Elderly Patient Simulation Paper

The x-ray department of the County Hospital has various departments, which include: ultrasound, computed tomography, interventional radiology, nuclear medicine, and magnetic resonance imaging. The five groups have partially their own processes

As technology evolved and based on the number of epidemics or even disasters being reported in recent years, most hospitals including the Veterans Hospital where I currently work have already opened a simulation lab. The simulation labs unlike before do not only focus on everyday concerns, but they have been having simulating drills for natural, epidemics, and man-made disasters. Based on my experience, the exercises are very intense and portrayed to be as real as it could be.

Furthermore, prompt infusion of antimicrobial agents ought to be priority and this may require extra vascular access ports (Dellinger, et al., 2008). Early goal-directed resuscitation has confirmed to improved survival for emergency department patients presenting with septic shock in a randomized, controlled, single-center study. Resuscitation lessen 28-day death rate (Dellinger, et al., 2008). In a reviewed conducted by Dellinger, et al., (2012) advocated administering one litre of crystalloid or 300-500ml of colloid more than 30 minutes, to accomplish a central venous pressure (CVP) of 8 mm Hg to 12 mm Hg. Volumes ought to be increased if there are huge indications of hypoperfusion (Dellinger, 2014).

The use of simulation allows students to experience hypothetical clinical scenarios without threat of harm to patients. One of the objectives of running the simulation is to allow to experience and learn from various scenarios that they will likely encounter on the nursing floor and provide an opportunity to apply theory into practice. Prior to this simulation, we were introduced to several literature covering concepts on nursing responsibilities when floating, impaired nursing, diversion of medication, reasonable suspicion, and the AACN standards for establishing and sustaining healthy work environments. Such concepts help the nurse to practice her profession safely and transform into a leader that can initiate and influence change towards the success of an organization.

Simulation can improve outcomes in four areas: laboratory, patient care, patient outcomes, and reduced healthcare costs.

The presented article from the New England Journal of Medicine discusses the relationship between the changes in healthcare regulation and the ways in which these changes serve to diminish concerns from the general public. The nature of the global health law system was then discussed and it was identified that in place of a treaty monitoring body are several “soft” and “hard” law instruments that the World Health Organization (WHO) utilizes to establish the “legal norms” that serve to establish the best practices in healthcare throughout the world (Gostin & Sridhar, 2014). Healthcare regulation at the international level is carried out via a combination of laws which are established at the national level and are then enforced by various governing health services in different countries. These legal norms are comprised of a combination of these soft and hard legal

Hypotension that occurs during hemodialysis primarily results from rapid removal of vascular volume (hypovolemia), decreased cardiac output, and decreased systemic vascular resistance (Lewis, 2014, pp. 1122-1123). The patient may experience a drop in blood pressure during dialysis process. As a result of cardiac ischemia the patient may also exhibit symptoms of light- headedness, nausea, vomiting, seizures, vision changes, and chest pain. To combat these complications of hypotension the volume of fluid being removed is decreased and administering 0.9% saline solution through IV therapy (Lewis, 2014, pp. 1122-1123).

Post operatively, John was receiving intravenous fluid therapy to maintain the fluid balance in the body and in this essay the fluid therapy is using as the third intervention. Normal fluid and electrolyte homeostasis of the intracellular, extracellular, intravascular under precise control is necessary to allow efficient cellular and organ function (Marsh and Brown, 2012). Body fluid composition may change from minutes to hours, making it difficult to the wound healing process and affects the homeostasis mechanism of the body (Selami et al, 2015). Homeostasis is the tendency of the organism to maintain the stability (Stephen and Gillian, 2011). Moreover, as a large volume of fluid associated with surgeries due to bleeding, intracellular fluid shift, drainage or urination, it results in imbalance in the body fluids (Selami et al, 2015). During the postoperative period, John’s blood pressure was low, and he had decreased urine out. Literature suggests that, tachycardia, oliiguria, and a reduced pulse pressure, progressing to hypotension are all recognized signs associated with hypovolaemia (Campbell, 2011). As John had these symptoms, which indicated that the homeostatic

If volume deficit and hypernatremia are present, intravascular volume should be restored with isotonic sodium chloride prior to free water administration.

At the beginning of the sim scenario, a clinical handover was given and it became clear that Jenny was due for her next dose of cefotaxime. The following steps to administering IV medication were followed; the nurse assessed for baseline vital signs then assessed the IV site for infiltration, inflammation

After surgery, Mr. Baker is taken to a room on the medical-surgical floor. He has an IV infusing at 125 ml/hr, a PCA pump, and a nasogastric tube connected to low suction. He is receiving oxygen through a nasal cannula.

Looking at an example, your medical control states you need to establish an IV on a cardiac patient complaining of chest pressure at a rate of 80 ml/hr using a 500 ml bag of Normal Saline solution. The drip set you choose is a 60 gtts/ml minidrip set. The formula is as follows:

Assessment of hemodynamic status in a shock state remains a challenging issue in Emergency Medicine. Early recognition and appropriate treatment of shock have been shown to decrease mortality (Moore and Copel, 2011; Volpicelli, 2011). In case of medical emergencies there may not be enough time to perform detailed diagnostic procedures and eliminating any imminently life-threatening conditions from the possibilities is always challenging in a busy ED.

Anything… the word I professed some time ago. I prayed the prayer that I would do anything. The woman who tends to always be in a state of trepidation, prayed that she would do anything for Him. From that one word, many plans surfaced. I had hoped that it was just spontaneous thoughts and that they did not mean anything. Among the list, was the idea of becoming a nurse. It was an outlandish notion. How on earth could I be a nurse? Somehow that random thought has turned into a reality. I am currently striving toward one of my “anythings”. I know that my current situation is definitely not by my own doing and that He has been continually opening doors. It has not been an easy road. Thoughts of doubt, negative

The set up was similar to my clinical routine. On entering the room, my teammates and I greeted her and asked her how she was doing. She was alert and oriented. She sounded exhausted. She was having generalized pain. I asked her if she was feeling short of breath she said “no.” She was already on 3L of oxygen through nasal cannula with an oxygen saturation of 93%. Her skin was warm to touch and her pulse bounding. She had crackles throughout her lung field. During my clinicals, I learned to link my patient’s assessment findings to her labs and orders. I also practiced using the SBAR to contact the physician. I attended an interdisciplinary round at the oncology unit where the team was planning palliative care for a patient. I noticed that the team was more directed towards pain management and therapeutic interventions. The team also made sure to include the family and the patient in the care. During the simulation, we contacted the doctor for an order of morphine.