CURRENT MEDICATIONS
1. IV NS at 150mL/Hr
1. Insulin injection twice each day – dose dependent upon sliding scale
1. Hypoglycemia standing orders as needed
PROVIDER ORDERS
1. NPO (except medications)
1. Initiate Saline lock
1. Oxygen to maintain SpO2 greater than 94%
1. Activity as tolerated
SCENARIO PROGRESSION
Client will require insulin injection as indicated by blood glucose level and sliding scale, this will require the mixing of insulin and the administration of a subcutaneous injection.
A simulated 30 minutes will pass and the confederate will call for help as the client becomes semi-conscious and nearly unable to respond to noxious stimuli. This will require the student to determine the situation as an adverse reaction to the previous insulin injection and require the reconstitution of glucagon and an intramuscular injection.
ROLES
1. Parent
1. Nurse
1. Client
STUDENT CRITICAL BEHAVIORS
1. Student will prepare and administer medications appropriately
1. Student will recognize the signs and symptoms of an adverse reaction to insulin
1. Student will interact with parent and client in a professional manner
SIMULATION SET UP
1. Adult manikin with bandage wraps on extremities
1. Appropriate vials and syringes for medication administration noted in scenario progression
1. IV NS at 150mL/Hr
1. Insulin injection twice each day – dose dependent upon sliding scale
1. Hypoglycemia standing orders as needed
RESOURCES 1. NPO (except medications)
1. Initiate Saline lock
1. Oxygen to maintain SpO2 greater than 94%
1. Activity as tolerated
National Patient Safety Goals (Hospital) Effective January 1, 2015. The Joint Commission Client will require insulin injection as indicated by blood glucose level and sliding scale, this will require the mixing of insulin and the administration of a subcutaneous injection.
A simulated 30 minutes will pass and the confederate will call for help as the client becomes semi-conscious and nearly unable to respond to noxious stimuli. This will require the student to determine the situation as an adverse reaction to the previous insulin injection and require the reconstitution of glucagon and an intramuscular injection.
Accessed online: http://www.jointcommission.org/standar 1. Parent
1. Nurse
1. Client
CURRENT MEDICATIONS 1. IV NS at 150mL/Hr
1. Insulin injection twice each day – dose dependent upon sliding scale
1. Hypoglycemia standing orders as needed
PROVIDER ORDERS 1. NPO (except medications)
1. Initiate Saline lock
1. Oxygen to maintain SpO2 greater than 94%
1. Activity as tolerated
SCENARIO PROGRESSION Client will require insulin injection as indicated by blood glucose level and sliding scale, this will require the mixing of insulin and the administration of a subcutaneous injection.
A simulated 30 minutes will pass and the confederate will call for help as the client becomes semi-conscious and nearly unable to respond to noxious stimuli. This will require the student to determine the situation as an adverse reaction to the previous insulin injection and require the reconstitution of glucagon and an intramuscular injection.
ROLES 1. Parent
1. Nurse
1. Client
STUDENT CRITICAL BEHAVIORS 1. Student will prepare and administer medications appropriately
1. Student will recognize the signs and symptoms of an adverse reaction to insulin
1. Student will interact with parent and client in a professional manner
SIMULATION SET UP 1. Adult manikin with bandage wraps on extremities
1. Appropriate vials and syringes for medication administration noted in scenario progression
1. Student will prepare and administer medications appropriately
1. Student will recognize the signs and symptoms of an adverse reaction to insulin
1. Student will interact with parent and client in a professional manner
RESOURCES 1. Adult manikin with bandage wraps on extremities
1. Appropriate vials and syringes for medication administration noted in scenario progression
RESOURCES
SCENARIO FOCUS Recognition and initial actions taken given signs and symptoms of an allergic reaction to a prescribed medication
OBJECTIVES 1. Use two ways to identify the client (2015 Joint Commission NPSG.01.01.01)
1. Recognize signs and symptoms related to a possible medication reaction
1. Formulate an accurate report to a healthcare provider in SBAR format
1. Analyze assessment data to appropriately prioritize the client’s triage category according to an established criteria scheme
REALTED COURSE OBJECTIVES
NUR3371 1. Demonstrate timely and accurate documentation of administration of medications, including any adverse responses or reactions
PATIENT DEMOGRAPHICS NAME: Josie Lancaster
AGE: 20 years old
DOB: May 11, XXXX
WEIGHT: 128 pounds (58kg)
HEIGHT: 66 inches (168cm)
PAST HISTORY Sexually active in last 12 months
CASE HISTORY Josie Lancaster is a 20 year old healthy female.
She is presenting to the triage desk at an outpatient care facility (urgent care) complaining of itching, runny nose and a rash over most of her body. She was seen about 18 hours ago in the primary care clinic and diagnosed with pelvic inflammatory disease. She was prescribed:
Ceftriaxone 250 mg IM in a single dose (Given at PCC) Doxycycline 100 mg orally twice a day for 14 days Metronidazole 500 mg orally twice a day for 14 days
She states that her first dose of oral medications was taken about 4 hours ago.