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16 SLS IMPLEMENTATION GUIDE FOR MEDICAL-SURGICAL NURSING Scenario MS-19 Advanced Patient Data Est. Scenario Time* Est. Debriefing Time* Delores Gallegos 82-year-old Female Scenario: 20-25 minutes Debriefing: 20-25 minutes Scenario Skills • Conduct assessment • Recognize signs and symptoms of acute renal failure • Notify provider of status change • Administer IV furosemide • Administer PO sodium polystyrene sulfonate • Provide patient education and support • Access and document care in EMR Acute Renal Failure | Hyperkalemia MS-33 Basic Paul Jungerson 61-year-old Male Scenario: 20-25 minutes Debriefing: 20-25 minutes Colostomy | Postanesthesia Confusion MS-34 Advanced Paul Jungerson 61-year-old Male Scenario: 20-25 minutes Debriefing: 20-25 minutes Colostomy | Hyperkalemia Secondary to Medication Error Scenario Presentation and Diagnoses Primary Simulation Challenge Patient in skilled nursing facility exhibits signs and symptoms of acute renal failure including confusion, decreased urine output, coarse lung sounds, and elevated serum BUN, creatinine, and potassium. Learner assesses and manages care for patient exhibiting signs and symptoms of acute renal failure. Primary diagnosis: Heart failure Secondary diagnosis: Atrial fibrillation • Conduct assessment • Recognize confusion, combativeness, and nasogastric tube pulled out by patient • Ensure patient safety • Use therapeutic communication to calm patient • Notify provider of status change • Administer IV lorazepam per order • Reinsert nasogastric tube • Provide patient education and support • Access and document care in EMR Patient experiences postanesthesia confusion and combativeness and threatens his own safety and therapeutic regimen by pulling at tubes. • • • • • • Patient experiences hyperkalemia caused by an IV fluid error. Conduct assessment Recognize hyperkalemia Identify incorrect IV fluid infusing Notify provider of situation and status Correct IV fluid per existing order Administer IV insulin and dextrose per order • Coordinate ECG and blood work • Provide patient education and support • Access and document care in EMR Learner assesses and manages care for a patient experiencing postanesthesia confusion and combativeness. Primary diagnosis: Colorectal cancer Secondary diagnosis: Colon resection with anastomosis Learner assesses and manages care for a patient experiencing hyperkalemia caused by an IV fluid error. Primary diagnosis: Colorectal cancer Secondary diagnosis: Colon resection with anastomosis ENDOCRINE MS-20 Basic Harry George 54-year-old Male Scenario: 20-30 minutes Debriefing: 20-30 minutes • Conduct assessment • Perform fingerstick blood glucose check • Recognize hypoglycemia • Administer juice, low-fat milk, or IV glucose • Reassess blood glucose level • Provide patient education and support • Access and document care in EMR Patient with diabetes is Learner assesses and manages admitted for cellulitis of the care for a patient experiencing foot. He experiences an acute hypoglycemia. episode of hypoglycemia. Primary diagnosis: Cellulitis Secondary diagnosis: Diabetes mellitus type 2 Diabetes & Cellulitis | Acute Hypoglycemia Copyright © 2011 by Elsevier Inc. All rights reserved.
