Fluent Essays

Just fill the uploaded questionaire by following the vsim virtual lab. If any question then please ask me. maternity_and_pediatrics_docucare.docx maternity_pediatrics_discussion_questions.docx med_surg_docucare.docx post_conference_questions_med_surg.docx pre_conference_med_surg.docx Unformatted Attachment Preview Scenario 1: Olivia Jones Documentation Assignments- Complete in DocuCare 1. Document the data from your focused antepartum assessment of both Ms. Jones and the fetus. 2. Write the situation-background-assessment-recommendation (SBAR) communications you would use to update the provider on Ms. Jones’s status at the time of her admission. 3. Document the teaching you would provide to the patient and her support person prior to administering magnesium sulfate. 4. Document the administration of the magnesium sulfate bolus and the initiation of the magnesium sulfate infusion. 5. Document your reassessment of the patient’s status after administering magnesium sulfate. Documentation Assignments- Complete in DocuCare 1.How did the simulated experience of Carla Hernandez’s case make you feel? 2. Describe the actions you felt went well in this scenario. 3. Consider the emergent nature of umbilical cord prolapse. What nursing actions should be initiated immediately? Why? 4. Reflecting on Carla Hernandezs case, were there any actions you would do differently? Explain. 5. Describe how you would apply the knowledge and skills that you obtained in Carla Hernandezs case to an actual patient care situation. Maternity Case 2: Brenda Patton Documentation Assignments-Document in DocuCare 1. Document your initial assessment data of Ms. Patton, including uterine activity (frequency and duration), fetal heart rate (FHR) activity (baseline FHR, long-term variability, accelerations, and decelerations), vaginal discharge, and maternal vital signs. 2. Document the medication(s) that you administered. 3. Document Ms. Patton’s pain during labor (severity during contractions, location, quality, interventions taken, and response to interventions) and the measures that were taken to promote her desire for a natural birth. 4. Document your handoff report in the situation-background-assessment-recommendation (SBAR) format to communicate what further care Ms. Patton needs. 5. Document the informal patient education that you provided to Ms. Patton during this scenario regarding group B streptococcus and the patient’s response to this teaching session. Maternity Case 3: Amelia Sung Documentation Assignment- Document in DocuCare 1. Document the fetal status and the progression of Ms. Sung’s labor from the time you took over care of Ms. Sung until the provider takes her to the delivery room. 2. Document the essential events related to the time of birth, including the activities and interventions from the time of crowning to the complete expulsion of the fetus. 3. Document the application of suprapubic pressure and the response and outcomes. 4. Document your communications with the neonatal intensive care unit (NICU) about the impending birth Maternity Case 5: Fatime Sanogo Document in Docucare. 1. Document your initial assessment data for Ms. Sanogo, including vital signs, fundal assessment (consistency, position, location), lochia assessment (amount, color, odor, consistency), and pain (location, quality, severity). 2. Write the situation-background-assessment-recommendation (SBAR) communications you would use to update the provider on Ms. Sanogo’s status after your first encounter with her. 3. Document the medication(s) you administered to Ms. Sanogo and evaluate each drug’s effectiveness. 4. Document the sequence of events during the simulation (i.e., vital signs, assessment findings, blood loss, nursing interventions, and patient response). 5. Ms. Sanogo is going to be taken back to labor and delivery for a manual examination. Write the transfer note. Pediatric Case 1: Jackson Weber Document in Docucare. 1. 2. 3. 4. 5. Document your initial focused assessment of Jackson Weber. Identify and document key nursing diagnoses for Jackson Weber. Referring to your feedback log, document the nursing care you provided and Jackson Weber’s response. Document the teaching that you would provide for Jackson Weber and his mother before discharge. Document your handoff report in the situation-background-assessment-recommendation (SBAR) format to communicate what further care Jackson Weber needs. Pediatric Case 2: Sabina Vasquez Documentation Assignment-Document in DocuCare 1. 2. 3. 4. Document your initial focused assessment of Sabina Vasquez. Identify and document key nursing diagnoses for Sabina Vasquez. Referring to your feedback log, document the nursing care you provided and Sabina Vasquez’s response. Document the patient teaching that you would provide for Sabina Vasquez and her family before discharge. Pediatric Case 4: Brittany Long Document in Docucare 1. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. 2. Document your initial focused assessment of Brittany Long. 3. Identify and document key nursing diagnoses for Brittany Long. 4. Referring to your feedback log, document the nursing care you provided and Brittany Long’s response. 5. Document the patient teaching that you would provide for Brittany Long and her family before discharge, including disease process, nutrition, signs and symptoms of crises, prevention of infection and dehydration, and pain management. Pediatric Case 3: Eva Madison Document in Docucare 1. Document your initial focused assessment of Eva Madison. 2. Identify and document key nursing diagnoses for Eva Madison. 3. Referring to your feedback log, document the nursing care you provided and Eva Madison’s response. Pediatric Case 5: Charlie Snow Document in Docucare 1. 2. 3. 4. Document your initial focused assessment of Charlie Snow. Identify and document key nursing diagnoses for Charlie Snow. Referring to your feedback log, document the nursing care you provided and Charlie Snow’s response. Document the patient teaching that you would provide before discharge. MATERNITY Olivia Jones is a 23-year-old African-American female, G1P0 at 36 weeks of gestation. She has been diagnosed with severe preeclampsia and is admitted to the labor and delivery unit for assessment and surveillance. Pregnancy has been unremarkable until routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. She has gained 3 pounds since prenatal visit 1 week ago. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial puffiness. Ms. Jones is complaining of a headache that is not resolved with acetaminophen. She presents with nausea and fatigue and complaining of epigastric pain, visual changes, and chest tightness. The fetus is active; however, patient states that it is a bit quieter than normal. There is a possibility of premature rupture of membranes. An IV with lactated Ringers is running at 125 mL/hr. Labs were obtained. Answer the following questions based on the above information in the corresponding discussion post in the discussions section. 1. What are the signs and symptoms of pre-eclampsia? 2. What medication(s) do you predict will be administered to our patient? 3. What will nurse teach the patient about pre-eclampsia and hypertension? 4. What laboratory test would you anticipate being ordered for the patient? Answer the following questions based on the Olivia Jones vSim. Post responses on the discussion board under discussion #1. 1. How did the simulated experience of Olivia Jones’s case make you feel? 2. Describe the actions you felt went well in this scenario. 3. What should the priority teaching for Olivia Jones include? 4. What key elements would you include in the handoff report for this patient? Consider the situation-backgroundassessment-recommendation (SBAR) format. 5. Based on your experience with Olivia Jones’s case, reflect on possible nursing actions for enhanced safety and quality improvement. 6. Respond to 2 students discussion post. Introduction This week you will be assigned to two patients. Pt A is Brenda Patton and Pt B is Carla Hernandez. Review summary for Pt A below and Pt B summary will be right after Pt A summary. Review both summaries and participate in the discussion for both patients. Patient A Brenda Pattons Introduction Brenda Patton is an 18-year-old Caucasian female, G1P0 at 38 2/7 weeks of gestation admitted to the labor and birthing unit for labor assessment. The patient states that her water may have broken earlier this morning and she thinks she is in labor. AmniSure was positive. Vaginal exam reveals 50\% effacement of cervix, cervical dilation 4 cm, and fetus at -2 station. The patients boyfriend is present, and she has phoned her mother to inform her of her admission. The provider has been notified, and prenatal records have been pulled. The lab report indicates that the patients group B strep vaginorectal culture taken at 36 weeks was positive. The patient wishes to have a natural birth without medication. Admission intrapartum orders have been initiated, initial labs have been drawn, and a saline lock has been placed in her forearm. 1. Describe what happens in the Active Phase of the first stage of labor. 2. What does AmniSure test for and why is this important to know? Patient B Carla Hernandezs Introduction Carla Hernandez is a 32-year-old Hispanic female, G2P1 (L1), at 39 5/7 weeks of gestation. She was admitted to labor and delivery in active labor at 0600 hours today, accompanied by her husband Earl. To progress the delivery, artificial rupture of membranes was performed by the provider a few minutes ago. The provider has just left the room to make rounds. Suddenly, the fetal heart rate drops dramatically, and you discover that the umbilical cord is prolapsed. You are ready to handle this situation with another nurse who is also present in the room. 1. Please describe what is umbilical cord prolapse. 2. What would be the patient teaching? Answer the following questions based on the Brenda Patton. 1. Reflecting on Brenda Patton’s case, were there any actions you would do differently? Explain. 2. Describe how you would apply the knowledge and skills that you obtained in Brenda Patton’s case to an actual patient care situation. 3. What complications can occur if group B streptococcus is not treated? Answer the following questions based on the Carla Hernandez. 1. Consider the emergent nature of umbilical cord prolapse. What nursing actions should be initiated immediately? Why? 2. How did the simulated experience of Carla Hernandezs case make you feel? 3. Describe the actions you felt went well in this scenario. Patient Introduction Amelia Sung is a 36-year-old Filipino female, G2P1 (L1) at 39 weeks of gestation, who was admitted 24 hours ago for induction of labor. First-born male delivered vaginally 3 years and 3 months ago. Weight: 3,345 g (7 lb 6 oz). Length 55 cm (22 in). She was started on oxytocin at 1 mL/1 mU, and the infusion was increased throughout the day per protocol. A mainline IV of lactated Ringers is running at 125 mL/hr, and oxytocin (30 units in 500 mL normal saline) is running at 20 mU/min (20 mL/hr). Her cervical exam at admission was 2 cm dilation, 80\% effaced, at -1 station, with fetus in vertex position. At 0100 hours, dilation was 4 cm, 100\% effaced, still at -1 station and fetus in vertex position. She received an epidural shortly after that, and 1 hour later, her membranes ruptured; the fluid was clear. Three hours ago, she was fully dilated and started pushing. The fetal heart rate has been stable with a baseline of 120/min, moderate variability, and early decelerations since she started pushing. She is getting tired from pushing, and the descent of the fetal head has been slow. During the past few contractions, the baby has started to crown. The provider has been called and has arrived, so Amelia may continue pushing. 1. What is oxytocin and why was she given this medication? 2. What is the McRoberts Maneuver? When would this procedure be used? Answer the following questions based on the Amelia Sung. 1. How did the simulated experience of Amelia Sung’s case make you feel? 2. Describe the actions you felt went well in this scenario. 3. Reflecting on Amelia Sung’s case, were there any actions you would do differently? Explain. 4. Describe how you would apply the knowledge and skills that you obtained in Amelia Sung’s case to an actual patient care situation. 5. List potential problems for Amelia Sung and her baby related to the shoulder dystocia. Patient Introduction Fatime Sanogo is a 23-year-old primiparous female from Mali in her first hour after vaginal delivery. The patient was admitted yesterday at 0600 hours for oxytocin induction of labor secondary to postdates (41 4/7 weeks). She declined all pain medication during labor. Following a prolonged second stage, she delivered a vigorous female infant at 0605 hours with Apgar scores of 9 and 9 and weight of 4,082 g (9 lb 0 oz). The patient contracted a second-degree perineal laceration during delivery; this has been repaired. Placenta was delivered manually at 0635 hours via Dr. Schultz. Bleeding was controlled by fundal massage and infusion of remaining oxytocin induction bag, which is still running at 20 mL/hr (20 mU/min); approximately 100 mL left in the bag. The patient was just up to the bathroom and couldnt void. She is now dozing, and the father of the baby is at the bedside, holding the baby and sending text messages from the phone. Fatime does not speak English fluently, as she has only been in the country for 7 months. You enter the room to assume care of the patient and to perform the second of four assessments every 15 minutes. 1. What are the signs and symptoms of Postpartum Hemorrhage? 2. What are some of the reasons why Ms. Sanogo can not void? How would you address this? 3. What nursing teaching would be addressed? Answer the following questions based on the Fatime Sanogo vSim. Post responses on the discussion board under discussion #2. 1. How did the simulated experience of Fatime Sanogo’s case make you feel? 2. Describe the actions you felt went well in this scenario. 3. List the actions that should be initiated if administering oxytocin is ineffective. 4. What communication techniques could be initiated to decrease the anxiety of Fatime Sanogo and her husband and provide care that is culturally sensitive? 5. Reflecting on Fatime Sanogo’s case, were there any actions you would do differently? Explain. 6. Describe how you would apply the knowledge and skills that you obtained in Fatime Sanogo’s case to an actual patient care situation. Patient Introduction Jackson Weber is a 5-year-old Caucasian male. He was diagnosed with generalized tonic-clonic seizures 2 years ago. Upon diagnosis, Jacksons neurologist started him on oral phenobarbital. Jackson has been seizure-free until last night, when his mother brought him to the emergency department following a 3-minute tonic-clonic seizure. She is a single mother and the sole source of financial support. Jackson has not seen his neurologist in 15 months due to his mothers work schedule. Jackson was seen by his health care provider this morning and currently has an intravenous infusion in his left arm running D5 NS + 20 mEq KCl/L at 58 mL/hr. He has been eating well, has urine output, and vital signs are stable. His pupils are equal and reactive to light. He is able to move all extremities equally. He is awake and alert and is watching cartoons. His mother is at the bedside. 1. What are tonic-clonic seizure and how are they treated? 2. What nursing teaching should be performed for this case? 3. What focus assessments would you perform and why? Answer the following questions based on the Jackson Weber vSim. Post responses on the discussion board under discussion. 1. How did the simulated experience of Jackson Weber’s case make you feel? 2. Describe the actions you felt went well in this scenario. 3. Describe strategies to empower Jackson Weber and his mother in the management of his seizures. 4. Reflecting on Jackson Weber’s case, were there any actions you would do differently? If so, what were these actions, and why would you do them differently? 5. Describe how you would apply the knowledge and skills you obtained in Jackson Weber’s case to an actual patient care situation. 6. What should the nurse teach Jackson Weber’s mother regarding the ongoing care of his condition? Patient Introduction Sabina Vasquez is a 5-year-old Hispanic girl admitted today from the emergency room with a diagnosis of pneumonia. She has a history of asthma and has had several episodes requiring use of an albuterol inhaler at home. Sabina has had an upper airway infection for the past few days. Earlier today she developed a fever of 39°C (102.2°F), so her mother brought her to the emergency room. She was placed on oxygen via nasal cannula at 2 L/min. She received a 380-mL bolus of normal saline and an albuterol nebulizer treatment at 5:00 PM. This improved her oxygen saturation to 94\%. The chest x-ray revealed right lower lobe pneumonia with effusion. An intravenous infusion of D5 ½NS is infusing at 61 mL/hr. Sabina just got settled in bed, and her mother is at the bedside. 1. Before performing an assessment, what would be the most relevant patient information needed? 2. What would be the primary nursing diagnosis for this patient? 3. What patient and parent education would be necessary and why? 4. How would your distinguish between mild respiratory discomfort and respiratory distress? Pediatric Case 2: Sabina Vasquez 1. How did the simulated experience of Sabina Vasquez’s case make you feel? 2. Describe the actions you felt went well in this scenario. 3. What key elements would you include in the handoff report for this patient? Consider the situation-background-assessmentrecommendation (SBAR) format. 4. What complications might Sabina Vasquez face if her symptoms are not recognized and if care is not initiated in a timely manner? 5. Reflecting on Sabina Vasquez’s case, were there any actions you would do differently? If so, what were these actions, and why would you do them differently? 6. Describe how you would apply the knowledge and skills obtained in Sabina Vasquez’s case to an actual patient care situation. Introduction This week you will be assigned to two patients. Pt A is Eva Madison and Pt B is Brittany Long. Review summary for Pt A below and Pt B summary will be right after Pt A summary. Review both summaries and participate in the discussion for both patients. Pediatric Case 2: Sabina Vasquez 1. How did the simulated experience of Sabina Vasquez’s case make you feel? 2. Describe the actions you felt went well in this scenario. 3. What key elements would you include in the handoff report for this patient? Consider the situation-background-assessmentrecommendation (SBAR) format. 4. What complications might Sabina Vasquez face if her symptoms are not recognized and if care is not initiated in a timely manner? 5. Reflecting on Sabina Vasquez’s case, were there any actions you would do differently? If so, what were these actions, and why would you do them differently? 6. Describe how you would apply the knowledge and skills obtained in Sabina Vasquez’s case to an actual patient care situation. Patient A Eva Madisons Introduction Eva Madison is a 5-year-old female who just arrived to the pediatric floor from the emergency department, where she arrived at 7:00 AM with a 3-day history of vomiting and diarrhea, inability to keep fluids down, and no urination since 8:00 PM yesterday. At her last check-up a few months ago, her weight was 21.2 kg, and today her weight is 20.5 kg. She is pale and listless, and her mucous membranes are dry. An intravenous saline bolus of 400 mL was started in the emergency department and has just finish ... Purchase answer to see full attachment