with a history of asthma, eczema, hay fever and migraines has
recently been admitted to a general medicine unit with
pyelonephritis. She has a sensitivity to animal dander.
The scenario starts with nurse-to-nurse handover at change
of shift (night to day). Key handover information includes
the patient’s medical history as well as treatment activity to
date - IV antibiotic and fluid administration, last set of vital
signs, and pertinent assessment findings. Immediately
after change of shift the patient, Mel, complains of feeling
very unwell with difficulty breathing and a noticeable
change in appearance. It should become clear to the
learner that Mel is experiencing anaphylaxis secondary to
SUMMARY
the IV antibiotic she received and the learner should take
Melanie Slater, a 28-year-old woman action to address this escalating emergency
with a history of asthma, eczema,
hay fever and migraines has recently
been admitted to a general medicine
unit with pyelonephritis. She has a
sensitivity to animal dander.
The scenario starts with nurse-to-
nurse handover at change of shift
(night to day). Key handover
information includes the patient’s
medical history as well as treatment
activity to date - IV antibiotic and
fluid administration, last set of vital
signs, and pertinent assessment
findings. Immediately after change
of shift the patient, Mel, complains LEARNING OBJECTIVES
of feeling very unwell with difficulty
breathing and a noticeable change
Assessment:
in appearance. It should become
Complete vital signs and document on EWS chart
clear to the learner that Mel is
Establish a history of the presenting complaint
experiencing anaphylaxis secondary
Establish medical history
to the IV antibiotic she received and Ask allergy status, verify name and date of birth
the learner should take action to Perform basic physical exam (Check airway, respiratory exam)
Review inpatient notes and charts
Perform follow-up assessments
Perform environmental safety check
Investigations:
Order labs (blood tests) (in line with orders)
Order blood gas (in line with orders)
Management
Identify change in status
Deliver oxygen to maintain saturations over 94%
Call for help
Appropriately deliver SBAR report to medical team
Melanie Slater, a 28-year-old woman
,Administer IM epinephrine (in line
with prescription) Non-technical Skills:
Start IV fluids resuscitation (in line Make rational, timely clinical decisions
with prescription) Effectively communicate with patient and team
Give alternate antibiotic for Maintain patient safety and comfort
pyelonephritis with Apply clinical knowledge and adapt to changes in patient
suspected penicillin allergy condition
(in line with prescription) Appropriately utilize other team members
Refer to anaphylaxis guidelines Escalate and refer appropriately
, APPLICABLE COMPETENCY FRAMEWORKS
AANP
Baccalaureate Essentials
C-CEI
NCLEX
QSEN
SWB001
INPATIENT ANAPHYLAXIS
TARGET LEARNERS
RNs
Nursing Students
LPNs
DELIVERY
Virtual Reality
On screen (computer)
MODALITY
Menu based
Single participant
ENVIRONMENT
Inpatient Unit
LOCALE
US
recently been admitted to a general medicine unit with
pyelonephritis. She has a sensitivity to animal dander.
The scenario starts with nurse-to-nurse handover at change
of shift (night to day). Key handover information includes
the patient’s medical history as well as treatment activity to
date - IV antibiotic and fluid administration, last set of vital
signs, and pertinent assessment findings. Immediately
after change of shift the patient, Mel, complains of feeling
very unwell with difficulty breathing and a noticeable
change in appearance. It should become clear to the
learner that Mel is experiencing anaphylaxis secondary to
SUMMARY
the IV antibiotic she received and the learner should take
Melanie Slater, a 28-year-old woman action to address this escalating emergency
with a history of asthma, eczema,
hay fever and migraines has recently
been admitted to a general medicine
unit with pyelonephritis. She has a
sensitivity to animal dander.
The scenario starts with nurse-to-
nurse handover at change of shift
(night to day). Key handover
information includes the patient’s
medical history as well as treatment
activity to date - IV antibiotic and
fluid administration, last set of vital
signs, and pertinent assessment
findings. Immediately after change
of shift the patient, Mel, complains LEARNING OBJECTIVES
of feeling very unwell with difficulty
breathing and a noticeable change
Assessment:
in appearance. It should become
Complete vital signs and document on EWS chart
clear to the learner that Mel is
Establish a history of the presenting complaint
experiencing anaphylaxis secondary
Establish medical history
to the IV antibiotic she received and Ask allergy status, verify name and date of birth
the learner should take action to Perform basic physical exam (Check airway, respiratory exam)
Review inpatient notes and charts
Perform follow-up assessments
Perform environmental safety check
Investigations:
Order labs (blood tests) (in line with orders)
Order blood gas (in line with orders)
Management
Identify change in status
Deliver oxygen to maintain saturations over 94%
Call for help
Appropriately deliver SBAR report to medical team
Melanie Slater, a 28-year-old woman
,Administer IM epinephrine (in line
with prescription) Non-technical Skills:
Start IV fluids resuscitation (in line Make rational, timely clinical decisions
with prescription) Effectively communicate with patient and team
Give alternate antibiotic for Maintain patient safety and comfort
pyelonephritis with Apply clinical knowledge and adapt to changes in patient
suspected penicillin allergy condition
(in line with prescription) Appropriately utilize other team members
Refer to anaphylaxis guidelines Escalate and refer appropriately
, APPLICABLE COMPETENCY FRAMEWORKS
AANP
Baccalaureate Essentials
C-CEI
NCLEX
QSEN
SWB001
INPATIENT ANAPHYLAXIS
TARGET LEARNERS
RNs
Nursing Students
LPNs
DELIVERY
Virtual Reality
On screen (computer)
MODALITY
Menu based
Single participant
ENVIRONMENT
Inpatient Unit
LOCALE
US
