This is a three-part simulation consisting of a pre sim activity, the simulation scenario and self-reflection exercise and a zoom debriefing. If you complete all three parts satisfactorily, you will receive 10 clinical hours.
Part I (below) this is a submission via moodle. It is due Feb. 14. No late submissions will be accepted.
Part II will open Feb. 15 and is due Feb. 22 via moodle submission. No late submissions will be accepted.
Part III is a 1 hour zoom meeting the week of Feb. 23 TBA in which we will discuss the scenario and your answers.
PART I Code Blue Scenario
Read the following scenario.
Admission Date: 2/1/21
Todays Date: 2/2/21
Name: John Bower
Gender: Male Age: 30
Weight: 133 kg Height 178 cm
Religion: catholic Major Support: Wife
Immunizations: Flu last September
Attending Physician: Hospitalist
Past Medical History: HTN; Hyperlipidemia; past fractures of ribs, left arm and right ankle MVA accident 2 years ago
HCTZ 25 mg QD
Lipitor 20 mg QD
Social History: 15 year heavy smoker, drinks alcohol a few times a week. Works for IT department remotely; sedentary lifestyle lives with wife and their cat
Primary medical Diagnosis: Closed Fracture of R femur from MVA. Surgery scheduled for this morning; admitted 2000 on the previous day.
Patient admitted to your unit at 2000; for scheduled surgery r/t to an MVA yesterday when he obtained a closed R femur fracture.
VS Q 4H
0.9% NSS IV at 50 ml/hr
IV morphine 1 mg Q2H for pain
HCTZ 25 mg PO daily
Lipitor 20 mg PO daily
2 gm low sodium diet
NPO after midnight for surgery in a.m.
Electrolytes, CBC, Type and Screen 2 units PRBC in a.m.
Activity as tolerated
VS on admission: BP 145/89; HR 80; RR 20; Temp 98.7; pain 6/10; A&O x 3
PIV in L AC; 0.9% NSS infusing at 50 mL/hr
1 mg morphine given at 2000, 2300, 0100, 0400
2348: VS 148/90; HR 84; RR 26; Temp. 99.0; pain 6/10 A&O x 3 patient resting
0400: VS 146/88; HR 90; RR 30; Temp. 100.4; pain 6/10; patient sleeping
You are the charge nurse coming on at 0700. After receiving report from the night nurse, you go in to assess Mr. Bower:
0730: VS 146/88; HR 120; RR 38; Temp. 102.2; restless, lethargic, A&O x 2; petechial rash on trunk, bilateral crackles ULL
Your critical thinking skills tells you that here is a concern.
First part of your assignment:
Submit your answers for this part in APA paragraph form. Use scholarly references.
Identify the disease process that may have occurred to this patient.
Identify the risk factors associated with this.
Identify the nursing interventions that could have been implemented earlier and those that will be implemented for this disease process
Second part of the assignment:
Since you know there is something wrong with this patient you will call the MD.
Complete an SBAR as to what you will say.
After your call to the MD and before the MD arrives, you go back into the patients room and find him unresponsive. You call a Code Blue.
This section can be in bullet form or outline form but beinclusive. Show me what happens during a code. Does not need APA format.
Outline the steps you would do as the initial responder in a Code Blue in the correct order
Discuss the main roles of the team members
Discuss interdisciplinary team members roles
Discuss the cardiac rhythm you may see and how you will treat it
Discuss possible medications used
Mr. Bowers wife is in the room; discuss how you will handle that
Discuss why communication is important during a CODE
Provide a nursing diagnosis for this patient
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