NR 446 Simulation Multi Client

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NR 446 Simulation Multi Client

Multi Client

1. The healthcare provider ordered 500mg Vancomycin Hydrochloride IVPB every six hours. The maximum safe dose range is 40mg/kg/day. The client weighs 165 lb. What is

the maximum therapeutic dose the nurse will administer per day? ___mg/day (If needed,

round to the nearest whole number)

3,000mg/day

2. What is the purpose of Vancomycin Hydrochloride and what are the side

effects/administration protocols?

Vancomycin Hydrochloride is an antibiotic.

Side effects include Ototoxicity (auditory portion of eighth cranial nerve).

Urogenital: Nephrotoxicity leading to uremia. Body as a Whole:Hypersensitivity

reactions (chills, fever, skin rash, urticaria, shock-like state), anaphylactoid

reaction with vascular collapse, superinfections, severe pain, thrombophlebitis at

injection site, generalized tingling following rapid IV infusion. Hematologic:

Transient leukopenia, eosinophilia. GI: Nausea, warmth. Other: Injection reaction

that includes hypotension accompanied by flushing and erythematous rash on

face and upper body (“red-neck syndrome”) following rapid IV infusion.

Protocol Give a single dose at a rate of 10 mg/min or over NOT LESS than 60 min.

Avoid rapid infusion, which may cause sudden hypotension. Monitor IV site closely;

necrosis and tissue sloughing will result from extravasation.

3. What are some of the risks that diabetics face as a result of uncontrolled blood

sugars?

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Explain the difference between Type I & Type II Diabetes. Discuss a diet that is

appropriate for a diabetic. How is it different from a general diet?

Complications of Uncontrolled Diabetes include:

 Diabetic retinopathy

 Glaucoma

 Kidney failure (diabetic nephropathy)

 Nerve damage (Diabetic neuropathy) which can lead to amputation of foot or

toes

 Diabetes Type I is insulin dependent diabetes because the pancreas does not

make insulin

 Diabetes Type II is insulin resistant diabetes because cells become resistant to

insulin or the pancreas does not produce enough

Diabetic Diet recommendations

Carbohydrates, which are found to the largest degree in grains, bread, pasta, milk,

sweets, fruit, and starchy vegetables, are broken down into glucose in the blood faster

than other types of food, which raises blood sugar, potentially leading to hyperglycemia.

Protein and fats do not directly impact blood sugar, but both should be consumed in

moderation to keep calories down and weight in a healthy range.Include fiber in the diet

to increase carbohydrate metabolism and to help control cholesterol levels.

4. What PPE is necessary for a patient who has MRSA?

Gloves and Gown

5. What is the nurse’s role in providing client and family support for the recent loss of a

family member?

 Assist the client in coping with suffering, grief, loss, bereavement

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 Support the client in anticipatory grieving

 Inform the client of expected reactions to grief and loss – ( Kubler Ross’s stages

of grieving: Denial, Anger, Bargaining, Depression, Acceptance)

 Provide resources to adjust to loss/bereavement-individual counseling, support

groups

 Evaluate coping and fears related to grief and loss

6. Review the causes and treatment options used for MVP with regurgitation and how

they can prevent further heart failure.

 Mitral valve prolapse: abnormality of the mitral valve leaflets and the papillary

muscles or chordae that allows the leaflets to prolapse or buckle back into the

LEFT atrium during systole. Most common valvular disease in U.S.

 MVP is usually benign but serious complications can occur.

 MVP etiology is unknown but some client have an increased family incidence

Treatment depends on how severe it is, is exhibiting sign and symptoms, condition

worsening, goal is to improve hearts function while minimizing s/s and avoid future

complications.

 medications: Beta adrenergic blocker to control palpitations, chest pain, diuretics,

blood thinners

 surgery to repair/replace valve, repair/replace may be needed even if no s/s are

being experienced since it may PREVENT complications (heart failure)

 healthy eating habits and avoid caffeine since it is a stimulant and may

exacerbate symptoms

 begin/maintain an exercise program to achieve optimal health

 Preventative measures to prevent heart failure.

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7. List 5 nursing interventions a nurse is responsible for performing to ensure safety of

the client when they are assigned a client who is disoriented.

 Respond to call lights in a timely manner-keep call light within reach

 Provide hourly rounding

 Keep assistive devices nearby (walkers, transfer devices, eyeglasses).

 Anticipate needs

 Possible bed/chair alarms

 Reorient client to room, time, place

 Clock on the wall

 Provide client with a daily schedule

 Request family to bring in personal items if possible ie photos

NR 446 Simulation Multi Client