Case Details — Critical Care
Case Title Linked To Description/Overview Case Objectives/Student Skills & Body Systems Nursing Diagnosis Admitting Gender Age (yrs.) Height Weight Learning Objectives
Competencies Diagnosis (in.) (lbs.)
Critical Care: Abdominal Goldsworthy, Sandra, and In this scenario, a 69-year-old female Objective: Demonstrate care of critical patient, Cardiovascular Ineffective peripheral Aneurysm, female 69 63 154 The student will be able to
Aortic Aneurysm Repair, Leslie Graham. Simulation is admitted to the critical care unit document, and use SBAR. tissue perfusion abdominal demonstrate the principles of
Laura Lewis Simplified: A Practical after undergoing an abdominal aortic Respiratory aortic accurate documentation.
Handbook for Nurse aneurysm repair. Laura Lewis is Postop, CVP, art line, PA catheter, wedge
Educators. intubated and ventilated, receiving pressures, cardiac monitoring and ECG, absent Peripheral vascular Acute pain The student will be able to
propofol via side port of PA catheter. distal pulses, A-fib, vent, enteral feeds, blood demonstrate the ability to do
As she emerges from the anesthetic, cultures, delirium care. a sample communication with
Laura Lewis becomes hypertensive. physician.
The nurse will initiate interventions Meds: dopamine, proprofol, nitro, SQ, heparin,
such as a vasodilator infusion, IVF, IVPB
analgesia, sedation and active
warming strategies to control the Diagnostics: chem, hematology, coag, cardiac,
Laura Lewis' BP. During the post ABG
operative assessment, the nurse is
unable to palpate distal pulses and
uses the Doppler to assess.
Critical Care: Acute Goldsworthy, Sandra, and In this scenario, an 88-year-old male Objectives: Demonstrate care and Respiratory Ineffective airway Respiratory male 88 72 190 The student will be able to
Respiratory Distress Leslie Graham. Simulation is admitted to the medical floor and documentation of worsening respiratory failure clearance distress demonstrate the ability to do
Syndrome, Phillip Simplified: A Practical then transferred to the intensive care and vent patient. Cardiovascular syndrome, the patient requiring mechani
Townsend Handbook for Nurse unit for acute respiratory distress. Ineffective breathing acute ventilation.
Educators. ABG’s (rsp. acidosis), ARDS, vent/vent settings, pattern
abnormal breath sounds, hemodynamics, The student will be able to
cardiac monitor tracing/rhythm analysis (ECG), Activity intolerance demonstrate the ability to do
arterial pressure monitoring. signs and symptoms of worse
Disturbed personal respiratory failure.
Meds: albuterol, atrovent, prednisone identity
Diagnostics: CBC, ABG, CXR
Critical Care: Closed Head Goldsworthy, Sandra, and In this scenario, a 22-year-old male is Objectives: Document admission note and Neurological Decreased intracranial Closed head male 22 72 245 The student will be able to do
Injury, Martin Neylander Leslie Graham. Simulation admitted after a motor vehicle recognize deterioration. adaptive capacity injury an event such as a change in c
Simplified: A Practical accident. The patient is intubated and Cardiovascular rhythm or a hypotensive even
Handbook for Nurse ventilated with a Glasgow coma scale Acute deterioration, ICP (increased), cardiac
Educators. of 8. The patient's rhythm monitor and ECG, CVP, arterial pressures, Respiratory The student will be able to
deteriorates with a hypotensive arrhythmias, GCS, enteral feeding, vent, type demonstrate the ability to do
response. With quick assessment and and cross match, Foley, CT (head), blood an admission note.
intervention, the cultures, seizure precautions.
patient stabilizes with a temporary
transcutaneous pacemaker. Meds: voluven, dopamine, SQ heparin, dilantin,
propofol, cefazolin, fentanyl
Diagnostics: chem, hematology, ABG, drug
screen, EKG, CXR
Critical Care: Drug Goldsworthy, Sandra, and In this scenario, an 18-year-old Objectives: Recognize and document S/S of Neurological Ineffective airway Drug female 18 65 125 The student will be able to do
Overdose, Emily Jackson Leslie Graham. Simulation female college student is admitted intentional OD. Monitor cardiac rhythym. clearance overdose the signs and symptoms of an
,Critical Care: Hypovolemic Goldsworthy, Sandra, and In this scenario, a 38-year-old female Objectives: recognize S/S of hypovolemic shock Cardiovascular Fluid volume deficit Shock, female 38 63 155 The student will be able to
Shock, Elise Chu Leslie Graham. Simulation postpartum patient begins to as well as recognize and document a hypovolemic demonstrate the ability to do
Simplified: A Practical hemorrhage large amounts of vaginal transfusion reaction Respiratory Fatigue a blood administration and ca
Handbook for Nurse sanguineous drainage. Suddenly, she arrest.
Educators. loses consciousness and a code is Hypovolemic shock, cardiac monitoring & ECG, Peripheral vascular
called. ventricular tachycardia, art line, NPO, The student will be able to
transfusion reaction, O2 Urinary demonstrate the ability to do
recognition and treatment of
Meds: dopamine, morphine sulfate, midazolam transfusion reactions.
hydrochloride
Diagnostics: Chem, hematology, CXR
Critical Care: Liver Failure, Goldsworthy, Sandra, and In this scenario, a 54-year-old male Objectives: Recognize and document S/S of Gastrointestinal Confusion Hepatic male 54 68 225 The student will be able to do
Daniel Adams Leslie Graham. Simulation patient is admitted to the intensive worsening liver failure. Communicate in family encephalop the signs and symptoms of wo
Simplified: A Practical care unit with an acute exacerbation conference. Cardiovascular Chronic low self- athy liver failure.
Handbook for Nurse of chronic liver disease. esteem
Educators. Liver failure, hemodynamic monitoring, cardiac Neurological The student will be able to
monitoring & ECG, CVC, hepatic Imbalanced nutrition demonstrate documentation
encephalopathy/GCS changes, cardiac rhythm less than body supporting the patient’s famil
interpretation, liver biopsy/MRI of liver, lab requirements bedside and during the family
analysis. conference.
Meds: Dopmine, morphine, albumin, lactulose,
Zantac, methylprednisone, vit. B12, folic acid.
Diagnostics: electrolytes, liver panel, CBC, CXR
Critical Care: Myocardial Goldsworthy, Sandra, and In this scenario, a 51-year-old male Objectives: Care for patient experiencing chest Cardiovascular Acute pain Myocardial male 51 72 250 The student will be able to do
Infarction, Colin Hawkins Leslie Graham. Simulation patient of Dr. Swan arrived to the pain. Recognize and document arrhythmia. infarction the cardiac patient experienci
Simplified: A Practical emergency room with chest pain. He Decreased cardiac pain.
Handbook for Nurse was diagnosed with rule out of MI interventions, cardiac monitoring & ECG, output
Educators. myocardial infarction. strip analysis, art line and pressure monitoring, The student will be able to
vasoactive drips. Impaired tissue demonstrate the ability to do
perfusion arrhythmias.
Meds: morphine sulfate, dopamine, nitro, ASA,
metoprolol, lovenox, Lipitor.
Diagnostics: Chem, hematology, trop, INR, CXR
Critical Care: Renal Failure, Goldsworthy, Sandra, and In this scenario, a 65-year-old male is Objectives: Review and report lab results. Cardiovascular Fluid volume excess Coronary male 65 69 130 The student will be able to do
Anthony Liu Leslie Graham. Simulation two days post quadruple bypass Receive, transcribe and document verbal order. artery patient safety when receiving
Simplified: A Practical surgery. He develops renal failure Renal Risk for electrolyte disease transcribing and enacting a ph
Handbook for Nurse (hyperkalemia, oliguria, and Abnormal lab interpretation and reporting imbalance or other practitioner’s order.
Educators. peripheral edema) precipitating (elevated K+), cardiac monitoring, central Respiratory
unstable ventricular tachycardia. The venous pressure monitoring, art line, O2 The student will be able to
nurse prepares for immediate cardioversion, SBAR, verbal order and order Endocrine demonstrate the ability to do
cardioversion. The physician arrives entry, consults, BS checks, IVF. safe communication practices
to cardiovert patient successfully to a receiving a verbal order or tel
sinus rhythm. Meds: insulin, Tylenol, fentanyl, morphine, lasix order.
IV, heparin SQ.
,Critical Care: Septic Shock, Goldsworthy, Sandra, and In this scenario, a 46-year-old male Objectives: Recognize and document S/S of Cardiovascular Risk for infection Shock, septic male 46 78 310 The student will be able to do
John French Leslie Graham. Simulation patient is admitted to the intensive septic shock. Vasoactive drip titration, analyze the signs and symptoms of se
Simplified: A Practical care unit following a colonoscopy and hemodynamic profile. Respiratory shock.
Handbook for Nurse subsequent large bowel perforation.
Educators. Vasoactive drips, cardiac monitoring, GU The student will be able to
hemodynamic monitoring, art line, ABG demonstrate ability to docum
interpretation (metabolic acidosis), cardiac interventions (i.e., vasoactive
rhythm analysis, Foley, JP drains. calculation and titration).
Meds: dopamine, heparin SQ, ceftazadime,
hydrocortisone.
Diagnostics: ECG, CXR, cortisol, Chem,
hematology
Critical Care: Trauma, Vijay Goldsworthy, Sandra, and In this scenario, a 24-year-old male Objectives: recognize and document Respiratory Impaired gas exchange Fracture, male 24 71 235 The student will be able to do
Surendra Leslie Graham. Simulation becomes short of breath and restless respiratory distress. Document vent settings. arm or leg a primary survey in the nurse’
Simplified: A Practical while his SaO2 level drops the day Musculoskeletal Acute pain as a narrative note.
Handbook for Nurse after admission to the ICU as a Pulmonary contusions, chest tubes, trauma,
Educators. multisystem trauma patient post-ORIF femur, Hemovac, emergency Peripheral vascular The student will be able to
(fractured left ribs, left radius/ulna, intubation-vent, pain management (PCA), ABG demonstrate the ability to do
and left femur). The patient requires interpretation, VAP care bundle, cardiac patient in respiratory distress
intubation and mechanical monitoring & ECG, CVP, art line, transfusion,
ventilation. delirium management, blood culture.
Meds: Cefazolin, heparin SQ, Zantac IV,
morphine prn, dopamine prn
Diagnostics: CXR
All Materials Copyright ©2013 by Lippincott Williams & Wilkins. All Rights Reserved.
, Case Details — Fundamentals
Case Title Linked To Description/Overview Case Objectives/Student Skills & Body Systems Nursing Diagnosis Admitting Gender Age (yrs.) Height Weight Learning Objectives Suggested Readings
Competencies Diagnosis (in.) (lbs.)
Fundamentals: Taylor, Carol. Fundamentals Molly, a 38-year-old woman who is Objectives: Assess and document abnormal Mental Health Anxiety Dysmenorr female 38 65 143 The student will be able to Taylor, C., Lillis, C, & Lynn, P. (2015). Perioperative Nursing.
Abnormal/Unexpected of Nursing: The Art and scheduled for a vaginal hysterectomy findings. Prepare patient psychologically. Notify hea demonstrate documenting head-to- Fundamentals of nursing: the art and science of patient-
Findings Requiring Science of Nursing Care later in the day, arrives at the hospital provider. Ineffective coping toe assessment. centered nursing care (8th ed., pp. 852-897). Philadelphia, Pa.:
Notification of Provider, at 6:30 a.m. With tears in her eyes Wolters Kluwer.
Dysmenorrhea: Molly and wringing her hands, she states: "I Orders: IV insertion, IVF @75mL/hr The student will be able to
Greenbaum really didn't sleep very much last demonstrate documenting vital signs.
night. I kept thinking about the Diagnostics: CBC
surgery." The student will prepare the patient
Use case for pre-op patient with anxiety and physically and psychologically for
interventions needed. surgery.
Abnormal assessment findings are under
mental health: anxiety related to surgery. VS
WNL.
Fundamentals: Abdominal Taylor, Carol. Fundamentals Martin, a 46-year-old male, comes to Objectives: Assess and document abnormal GI Constipation Diverticula Male 46 67 175 The student will be able to Taylor, C., Lillis, C., & Lynn, P. (2015). Diagnosing.
Physical Assessment: of Nursing: The Art and the health clinic for a routine physical findings. Analyze data and report to physician. r disease demonstrate documenting focused Fundamentals of nursing: the art and science of patient-
Martin Prescott Science of Nursing Care exam. During assessment, he states Knowledge deficit abdominal assessment. centered nursing care (8th ed., pp. 253-274). Philadelphia, Pa.:
"I've had problems with constipation Orders: Fecal occult blood test Wolters Kluwer.
and have seen some blood when I The student will be able to
wipe myself after a bowel movement. demonstrate documenting a nurse’s
It's just hemorroids right? Nothing to note for an event regarding Martin’s
worry about?" report of bright red blood in his stool.
The student will analyze laboratory
data.
Fundamentals: Taylor, Carol. Fundamentals James, a 62-year-old man is admitted Objectives: Assess and document abnormal GI Excess fluid volume Cirrhosis Male 62 68 165 The student will be able to Taylor, C., Lillis, C., & Lynn, P. (2015). Implementing.
Abnormal/Unexpected of Nursing: The Art and to the ICU in hepatic failure. He is findings. Notify provider. demonstrate documenting a head-to- Fundamentals of nursing: the art and science of patient-
Findings Requiring Science of Nursing Care critcally ill, being monitored Risk for injury toe assessment. centered nursing care (8th ed., pp. 302-319). Philadelphia, Pa.:
Notification of Provider: continuously, and receving IV fluids Assess and adjust IV lines to improve safety Wolters Kluwer.
James McMahon and meds via central and peripheral The student will be able to
IV catheters. The student enters the Orders: Blood transfusion, seizure demonstrate documenting vital signs.
room and finds several IV infusion management, NPO, PICC
lines and numerous technological The student will demonstrate
devices for monitoring. The nurse MAR: spironlactone, potassium chloride IVPB, improved patient safety.
asks the student to hang the new IV
medication. The student will implement care that
integrates intellectual, interpersonal,
and ethical/legal competencies.
Fundamentals: Taylor, Carol. Fundamentals Doretha brings her husband, Max, a Objectives: Assess and document abnormal Cardiovascular Decreased cardiac Hypertensi male 65 73 245 The student will be able to Taylor, C., Lillis, C., & Lynn, P. (2015). Teacher and Counselor &
Abnormal/Unexpected of Nursing: The Art and 65-year-old male with high blood findings. Notify provider. Patient education output on demonstrate documenting head-to- Vital Signs. Fundamentals of nursing: the art and science of
Findings Requiring Science of Nursing Care pressure to the clinic for evaluation. toe assessment. patient-centered nursing care (8th ed., pp. 478-505 & 578-
Notification of Provider, He is 5'10" and overweight. Presents Orders/MAR: Furosemide, enalaprilat Knowledge deficit 623). Philadelphia, Pa.: Wolters Kluwer.
Max Renfrow today with continuing times of feeling The student will notify the provider
tired and at times when standing up
becomes dizzy. Mrs. Renfrow states, The student will be able to
"I'd really would like to learn how to demonstrate documenting vital signs.
take my husband's blood pressure so
that I can keep track of his progress.
Can you teach me how to do it?"
Fundamentals: Taylor, Carol. Fundamentals Mildred, a 65-year-old woman with a Objectives: Demonstrate and document GI Chronic pain Appendici female 65 65 170 The student will be able to verify the Taylor, C., Lillis, C., & Lynn, P. (2015). Medications.
Administering Oral of Nursing: The Art and history of arthritis and hypertension medication administration and teaching. tis physician order for oral medication Fundamentals of nursing: the art and science of patient-
Medications: Mildred Science of Nursing Care (high blood pressure), admitted for Cardiovascular Knowledge deficit administration. centered nursing care (8th ed., pp. 750-851). Philadelphia, Pa.:
Campbell evaluation of her painful joints. She Orders/MAR: metoprolol, enalapril, Wolters Kluwer.
states, "I just saw this new medicine furosemide, celecoxib, percocet The student will be able to
advertised on television that is demonstrate the administration of
supposed to be really helpful in Med reconciliation oral medications using the rights of
relieving joint pain. What do you medication administration.
think? Is it something I should try?"
Fundamentals: Wound Taylor, Carol. Fundamentals Millie, a 44-year-old woman, Objectives: Complete wound care per orders. Integumentary Impaired skin integrity Wound female 44 64 183 The student will be able describe theTaylor, C., Lillis, C., & Lynn, P. (2015). Documenting, Reporting,
Care: Millie DeLong of Nursing: The Art and develops a wound infection following Document wound care appropriately. infection principles of documentation. Conferring, and Using Informatics. Fundamentals of nursing:
Science of Nursing Care Laparatomy abdominal surgery. Temp Communicate to provider. the art and science of patient-centered nursing care (8th ed.,
101. Wound care with normal saline The student will be able to document pp. 338-369). Philadelphia, Pa.: Wolters Kluwer.
irrigations is ordered 4 times a day. Orders: Wound irrigation with NS QID, contact nursing interventions and
precautions, Wound/ostomy nurse consult assessments according to
documentation principles.
Diagnostics:CBC, micro
Case Title Linked To Description/Overview Case Objectives/Student Skills & Body Systems Nursing Diagnosis Admitting Gender Age (yrs.) Height Weight Learning Objectives
Competencies Diagnosis (in.) (lbs.)
Critical Care: Abdominal Goldsworthy, Sandra, and In this scenario, a 69-year-old female Objective: Demonstrate care of critical patient, Cardiovascular Ineffective peripheral Aneurysm, female 69 63 154 The student will be able to
Aortic Aneurysm Repair, Leslie Graham. Simulation is admitted to the critical care unit document, and use SBAR. tissue perfusion abdominal demonstrate the principles of
Laura Lewis Simplified: A Practical after undergoing an abdominal aortic Respiratory aortic accurate documentation.
Handbook for Nurse aneurysm repair. Laura Lewis is Postop, CVP, art line, PA catheter, wedge
Educators. intubated and ventilated, receiving pressures, cardiac monitoring and ECG, absent Peripheral vascular Acute pain The student will be able to
propofol via side port of PA catheter. distal pulses, A-fib, vent, enteral feeds, blood demonstrate the ability to do
As she emerges from the anesthetic, cultures, delirium care. a sample communication with
Laura Lewis becomes hypertensive. physician.
The nurse will initiate interventions Meds: dopamine, proprofol, nitro, SQ, heparin,
such as a vasodilator infusion, IVF, IVPB
analgesia, sedation and active
warming strategies to control the Diagnostics: chem, hematology, coag, cardiac,
Laura Lewis' BP. During the post ABG
operative assessment, the nurse is
unable to palpate distal pulses and
uses the Doppler to assess.
Critical Care: Acute Goldsworthy, Sandra, and In this scenario, an 88-year-old male Objectives: Demonstrate care and Respiratory Ineffective airway Respiratory male 88 72 190 The student will be able to
Respiratory Distress Leslie Graham. Simulation is admitted to the medical floor and documentation of worsening respiratory failure clearance distress demonstrate the ability to do
Syndrome, Phillip Simplified: A Practical then transferred to the intensive care and vent patient. Cardiovascular syndrome, the patient requiring mechani
Townsend Handbook for Nurse unit for acute respiratory distress. Ineffective breathing acute ventilation.
Educators. ABG’s (rsp. acidosis), ARDS, vent/vent settings, pattern
abnormal breath sounds, hemodynamics, The student will be able to
cardiac monitor tracing/rhythm analysis (ECG), Activity intolerance demonstrate the ability to do
arterial pressure monitoring. signs and symptoms of worse
Disturbed personal respiratory failure.
Meds: albuterol, atrovent, prednisone identity
Diagnostics: CBC, ABG, CXR
Critical Care: Closed Head Goldsworthy, Sandra, and In this scenario, a 22-year-old male is Objectives: Document admission note and Neurological Decreased intracranial Closed head male 22 72 245 The student will be able to do
Injury, Martin Neylander Leslie Graham. Simulation admitted after a motor vehicle recognize deterioration. adaptive capacity injury an event such as a change in c
Simplified: A Practical accident. The patient is intubated and Cardiovascular rhythm or a hypotensive even
Handbook for Nurse ventilated with a Glasgow coma scale Acute deterioration, ICP (increased), cardiac
Educators. of 8. The patient's rhythm monitor and ECG, CVP, arterial pressures, Respiratory The student will be able to
deteriorates with a hypotensive arrhythmias, GCS, enteral feeding, vent, type demonstrate the ability to do
response. With quick assessment and and cross match, Foley, CT (head), blood an admission note.
intervention, the cultures, seizure precautions.
patient stabilizes with a temporary
transcutaneous pacemaker. Meds: voluven, dopamine, SQ heparin, dilantin,
propofol, cefazolin, fentanyl
Diagnostics: chem, hematology, ABG, drug
screen, EKG, CXR
Critical Care: Drug Goldsworthy, Sandra, and In this scenario, an 18-year-old Objectives: Recognize and document S/S of Neurological Ineffective airway Drug female 18 65 125 The student will be able to do
Overdose, Emily Jackson Leslie Graham. Simulation female college student is admitted intentional OD. Monitor cardiac rhythym. clearance overdose the signs and symptoms of an
,Critical Care: Hypovolemic Goldsworthy, Sandra, and In this scenario, a 38-year-old female Objectives: recognize S/S of hypovolemic shock Cardiovascular Fluid volume deficit Shock, female 38 63 155 The student will be able to
Shock, Elise Chu Leslie Graham. Simulation postpartum patient begins to as well as recognize and document a hypovolemic demonstrate the ability to do
Simplified: A Practical hemorrhage large amounts of vaginal transfusion reaction Respiratory Fatigue a blood administration and ca
Handbook for Nurse sanguineous drainage. Suddenly, she arrest.
Educators. loses consciousness and a code is Hypovolemic shock, cardiac monitoring & ECG, Peripheral vascular
called. ventricular tachycardia, art line, NPO, The student will be able to
transfusion reaction, O2 Urinary demonstrate the ability to do
recognition and treatment of
Meds: dopamine, morphine sulfate, midazolam transfusion reactions.
hydrochloride
Diagnostics: Chem, hematology, CXR
Critical Care: Liver Failure, Goldsworthy, Sandra, and In this scenario, a 54-year-old male Objectives: Recognize and document S/S of Gastrointestinal Confusion Hepatic male 54 68 225 The student will be able to do
Daniel Adams Leslie Graham. Simulation patient is admitted to the intensive worsening liver failure. Communicate in family encephalop the signs and symptoms of wo
Simplified: A Practical care unit with an acute exacerbation conference. Cardiovascular Chronic low self- athy liver failure.
Handbook for Nurse of chronic liver disease. esteem
Educators. Liver failure, hemodynamic monitoring, cardiac Neurological The student will be able to
monitoring & ECG, CVC, hepatic Imbalanced nutrition demonstrate documentation
encephalopathy/GCS changes, cardiac rhythm less than body supporting the patient’s famil
interpretation, liver biopsy/MRI of liver, lab requirements bedside and during the family
analysis. conference.
Meds: Dopmine, morphine, albumin, lactulose,
Zantac, methylprednisone, vit. B12, folic acid.
Diagnostics: electrolytes, liver panel, CBC, CXR
Critical Care: Myocardial Goldsworthy, Sandra, and In this scenario, a 51-year-old male Objectives: Care for patient experiencing chest Cardiovascular Acute pain Myocardial male 51 72 250 The student will be able to do
Infarction, Colin Hawkins Leslie Graham. Simulation patient of Dr. Swan arrived to the pain. Recognize and document arrhythmia. infarction the cardiac patient experienci
Simplified: A Practical emergency room with chest pain. He Decreased cardiac pain.
Handbook for Nurse was diagnosed with rule out of MI interventions, cardiac monitoring & ECG, output
Educators. myocardial infarction. strip analysis, art line and pressure monitoring, The student will be able to
vasoactive drips. Impaired tissue demonstrate the ability to do
perfusion arrhythmias.
Meds: morphine sulfate, dopamine, nitro, ASA,
metoprolol, lovenox, Lipitor.
Diagnostics: Chem, hematology, trop, INR, CXR
Critical Care: Renal Failure, Goldsworthy, Sandra, and In this scenario, a 65-year-old male is Objectives: Review and report lab results. Cardiovascular Fluid volume excess Coronary male 65 69 130 The student will be able to do
Anthony Liu Leslie Graham. Simulation two days post quadruple bypass Receive, transcribe and document verbal order. artery patient safety when receiving
Simplified: A Practical surgery. He develops renal failure Renal Risk for electrolyte disease transcribing and enacting a ph
Handbook for Nurse (hyperkalemia, oliguria, and Abnormal lab interpretation and reporting imbalance or other practitioner’s order.
Educators. peripheral edema) precipitating (elevated K+), cardiac monitoring, central Respiratory
unstable ventricular tachycardia. The venous pressure monitoring, art line, O2 The student will be able to
nurse prepares for immediate cardioversion, SBAR, verbal order and order Endocrine demonstrate the ability to do
cardioversion. The physician arrives entry, consults, BS checks, IVF. safe communication practices
to cardiovert patient successfully to a receiving a verbal order or tel
sinus rhythm. Meds: insulin, Tylenol, fentanyl, morphine, lasix order.
IV, heparin SQ.
,Critical Care: Septic Shock, Goldsworthy, Sandra, and In this scenario, a 46-year-old male Objectives: Recognize and document S/S of Cardiovascular Risk for infection Shock, septic male 46 78 310 The student will be able to do
John French Leslie Graham. Simulation patient is admitted to the intensive septic shock. Vasoactive drip titration, analyze the signs and symptoms of se
Simplified: A Practical care unit following a colonoscopy and hemodynamic profile. Respiratory shock.
Handbook for Nurse subsequent large bowel perforation.
Educators. Vasoactive drips, cardiac monitoring, GU The student will be able to
hemodynamic monitoring, art line, ABG demonstrate ability to docum
interpretation (metabolic acidosis), cardiac interventions (i.e., vasoactive
rhythm analysis, Foley, JP drains. calculation and titration).
Meds: dopamine, heparin SQ, ceftazadime,
hydrocortisone.
Diagnostics: ECG, CXR, cortisol, Chem,
hematology
Critical Care: Trauma, Vijay Goldsworthy, Sandra, and In this scenario, a 24-year-old male Objectives: recognize and document Respiratory Impaired gas exchange Fracture, male 24 71 235 The student will be able to do
Surendra Leslie Graham. Simulation becomes short of breath and restless respiratory distress. Document vent settings. arm or leg a primary survey in the nurse’
Simplified: A Practical while his SaO2 level drops the day Musculoskeletal Acute pain as a narrative note.
Handbook for Nurse after admission to the ICU as a Pulmonary contusions, chest tubes, trauma,
Educators. multisystem trauma patient post-ORIF femur, Hemovac, emergency Peripheral vascular The student will be able to
(fractured left ribs, left radius/ulna, intubation-vent, pain management (PCA), ABG demonstrate the ability to do
and left femur). The patient requires interpretation, VAP care bundle, cardiac patient in respiratory distress
intubation and mechanical monitoring & ECG, CVP, art line, transfusion,
ventilation. delirium management, blood culture.
Meds: Cefazolin, heparin SQ, Zantac IV,
morphine prn, dopamine prn
Diagnostics: CXR
All Materials Copyright ©2013 by Lippincott Williams & Wilkins. All Rights Reserved.
, Case Details — Fundamentals
Case Title Linked To Description/Overview Case Objectives/Student Skills & Body Systems Nursing Diagnosis Admitting Gender Age (yrs.) Height Weight Learning Objectives Suggested Readings
Competencies Diagnosis (in.) (lbs.)
Fundamentals: Taylor, Carol. Fundamentals Molly, a 38-year-old woman who is Objectives: Assess and document abnormal Mental Health Anxiety Dysmenorr female 38 65 143 The student will be able to Taylor, C., Lillis, C, & Lynn, P. (2015). Perioperative Nursing.
Abnormal/Unexpected of Nursing: The Art and scheduled for a vaginal hysterectomy findings. Prepare patient psychologically. Notify hea demonstrate documenting head-to- Fundamentals of nursing: the art and science of patient-
Findings Requiring Science of Nursing Care later in the day, arrives at the hospital provider. Ineffective coping toe assessment. centered nursing care (8th ed., pp. 852-897). Philadelphia, Pa.:
Notification of Provider, at 6:30 a.m. With tears in her eyes Wolters Kluwer.
Dysmenorrhea: Molly and wringing her hands, she states: "I Orders: IV insertion, IVF @75mL/hr The student will be able to
Greenbaum really didn't sleep very much last demonstrate documenting vital signs.
night. I kept thinking about the Diagnostics: CBC
surgery." The student will prepare the patient
Use case for pre-op patient with anxiety and physically and psychologically for
interventions needed. surgery.
Abnormal assessment findings are under
mental health: anxiety related to surgery. VS
WNL.
Fundamentals: Abdominal Taylor, Carol. Fundamentals Martin, a 46-year-old male, comes to Objectives: Assess and document abnormal GI Constipation Diverticula Male 46 67 175 The student will be able to Taylor, C., Lillis, C., & Lynn, P. (2015). Diagnosing.
Physical Assessment: of Nursing: The Art and the health clinic for a routine physical findings. Analyze data and report to physician. r disease demonstrate documenting focused Fundamentals of nursing: the art and science of patient-
Martin Prescott Science of Nursing Care exam. During assessment, he states Knowledge deficit abdominal assessment. centered nursing care (8th ed., pp. 253-274). Philadelphia, Pa.:
"I've had problems with constipation Orders: Fecal occult blood test Wolters Kluwer.
and have seen some blood when I The student will be able to
wipe myself after a bowel movement. demonstrate documenting a nurse’s
It's just hemorroids right? Nothing to note for an event regarding Martin’s
worry about?" report of bright red blood in his stool.
The student will analyze laboratory
data.
Fundamentals: Taylor, Carol. Fundamentals James, a 62-year-old man is admitted Objectives: Assess and document abnormal GI Excess fluid volume Cirrhosis Male 62 68 165 The student will be able to Taylor, C., Lillis, C., & Lynn, P. (2015). Implementing.
Abnormal/Unexpected of Nursing: The Art and to the ICU in hepatic failure. He is findings. Notify provider. demonstrate documenting a head-to- Fundamentals of nursing: the art and science of patient-
Findings Requiring Science of Nursing Care critcally ill, being monitored Risk for injury toe assessment. centered nursing care (8th ed., pp. 302-319). Philadelphia, Pa.:
Notification of Provider: continuously, and receving IV fluids Assess and adjust IV lines to improve safety Wolters Kluwer.
James McMahon and meds via central and peripheral The student will be able to
IV catheters. The student enters the Orders: Blood transfusion, seizure demonstrate documenting vital signs.
room and finds several IV infusion management, NPO, PICC
lines and numerous technological The student will demonstrate
devices for monitoring. The nurse MAR: spironlactone, potassium chloride IVPB, improved patient safety.
asks the student to hang the new IV
medication. The student will implement care that
integrates intellectual, interpersonal,
and ethical/legal competencies.
Fundamentals: Taylor, Carol. Fundamentals Doretha brings her husband, Max, a Objectives: Assess and document abnormal Cardiovascular Decreased cardiac Hypertensi male 65 73 245 The student will be able to Taylor, C., Lillis, C., & Lynn, P. (2015). Teacher and Counselor &
Abnormal/Unexpected of Nursing: The Art and 65-year-old male with high blood findings. Notify provider. Patient education output on demonstrate documenting head-to- Vital Signs. Fundamentals of nursing: the art and science of
Findings Requiring Science of Nursing Care pressure to the clinic for evaluation. toe assessment. patient-centered nursing care (8th ed., pp. 478-505 & 578-
Notification of Provider, He is 5'10" and overweight. Presents Orders/MAR: Furosemide, enalaprilat Knowledge deficit 623). Philadelphia, Pa.: Wolters Kluwer.
Max Renfrow today with continuing times of feeling The student will notify the provider
tired and at times when standing up
becomes dizzy. Mrs. Renfrow states, The student will be able to
"I'd really would like to learn how to demonstrate documenting vital signs.
take my husband's blood pressure so
that I can keep track of his progress.
Can you teach me how to do it?"
Fundamentals: Taylor, Carol. Fundamentals Mildred, a 65-year-old woman with a Objectives: Demonstrate and document GI Chronic pain Appendici female 65 65 170 The student will be able to verify the Taylor, C., Lillis, C., & Lynn, P. (2015). Medications.
Administering Oral of Nursing: The Art and history of arthritis and hypertension medication administration and teaching. tis physician order for oral medication Fundamentals of nursing: the art and science of patient-
Medications: Mildred Science of Nursing Care (high blood pressure), admitted for Cardiovascular Knowledge deficit administration. centered nursing care (8th ed., pp. 750-851). Philadelphia, Pa.:
Campbell evaluation of her painful joints. She Orders/MAR: metoprolol, enalapril, Wolters Kluwer.
states, "I just saw this new medicine furosemide, celecoxib, percocet The student will be able to
advertised on television that is demonstrate the administration of
supposed to be really helpful in Med reconciliation oral medications using the rights of
relieving joint pain. What do you medication administration.
think? Is it something I should try?"
Fundamentals: Wound Taylor, Carol. Fundamentals Millie, a 44-year-old woman, Objectives: Complete wound care per orders. Integumentary Impaired skin integrity Wound female 44 64 183 The student will be able describe theTaylor, C., Lillis, C., & Lynn, P. (2015). Documenting, Reporting,
Care: Millie DeLong of Nursing: The Art and develops a wound infection following Document wound care appropriately. infection principles of documentation. Conferring, and Using Informatics. Fundamentals of nursing:
Science of Nursing Care Laparatomy abdominal surgery. Temp Communicate to provider. the art and science of patient-centered nursing care (8th ed.,
101. Wound care with normal saline The student will be able to document pp. 338-369). Philadelphia, Pa.: Wolters Kluwer.
irrigations is ordered 4 times a day. Orders: Wound irrigation with NS QID, contact nursing interventions and
precautions, Wound/ostomy nurse consult assessments according to
documentation principles.
Diagnostics:CBC, micro
