacobson
\nRoom 2\tMorning session: Activity- look through patient chart-develop “nursing brains.” Fill out print-off.
\nAfternoon session: Activity-in small groups, develop an SBAR from the morning session-will discuss in group debrief-practice reading this with a partner. Fill out print off of SBAR
\nRoom 3\tMorning session: Review proper patient alignment and the importance of repositioning the patient. Activity- with a partner, practice repositioning using appropriate body mechanic techniques and appropriate use of various supplies to Help with proper body alignment. Activity-Identify Morse Fall Risk Scale-Read handout and fill out Morse Fall Scale after reviewing given scenario. Activity-Using a mannequin to identify different lung sounds.
\nAfternoon session: Activity-Perform focused Musculoskeletal Assessment on a partner (check muscle strength and ROM, assess skin, assess warmth, check pedal pulses and capillary refill). View video before going through the assessment: https:\/\/www.youtube.com\/watch?v=t6hE_ntz4Ho<\/p>\n
Musculoskeletal Assessment
\nInspect and palpate extremities for edema, tenderness, temperature, deformities & lesions
\nCheck capillary refill of fingers and toes
\nInspect gait and balance (Romberg test)
\nAssess range of motion of neck, arms, & legs (at least 3 directions for each)
\nAssess strength in all extremities
\nAssess the following deep tendon reflexes: patellar, plantar, triceps, Achilles, biceps, & brachioradialis.
\nLocate and palpate radial, brachial, popliteal, posterior tibial, and dorsalis pedis pulses, assessing for symmetry and strength.<\/p>\n
-Activity- Chart findings from partner in EHR. Follow directions on how to chart in EHR.
\n-EHR Tutor: (may need to use Chrome)
\n-Go To \uf0e0 ATI \uf0e0 My ATI \uf0e0 EHR Tutor Folder\uf0e0 SIM Day 1 MD1\uf0e0Musculoskeletal Assessment
\nTo access this activity, you must “add a course” then enroll in the course by using the code below.
\nCode: 3SWGPSE<\/p>\n
THERE IS NOTHING TO HAND IN FOR EHR. THE INSTRUCTOR WILL LOOK AT YOUR CHARTING THROUGH EHR.
\nRoom 4\tMorning session- Research the proper techniques for using a walker\/cane -make sure you identify the difference between these tools and the difference each has, for example, a wheeled walker or a 3-point cane. Activity- Practice educating others on the proper usage of a walker\/cane (student nurse to demonstrate proper usage of devices).
\nAfternoon session- Activity -Develop a Quizlet game using the above information (patho map\/medication and lab information). You and a partner will develop a total of 10 questions. Each question should have the correct answer WITH rationale. Be sure to use evidence-based information. This will be presented in a large group debrief. Place link to Quizlet game here:
\n-If you have additional time- Practice giving report to another nurse
\nIf spare time is noted at any time throughout the day, students should complete the application questions at the end of the Med\/Surg book in ATI on osteoporosis. Writing down the answers to each question (1-5).
\nOr
\nATI Individual Quizzing
\n(Fundamentals)<\/p>\n
Post-SIM Activity
\nNursing Care Plan
\nArticle review: Please locate a peer-reviewed article published within the past 5 years that pertains to today’s SIM (examples: workplace injuries due to poor body mechanics, osteoporosis, hip surgery, etc.). Include a one-half to a one-page discussion of the article and how it relates to patient care.
\nPatient education: Complete in a narrative format exactly how you would educate a patient on post-hip surgery; this can include, but is not limited to medication, possible complications associated with wounds, nutrition, activity. Include 4 narrated sentences.
\nComplete care plan: Using information from today’s SIM, you will complete the care plan below. Make sure you are writing a problem nursing diagnosis. DO NOT USE “RISK FOR” as the start of your nursing diagnosis. I am looking for keywords such as related to and as evidence by in your nursing diagnosis.<\/p>\n
A-\tAssessment\tP- Planning (outcome-specific and measurable goal). This should be a SMART goal\tI-Interventions-
\n(evidenced-based). This needs to be working towards your goal. Placing the call light next to the bed is not an intervention,\tRationale (why are you doing the intervention?)
\nS (what the pt says):<\/p>\n
O (Information-assessment, lab\/diagnostic):\t\t1.<\/p>\n
2.<\/p>\n
3.<\/p>\n
4.<\/p>\n
5.<\/p>\n
1.<\/p>\n
2.<\/p>\n
3.<\/p>\n
4.<\/p>\n
5.<\/p>\n
Outcome: Critical Thinking: Self-assessment:
\nSelf-reflect on how your simulation experience correlates with what you have learned in this lecture. Objectives are located in the course under each module and are helpful in completing this section.<\/p>\n
Outcome: Caring
\nIdentify one example from your simulation day in which you observed, participated in, or provided some aspect of caring for the provision of psychosocial and\/or cultural diversity needs. How did you inspire or make a difference in your patient’s life today?<\/p>\n
Create individualized quizzing checking Fundamentals.
\nTake a screenshot of quiz made and how many questions answered (60 questions should be completed) (below is an example of the screenshot I want copy and paste to this worksheet)<\/p>\n
References
\n(Do not forget to put in-text citations within your worksheet)<\/p>\n
—–<\/p>\n
MD1 SIM DAY 1<\/p>\n
(Turing a patient with a hip fracture-Edith Jacobson)<\/p>\n
THE BELOW ACTIVITIES ARE REQUIRED TO BE COMPLETED BEFORE YOU ARRIVE TO THE SIMULATION.<\/p>\n
If this is not completed, you will not be allowed to participate in the simulation (please be advised that simulations are limited, so make-up is not guaranteed. If the simulation is not completed for this course NUR2356 Multidimensional Care 1, you will fail to meet the objectives and not pass this course-both lecture and clinical).<\/p>\n
1. Go To “My ATI” \uf0e0 Apply \uf0e0 Skills Modules 3.0 \uf0e0 Mobility (1hr)<\/p>\n
a. Complete the pretest (if you have not taken it yet), review the lesson, and finish with the posttest for Mobility (screenshot posttest results showing 95% or greater and showing 1 hour spent<\/p>\n","protected":false},"excerpt":{"rendered":"
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