Scenario: Kai Sugamoto: Care of a Client with Diabetic Ketoacidosis
Student Pre-Simulation Guide
PURPOSE:
The purpose of this document is to provide an overview of the simulation-based education (SBE) activity
aligned with the course and guide your preparation activities. This document will review the required
foundational concepts related to pathophysiology, management of the disease process, and the clinical skills
that learners will be expected to apply during the scenario.
SCENARIO OVERVIEW:
Kai Sugamoto is a 40-year-old male directly admitted to the Intensive Care Unit from the healthcare
provider’s office with a diagnosis of diabetic ketoacidosis. The client was diagnosed with type 1 diabetes
mellitus 1 year ago. The scenario takes place at 0900 with nurse to nurse handoff report.
SCENARIO RUN TIME: 45 minutes
MAPPING OF LEARNING OBJECTIVES:
Didactic Course Objectives MET UNMET
1. Implement safe and effective nursing care to adults and older adults ☒ ☐
experiencing complex health alterations to achieve desired patient,
systems, and population outcomes.
2. Defend the choice of nursing therapeutics based on the best available ☐ ☒
evidence to achieve patient systems, and population outcomes.
3. Revise the plan of care based on biopsychosocial assessment data to ☒ ☐
achieve desired patient and population outcomes.
4. Prioritize nursing actions across patients based on aggregate ☒ ☐
biopsychosocial assessment data.
5. Lead the development of the interprofessional plan of care. ☐ ☒
6. Defend decisions from a cost-effectiveness perspective. ☐ ☒
Lab Course Objectives MET UNMET
1. Provide safe, effective evidence-based care to a group of adult and ☒ ☐
older adult patients to achieve desired patient, systems, and population
outcomes.
2. Administer prescribed therapeutics safely, effectively, and cost ☒ ☐
effectively.
3. Transition patients safely to other levels of care to achieve quality and ☐ ☒
cost system and population outcomes.
4. Gather and report nursing sensitive patient and population data to ☒ ☐
improve outcomes.
5. Manage self in a manner that promotes patient safety and quality of ☐ ☒
, care.
6. Establish a therapeutic relationship with patients. ☐ ☒
Scenario Learning Objectives
1. Correlate assessment findings and diagnostic lab data with the pathophysiology of the disease
process.
2. Prioritize nursing interventions in the plan of care for a client with DKA.
3. Evaluate the effectiveness of interventions for DKA and modify the plan of care as appropriate.
4. Correctly calculate intravenous insulin dosage and safely administer medication according to
the Six Rights.
5. Interpret diagnostic lab data and report abnormal findings to the healthcare provider in a timely
manner using SBAR.
6. Utilize the electronic health record to accurately document assessments, interventions, and
evaluations.
7. Provide developmentally appropriate client education on the rationale for interventions
performed as part of the plan of care.
LEARNER ROLES DURING THE SIMULATION-BASED ACTIVITY
The facilitator of the SBE activity will ensure that each learner is assigned to a specific nursing role. While
each of the roles represent a component of the responsibilities of a nurse providing client care, it is important
that learners function as a nursing team to successfully complete the SBE activity. This may require
delegation and/or learners to assume responsibilities aligned with other roles. The learner roles for this
scenario are as follows:
Charge Nurse
The charge nurse is the team leader, ensuring the client receives safe, organized, high-quality care. The
learner fulfilling this role may delegate duties to members of the nursing team as appropriate. The charge
nurse will be the primary point person for communicating with members of the interdisciplinary team to
coordinate client care. This role requires the learner to keep members of the nursing team updated with
changes in client status, healthcare provider updates, and new information learned throughout the scenario.
Additionally, this role will support the primary nurse with the implementation of orders as needed.
Primary Nurse
The primary nurse is fundamentally responsible for maintaining effective communication with the client
and/or family member(s). The learner fulfilling this role will obtain the client’s health history, perform
initial comprehensive or focused physical assessments and follow-up reassessments, and implement non-
medication interventions included in the plan of care. The primary nurse will purposefully observe the client
for any changes in status. Additionally, the primary nurse will provide all clients and family members with
education, with the exception of medication administration.
Medication Nurse
The medication nurse is accountable for performing all aspects of medication administration and
documentation. The learner fulfilling this role will ensure all medications are administered according to the
Rights of Medication Administration and clarify related orders with the healthcare provider. The medication
nurse will provide client education on the actions, expected effects, required monitoring, and adverse
reactions for each medication administered during the simulation-based activity. Additionally, the
Student Pre-Simulation Guide
PURPOSE:
The purpose of this document is to provide an overview of the simulation-based education (SBE) activity
aligned with the course and guide your preparation activities. This document will review the required
foundational concepts related to pathophysiology, management of the disease process, and the clinical skills
that learners will be expected to apply during the scenario.
SCENARIO OVERVIEW:
Kai Sugamoto is a 40-year-old male directly admitted to the Intensive Care Unit from the healthcare
provider’s office with a diagnosis of diabetic ketoacidosis. The client was diagnosed with type 1 diabetes
mellitus 1 year ago. The scenario takes place at 0900 with nurse to nurse handoff report.
SCENARIO RUN TIME: 45 minutes
MAPPING OF LEARNING OBJECTIVES:
Didactic Course Objectives MET UNMET
1. Implement safe and effective nursing care to adults and older adults ☒ ☐
experiencing complex health alterations to achieve desired patient,
systems, and population outcomes.
2. Defend the choice of nursing therapeutics based on the best available ☐ ☒
evidence to achieve patient systems, and population outcomes.
3. Revise the plan of care based on biopsychosocial assessment data to ☒ ☐
achieve desired patient and population outcomes.
4. Prioritize nursing actions across patients based on aggregate ☒ ☐
biopsychosocial assessment data.
5. Lead the development of the interprofessional plan of care. ☐ ☒
6. Defend decisions from a cost-effectiveness perspective. ☐ ☒
Lab Course Objectives MET UNMET
1. Provide safe, effective evidence-based care to a group of adult and ☒ ☐
older adult patients to achieve desired patient, systems, and population
outcomes.
2. Administer prescribed therapeutics safely, effectively, and cost ☒ ☐
effectively.
3. Transition patients safely to other levels of care to achieve quality and ☐ ☒
cost system and population outcomes.
4. Gather and report nursing sensitive patient and population data to ☒ ☐
improve outcomes.
5. Manage self in a manner that promotes patient safety and quality of ☐ ☒
, care.
6. Establish a therapeutic relationship with patients. ☐ ☒
Scenario Learning Objectives
1. Correlate assessment findings and diagnostic lab data with the pathophysiology of the disease
process.
2. Prioritize nursing interventions in the plan of care for a client with DKA.
3. Evaluate the effectiveness of interventions for DKA and modify the plan of care as appropriate.
4. Correctly calculate intravenous insulin dosage and safely administer medication according to
the Six Rights.
5. Interpret diagnostic lab data and report abnormal findings to the healthcare provider in a timely
manner using SBAR.
6. Utilize the electronic health record to accurately document assessments, interventions, and
evaluations.
7. Provide developmentally appropriate client education on the rationale for interventions
performed as part of the plan of care.
LEARNER ROLES DURING THE SIMULATION-BASED ACTIVITY
The facilitator of the SBE activity will ensure that each learner is assigned to a specific nursing role. While
each of the roles represent a component of the responsibilities of a nurse providing client care, it is important
that learners function as a nursing team to successfully complete the SBE activity. This may require
delegation and/or learners to assume responsibilities aligned with other roles. The learner roles for this
scenario are as follows:
Charge Nurse
The charge nurse is the team leader, ensuring the client receives safe, organized, high-quality care. The
learner fulfilling this role may delegate duties to members of the nursing team as appropriate. The charge
nurse will be the primary point person for communicating with members of the interdisciplinary team to
coordinate client care. This role requires the learner to keep members of the nursing team updated with
changes in client status, healthcare provider updates, and new information learned throughout the scenario.
Additionally, this role will support the primary nurse with the implementation of orders as needed.
Primary Nurse
The primary nurse is fundamentally responsible for maintaining effective communication with the client
and/or family member(s). The learner fulfilling this role will obtain the client’s health history, perform
initial comprehensive or focused physical assessments and follow-up reassessments, and implement non-
medication interventions included in the plan of care. The primary nurse will purposefully observe the client
for any changes in status. Additionally, the primary nurse will provide all clients and family members with
education, with the exception of medication administration.
Medication Nurse
The medication nurse is accountable for performing all aspects of medication administration and
documentation. The learner fulfilling this role will ensure all medications are administered according to the
Rights of Medication Administration and clarify related orders with the healthcare provider. The medication
nurse will provide client education on the actions, expected effects, required monitoring, and adverse
reactions for each medication administered during the simulation-based activity. Additionally, the
