CLINICAL REPLACEMENT PACKAGE

CLINICAL REPLACEMENT PACKAGE STUDENT RESOURCES STUDENT INSTRUCTIONS FOR VIRTUAL CLINICAL REPLACEMENT This activity packet is intended to be used with your assigned virtual patient found in vSim. The Six Step learn flow in vSim is to be followed as instructed below. Once you have completed the Six Steps, in addition to this Clinical Replacement Activity Packet, submit for grading as instructed in your syllabus. LEARN FLOW - STEP ONE • Finish the Suggested Readings, then complete the following four activities: ◦ Clinical Worksheet ◦ Plan of Care Concept Map ◦ Pharm4Fun Worksheet (one per medication) ◦ ISBAR Worksheet LEARN FLOW – STEP TWO • Take the Pre-Simulation Quiz ◦ Student may take several times using the answer key to provide immediate remediation prior to the virtual simulation. Quiz is recorded as complete. LEARN FLOW – STEP THREE • Launch the virtual simulation ◦ Suggest student complete the vSim Tutorial prior to launching Step Three. ◦ Each clinical experience in the simulation lasts a maximum of 30 minutes. ◦ Student is to complete the simulation as many times as it takes to meet an 80% benchmark. LEARN FLOW – STEP FOUR • Complete the Post-Quiz ◦ The answer key is not visible to the student until after they have submitted the quiz. ◦ The quiz grade is recorded as a percentage LEARN FLOW – STEP FIVE • Document ◦ The student documents the clinical events that occurred during the simulation using the information contained in step five. ◦ If using DocuCare, the instructor assigns the same vSim patient which can be found in DocuCare cases. LEARN FLOW – STEP SIX • Reflection Questions ◦ Students are to complete the reflection questions and submit to instructor post clinical replacement (see syllabus for details). ◦ The quiz grade is recorded as a percentage This activity creates an opportunity for you to organize the nursing care required for the patient care presented in your assigned vSim. STUDENT LEARNING OUTCOMES At the end of this activity, student will be able to: 1. Describe pathological events associated with the patient’s disease process or condition. 2. Create a plan of care and prioritized nursing interventions based on patient care needs. 3. Identify anticipated diagnostic and physical assessment findings related to the identified condition or disease process. ASSIGNMENT 1. Log into thePoint and launch the assigned vSim, following all instructions posted on your learning management system (LMS). 2. Review the information contained in the patient information. 3. Review the smart sense links associated with Nursing Care, Diagnostics, and Pharmacology found in the suggested reading area. 4. Create the following “concept map”. List the pathophysiology associated with the patient’s disease process or condition, the anticipated physical assessment findings, vital signs, diagnostics, specific nursing interventions, and other patient information associated with the patient situation. 5. Utilize the smart sense links throughout the vSim to complete the worksheet. 6. Submit your concept map for review. CONCEPT MAP WORKSHEET DESCRIBE MENTAL HEALTH DISORDER AFFECTING PATIENT (Include Neurobiology of Disorder) Schizophrenia is a long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behavior, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation. Dopaminergic, glutamatergic and GABAergic neurotransmitter systems are affected in schizophrenia and interactions between these receptors contribute to the pathophysiology of the disease. 2 INEFFECTIVE THERAPEUTIC COMMUNICATION TECHNIQUES PATIENT HISTORY (LEGAL, ASSAULT HX, ILLICIT DRUG ANTICIPATED COGNITIVE/BEHAVIORAL • Telling the pt. that he/she is sick and needs help. • False reassurance. • Making promises you can not fullfil. • David Carter • 28 Year old • Male • 10 yr history of schizophrenia • Active hallucinations and delusions. • Smoker 1 pack/day • Use of marijuana less than onceper day. • Patients with schizophrenia can display S&S diffently. They can have motor disturbances before exposure to antipsychotic agents. • It has been associated with left and mixed handedness, minor physical anomalies, and neurologic signs. • Extrapyramidal effects. ANTICIPATED NURSING INTERVENTIONS (NON- PHARMACOLOGICAL INTERVENTIONS, SAFETY, AND CLIENT EDUCATION - NO LESS THAN 2 FOR EACH CATEGORY) • EVALUATE THE PATIENT'S ABILITY TO CARRY OUT ACTIVITIES OF DAILY LIVING. • PROVIDE ASSISTANCE AS NECESSARY, ENCOURAGE THE PATIENT TO PARTICIPATE IN CARE AS MUCH AS POSSIBLE; IF NECESSARY, BREAK DOWN TASKS INTO SIMPLE STEPS THAT THE PATIENT CAN COMPLETE; AVOID PROMOTING DEPENDENCE. • MAINTAIN A SAFE ENVIRONMENT, MINIMIZING STIMULI. INSTITUTE SUICIDE PRECAUTIONS AND DEVELOP A SAFETY PLAN WITH THE PATIENT THAT INCLUDES A LIST OF APPROPRIATE COPING STRATEGIES AND SOURCES OF SUPPORT. • REMOVE ALL POTENTIALLY HARMFUL ITEMS FROM THE PATIENT'S ENVIRONMENT; OBSERVE FOR CHANGES IN BEHAVIOR THAT MAY SIGNAL AN INCREASING RISK FOR VIOLENCE, SUCH AS IRRITABILITY, INTIMIDATING BEHAVIOR, MOTOR RESTLESSNESS, LOUD SPEECH, OR OVERT THREATS. IMPLEMENT THE LEAST-RESTRICTIVE ENVIRONMENT FOR THE PATIENT. • OFFER SIMPLE AND MATTER-OF-FACT EXPLANATIONS FOR ENVIRONMENTAL SAFEGUARDS, DRUGS, AND POLICIES. • BUILD TRUST; BE HONEST AND DEPENDABLE. DON'T THREATEN, AND DON'T PROMISE WHAT YOU CAN'T FULFILL. This ISBAR activity assists you in building the skill of communicating pertinent information when caring for a patient. Appropriate actions you should do to complete this activity include finding appropriate data to provide a thorough ISBAR report. STUDENT LEARNING OUTCOMES At the end of this activity, student will be able to: 1. Identify pertinent data from the patient information area of the vSim suggested reading section. 2. Communicate pertinent information for a patient using ISBAR. ASSIGNMENT 1. Log into thePoint and launch the assigned vSim, following all instructions posted on your learning management system (LMS). 2. Review the information contained in the patient information area of the suggested reading section. 3. Review the smart sense links found within the Nursing Care, Diagnostics and Pharmacology areas of the suggested reading. 4. Navigate and fill out the data in the following document using the patient information provided in the suggested reading area. 5. Submit for review. VSIM ISBAR ACTIVITY Student Worksheet INTRODUCTION • Grace Uwamahoro RN. • Working on the Locked Mental Health Unit. Your name, position (RN), unit you are working on SITUATION - David Carter, a 28-year-old male. He was admitted today after he became violent with his mother and threw a table at her when she asked him to take his medications. Patient’s name, age, specific reason for visit BACKGROUND • Primary Diagnosis: Schizophrenia - DOA: 01/21/2021 • Orders: Olanzepine 10 mg PO, Venlafaxine 75 mg PO daily, Lorazepam 2 mg PO q 8 hrs, Haloperidol 5 mg PO q 8 hrs, Acetaminophen 650 mg PO q 8 hrs PRN for pain, mental status exam assessment Patient’s primary diagnosis, date of admission, current orders for patient ASSESSMENT • The patient is disheveled and pulled back. He is sitting down and mumbling about someone listening to his thoughts. • He is anxious and his eyes depressed. Since he has auditory hallucinations, he is having a hard time focusing on the discussion being had. He is anxious yet his movements are coordinated. There are no signs of tics or tremors or irregular movements. • Vitals are stable. Current pertinent assessment data using head-to-toe approach, pertinent diagnostics, vital signs. RECOMMENDATION • I would recommend that the patient be observed and ensure that he eats and takes his medications. • Also to be one-on-one supervison to prevent self harm and to others even though he denies any thoughts of SI and HI. Any orders or recommendations you may have for this patient This activity provides you with the opportunity to create pertinent patient education on the pharmacological agents associated with the vSim activity. You will utilize this worksheet for each drug listed under the pharmacology area of the suggested reading section. STUDENT LEARNING OUTCOMES At the end of this activity, student will be able to: 1. Explain purpose for taking the identified pharmacological agents. 2. Discuss pertinent patient education related to all the listed pharmacological agent. ASSIGNMENT 1. Log into thePoint and launch the assigned vSim, following all instructions posted on your Learning Management System (LMS). 2. Review the information contained in the patient information. 3. Review the smart sense links associated with the Pharmacological agents found in the suggested reading area. 4. Use the smart sense link to complete the following “patient education” worksheet for each pharmacological agent listed in the Pharmacology are of the suggested reading section. 5. Submit for review.. PATIENT EDUCATION WORKSHEET NAME OF MEDICATION, CLASSIFICATION AND INCLUDE PROTOTYPE MEDICATION: LORAZEPAM. CLASSIFICATION: BENZODIAZEPINES PROTOTYPE: LORAZEPAM SAFE DOSE OR DOSE RANGE, SAFE ROUTE Anxiety: Adults: 2 to 6 mg PO daily in divided doses, with the largest dose taken before bedtime. Maximum, 10 mg daily. Elderly patients: 1 to 2 mg PO daily in divided doses. Maximum, 10 mg daily. Preoperative sedation: Adults: 2 mg IV total or 0.044 mg/kg IV, whichever is smaller, 15 to 20 minutes before the anticipated operative procedure. Larger doses up to 0.05 mg/kg IV, to total of 4 mg, may be needed. Or, 0.05 mg/kg IM 2 hours before procedure. Total dose shouldn’t exceed 4 mg. Status epilepticus: Adults: 4 mg IV at a rate of 2 mg/minute. If seizures continue or recur after 10 to PURPOSE FOR TAKING THIS MEDICATION • Anesthetic adjuncts. • Antianxiety agents. • Sedative/hypnotics. PATIENT EDUCATION WHILE TAKING THIS MEDICATION