vSim for Nursing | Pharmacology Scenario 5: Mary Richards Pharmacology Scenario 5: Mary Richards

Scenario Overview Patient: Mary Richards Brief Summary: This scenario presents an 82-year-old African American female with heart failure who was admitted to the hospital with weakness, dizziness, and nausea. Ms. Richards have been admitted to the cardiology unit from the emergency department where you are her nurse. Learning Objectives General: □ Identify the pharmacotherapeutics of the drug regimen □ Evaluate the appropriateness of the medication order for the particular patient (e.g., contraindications, lab results, physical assessment data, allergies, potential interactions, drug history, and medication reconciliation) □ Calculate the medication dosages as appropriate □ Administer medications, ensuring safety in the pharmacological process and applying rights of medication administration □ Evaluate the patient response to medication (e.g., therapeutic effects, side effects, and adverse reactions) □ Provide appropriate patient-centered patient education on medications (at the appropriate level, including side effects, interactions, etc.) Patient Case Cardiology unit Time: 2200 SBAR report from ED nurse: Situation: I took care of Ms. Richards in the emergency department and I would like to give you a report on her. Ms. Richards is an 82-year-old African American female who was brought to the emergency department by her son this evening when he found her confused and complaining of trouble with her vision. Ms. Richards has been ill for several days with complaints of nausea, dizziness, and weakness. 1 Background: Ms. Richards has a history of hypertension, diagnosed 40 years ago, and heart failure, diagnosed 30 years ago. Her current medications include furosemide, amlodipine, and digoxin. Assessment: Ms. Richards is complaining of slight abdominal pain and nausea. She has not vomited. Her last set of vitals are: temperature: 37.1°C (98.7°F), pulse: 58/min, respirations: 22/min, blood pressure: 96/54 mmHg, and an SpO2 of 96% on room air. She has an IV of lactated Ringer’s infusing at 100 mL/hr through a 20-gauge IV catheter in her right arm. A blood sample has been drawn for evaluation of her digoxin level. Recommendation: Ms. Richards is being admitted for observation and is due for a vital signs check. Lab results just came back and should be reviewed. Please notify the provider about the results. Patient Details Name: Mary Richards Gender: Female Age: 82 years Weight: 88 kg (194 lb) Height: 170 cm (67 in.) Race: African American Religion: Baptist Next of Kin: Son (Kevin Richards) Allergies: No known allergies Immunizations: Up to date Primary Medical Diagnosis □ Heart failure History of Chief Concern □ Ms. Richards has been ill for several days with complaints of nausea, dizziness, and weakness. □ This evening her son found her confused and complaining of vision problems so he brought her to the hospital. Past Medical History □ History of hypertension diagnosed 40 years ago and heart failure diagnosed 30 years ago. Currently treated with furosemide 20 mg orally 1 time daily, amlodipine 5 mg orally 1 time daily, and digoxin 0.25 mg orally 1 time daily. □ No previous surgeries Social History □ Widowed 10 years ago and lives alone □ Retired mail carrier © Laerdal Medical