vSim Clinical Replacement Packet (Complete)

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School

Community College of Baltimore County *

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218

Subject

Nursing

Date

Apr 29, 2024

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docx

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Uploaded by patrickcook1896

C LINICAL R EPLACEMENT P ACKAGE S TUDENT R ESOURCES

vS IM C LINICAL R EPLACEMENT P ACKET FOR S TUDENTS Est. Time: 4-6 Hours S TUDENT I NSTRUCTIONS FOR V IRTUAL C LINICAL R EPLACEMENT 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. L EARN F LOW - S TEP O NE  Finish the Suggested Readings, then complete the following four activities:  Clinical Worksheet  Plan of Care Concept Map  Pharm4Fun Worksheet (one per medication)  ISBAR Worksheet L EARN F LOW – S TEP T WO  Take the Pre-Simulation Quiz  You may take several times using the answer key to provide immediate remediation prior to the virtual simulation. Quiz is recorded as complete. L EARN F LOW – S TEP T HREE  Launch the virtual simulation  Complete the vSim Tutorial prior to launching Step Three.  Each clinical experience in the simulation lasts a maximum of 30 minutes.  Complete the simulation as many times as it takes to meet an 80% benchmark. L EARN F LOW – S TEP F OUR  Complete the Post-Quiz  The answer key is visible after you submit the quiz.  The quiz grade is recorded as a percentage L EARN F LOW – S TEP F IVE  Document  Document the clinical events that occurred during the simulation using the information contained in step five.  If using DocuCare, follow the instructions provided by your instructor using DocuCare. L EARN F LOW – S TEP S IX  Reflection Questions  Complete the reflection questions and submit as instructed in your syllabus.  The quiz grade is recorded as a percentage Last Updated 4/27/2024 1 | P a g e

C LINICAL W ORKSHEET This activity creates an opportunity for you to prepare for a virtual clinical experience. This activity provides you with the opportunity to manage patient care, prioritize interventions, and identify aspects of care that could be delegated. S TUDENT L EARNING O UTCOMES At the end of this, student will be able to: 1. Describe pathological events associated with the patient’s disease process or condition. 2. Create a plan of care that is prioritized and is based on the patient’s care needs. 3. Identifies path to healing or health and path to death or injury. 4. Describes aspects of care that can be delegated and appropriate personnel to complete delegated tasks. A SSIGNMENT 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 Nursing Care, Diagnostics, and Pharmacology, found in the suggested reading area. 4. Complete all areas of the attached clinical worksheet. 5. Submit the completed worksheet. Last Updated 4/27/2024 2 | P a g e

C LINICAL W ORKSHEET Dat e: 4/16/2024 Student Name: Patrick Cook Assigned vSim: Carla Hernandez Initia ls: C.H. Diagnosis: HCP: Isolation: IV Type: Critical Labs: Other Services Ag e: 32y Active labor, prolapsed umbilical cord Dr. Sittner None Not shown on vSims Hb: 12.7 NICU, Anesthesia, and Surgery notified by the end of simulation M/ F: F Length of Stay: Fall Risk: Location: Code Status: 1 st day Consults: Fall risk Right Arm Consults Needed: Full Code Allergies: N/A Transfer: Fluid/Rate: N/A NKA Sims position Lactated Ringers 125mL/hr Why is your patient in the hospital (Answer in your own words and include the History of present illness)? Patient was admitted after she went into active labor this morning. After admission, the patient received an amniotomy, after which a prolapsed umbilical cord was discovered. Health History/Comorbidities (that relate to this hospitalization): The patient had a previous uncomplicated vaginal delivery. The artificial rupture of the amniotic membrane put te patient at an increased risk of prolapsed umbilical cord. Shift Goals/ Patient Education Needs: 1. Relieve pressure on umbilical cord by exerting pressure on presenting part 2. Prepare patient for an emergency caesarian section delivery 3. Contact surgery, anesthesia, NICU, and provider to update them on the current emergent situation 4. Educate patient on their current condition, the need for a caesarian section procedure, and the risks associated Last Updated 4/27/2024 3 | P a g e

Path to Discharge: Path to discharge involves an emergent caesarian section procedure to safely deliver the baby. In the meantime, the nurse needs to maintain upward pressure on the fetal presenting part to prevent pressure on the umbilical cord. Following the procedure, the mother and baby need to show normal recovery and vital signs Path to Death or Injury: Path to death or injury would involve a failure to recognize the prolapsed umbilical cord or failure to intervene by relieving pressure on the umbilical cord. C LINICAL W ORKSHEET Alerts: What are you on Alert for with this patient? (Signs & Symptoms) Management of Care: What needs to be done for this Patient Today? 1. Sudden fetal bradycardia 2. Recurrent decelerations 3. Progressively lower fetal heartrate 1. Relieve pressure on umbilical cord by lifting against presenting part 2. Administer oxygen and lactated ringers bolus (if ordered) 3. Get patient into Trendelenburg position 4. Educate Patient on current condition 5. Prepare patient for c-section procedure by inserting urinary catheter What Assessments will you focus on for this patient? (How will I identify the above signs & symptoms?) 1. Vaginal examination to assess for prolapse 2. FHR monitoring 3. Sudden changes in blood pressure Last Updated 4/27/2024 4 | P a g e

List Complications may occur related to dx, procedure, comorbidities: Priorities for Managing the Patient’s Care Today 1. Fetal hypoxia 2. Fetal brain damage 3. Fetal death 1. Assessment and management prolapse 2. Continuous monitoring of FHR & maternal VS 3. Notify provider What nursing or medical interventions may prevent the above alert or complications? What aspects of the patient care can be Delegated and who can do it? 1. Relieve pressure from umbilical cord 2. Move patient to Trendelenburg position 3. Administer oxygen 1. No delegation possible R UBRIC FOR G RADING V S IM C LINICAL W ORKSHEET 5 3 1 0 Patient Information: Demographics, Diagnosis, Allergies, Provider, Consults, Isolation, Fall Risk, Intravenous Therapy, Critical Labs, Services and Needed Consults All documented areas 100% complete and provide thorough information. Three listed areas completed OR documented areas 75% complete. Less than three listed areas completed OR documented areas less than 50% completed. Patient information area blank. Medical History: Why patient is in the hospital, History of present Illness, Past Medical/Surgical History, Comorbidity Factors 100% of HPI, Past Medical/Surgical History and Comorbidity Factors completed with thorough, relevant information. 75% of HPI, Past Medical/Surgical History and Comorbidity Factors completed. Information relevant to scenario. 50% of HPI, Past Medical/Surgical History and Comorbidity Factors completed. Information basic and lacks relevancy. 25% of HPI, Past Medical/Surgical History and Comorbidity Factors completed. Information not relevant, or content areas left blank Patient Education/Goals: Shift Goals, Patient Education Needs Thorough and detailed patient education. Patient shift. goals are SMART, relevant, and detailed goals. 100% of worksheet area is complete. Provides patient education but lacks thoroughness or details. Patient shift goals missing 1-2 components of SMART goals. 75% of information needed for worksheet area present. Patient education lacks thoroughness and details. Patient shift goals missing 3 – 4 components of SMART goals. 50% of the information needed for worksheet area present. Missing patient education and/or patient shift goals. Patient shift goals lack all components of SMART goals. 25% of the information needed for worksheet area Last Updated 4/27/2024 5 | P a g e

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