Sherman “Red” Yoder – Part A
Part 1: Plan of Care Concept Map (adapted from vSim template)
Simulation Patient Overview
Client summary: presentation, medical history and background, physical assessment
findings, medications, diagnostics
brief summary of pathophysiology and rationale for clinical manifestations
Red is an 80-year-old male who lives alone, 20 miles from the nearest city. The patient has previously
been diagnosed with type 2 diabetes (six months ago) and has recently began taking insulin. The nurse
came to Reds’ house to assess and evaluate a wound that was caused by wearing shoes that were too
tight. The toe was injured about three weeks ago. It is plausible that Red has developed peripheral
neuropathy which is typically caused by diabetes. This causes loss of sensation and numbness to the
extremities. In Reds’ case, he might have not felt in the injury on his toe and that is why he did not
address it immediately. Red also lives alone so there was no was else in the household to bring his
attention to the injured toe.
The Assessment
Anticipated Physical Assessment Findings Anticipated Diagnostic Tests
additional focused assessment relevant cues (abnormal findings)
relevant cues (S&S) additional tests to consider
cues indicating need for immediate
concern and rationale
Peripheral neuropathy – numbness and loss of Abnormal Values
sensation in the feet Part A: No diagnostic tests
Right toe wound
Additional tests to consider – monitoring of blood
glucose x 4 times a day.
Plan
Anticipated Care Priorities Anticipated Nursing Interventions
Educate patient on: the importance of monitoring
Monitor blood glucose levels and adhere to his blood glucose after meals, and adhering to the
medication. sliding scale dosage, daily inspection of feet with
help of mirrors and family, how to apply wound
Wound dressing. dressings on his right toe to prevent further
complications, information on diet and nutrition.
Feet inspection.
Great importance must be placed on footcare.
© Wolters Kluwer Health | Lippincott Williams & Wilkins
, Diet and nutrition information.
Sleep education. Assess independence in ADLs.
ISBAR Worksheet (adapted from vSim)
ISBAR Student Notes
Introduction Hello, my name is Ronit Patel. I am student RN
Your name, position (Nursing student), unit with a home health agency. I will be giving you a
you are working on report on Red Yoder.
What is the purpose of this communication?
Situation Red Yoder is an 80-year-old male that is being
What is happening at the moment? seen at home for a right toe wound.
Patient’s name, age, specific reason for
visit/admission
Background The patient was diagnosed with type two diabetes
What are the issues that led up to this six months ago. He has recently began taking
situation? insulin. Red suffered an injury to his toe three
Patient’s primary diagnosis, date of weeks ago. Up till now, he has been wearing tight
admission, current orders shoes which progressively made his injury worse.
No current orders.
Assessment The issue with the patient is the lack of
What do you believe the problem is? knowledge regarding the disease, as well as non-
Current pertinent assessment data using head adherence to treatment.
to toe or focused assessment approach,
Pertinent diagnostics
Vital signs
Recommendation I would recommend that the patient be connected
What should be done to correct this situation? with a diabetes education, a dietician, and be a
Any orders or recommendations you have for participant for a sleep study. The patient also
this patient might need assistance with ADLs so an OT/PT
assessment might also benefit the patient.
© Wolters Kluwer Health | Lippincott Williams & Wilkins
Part 1: Plan of Care Concept Map (adapted from vSim template)
Simulation Patient Overview
Client summary: presentation, medical history and background, physical assessment
findings, medications, diagnostics
brief summary of pathophysiology and rationale for clinical manifestations
Red is an 80-year-old male who lives alone, 20 miles from the nearest city. The patient has previously
been diagnosed with type 2 diabetes (six months ago) and has recently began taking insulin. The nurse
came to Reds’ house to assess and evaluate a wound that was caused by wearing shoes that were too
tight. The toe was injured about three weeks ago. It is plausible that Red has developed peripheral
neuropathy which is typically caused by diabetes. This causes loss of sensation and numbness to the
extremities. In Reds’ case, he might have not felt in the injury on his toe and that is why he did not
address it immediately. Red also lives alone so there was no was else in the household to bring his
attention to the injured toe.
The Assessment
Anticipated Physical Assessment Findings Anticipated Diagnostic Tests
additional focused assessment relevant cues (abnormal findings)
relevant cues (S&S) additional tests to consider
cues indicating need for immediate
concern and rationale
Peripheral neuropathy – numbness and loss of Abnormal Values
sensation in the feet Part A: No diagnostic tests
Right toe wound
Additional tests to consider – monitoring of blood
glucose x 4 times a day.
Plan
Anticipated Care Priorities Anticipated Nursing Interventions
Educate patient on: the importance of monitoring
Monitor blood glucose levels and adhere to his blood glucose after meals, and adhering to the
medication. sliding scale dosage, daily inspection of feet with
help of mirrors and family, how to apply wound
Wound dressing. dressings on his right toe to prevent further
complications, information on diet and nutrition.
Feet inspection.
Great importance must be placed on footcare.
© Wolters Kluwer Health | Lippincott Williams & Wilkins
, Diet and nutrition information.
Sleep education. Assess independence in ADLs.
ISBAR Worksheet (adapted from vSim)
ISBAR Student Notes
Introduction Hello, my name is Ronit Patel. I am student RN
Your name, position (Nursing student), unit with a home health agency. I will be giving you a
you are working on report on Red Yoder.
What is the purpose of this communication?
Situation Red Yoder is an 80-year-old male that is being
What is happening at the moment? seen at home for a right toe wound.
Patient’s name, age, specific reason for
visit/admission
Background The patient was diagnosed with type two diabetes
What are the issues that led up to this six months ago. He has recently began taking
situation? insulin. Red suffered an injury to his toe three
Patient’s primary diagnosis, date of weeks ago. Up till now, he has been wearing tight
admission, current orders shoes which progressively made his injury worse.
No current orders.
Assessment The issue with the patient is the lack of
What do you believe the problem is? knowledge regarding the disease, as well as non-
Current pertinent assessment data using head adherence to treatment.
to toe or focused assessment approach,
Pertinent diagnostics
Vital signs
Recommendation I would recommend that the patient be connected
What should be done to correct this situation? with a diabetes education, a dietician, and be a
Any orders or recommendations you have for participant for a sleep study. The patient also
this patient might need assistance with ADLs so an OT/PT
assessment might also benefit the patient.
© Wolters Kluwer Health | Lippincott Williams & Wilkins
