Simulated case studies

This simulated assignment includes five patients. Review each scenario, and after review of each patient, determine priorities and/or delegations of care.

Scenario 1

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Patient: Karen John; Age: 24; DOB: 10/30/1996; Gender: Female

You are the nurse taking care of Ms. Karen John. The health care provider has completed an assessment of the patient. You cared for her yesterday after delivery. She appears more confused than when you cared for her previously. The newborn is in the crib in the corner, sucking on her fist.

Vital Signs: Temp 100.9, HR 116, RR 32, BP 80/60, SPO2 85% on Room Air

On your assessment, you note a boggy fundus, large clots, fundus remains boggy on massage. Saline lock is in Right hand.

What will you do next?

Scenario 2

Patient: Helen Garcia; Age: 1 day; DOB: 3/18/2020; Gender: Female

You are the nurse taking care of a newborn. The newborn is in the crib in the corner of the mom’s room.

Vital Signs: Temp 37.2 C., HR 140, RR 34, BP 70/55, SPO2 95%

Weight: 7lb 2oz. Admit Apgar 8 at 1 minute and 9 at 5 minutes

On assessment, you note the vital signs are the same as what was given to you in the hand-off report. The baby is sucking on her fist and moving around. You attempt to obtain a feeding schedule from the mom, but she is not responding appropriately to your questions.

What will you do next?

Scenario 3

Patient: Mary Jean; Age: 23; DOB: 3/30/1993; Gender: Female

Vital signs: Temp 98.6, HR 80, RR 16, BP 116/80.

On assessment the fundus is boggy with clots; the fundus firms with massage.

Hemoglobin is 8 from 11 on yesterday

Hematocrit is 28 from 32 yesterday

You received from hand-off report that there was an order for a blood transfusion.

You see the blood is sitting on the counter and it has been there for 20 minutes.

What will you do next?

Scenario 4

Patient: Anita Suarez; Age: 28; DOB: 04/19/1990; Gender: Female

You are the nurse for the patient who is 39 weeks gestation, Gravida 2 Para 2.

Vital Signs: Temp 99.1, HR 88, BP 122/60.

Her underpad is wet. You place the external fetal monitor and interpret the reading as contractions 8 minutes apart, irregular, FHR is 120-130, moderate variability.

What will you do next?

Scenario 5

Patient: Rosie Hernandez; Age: 23; DOB: 10/30/1995; Gender: Female

Vital signs: Temp 98.6, HR 110, RR 28, BP 98/60

On assessment the fundus is boggy; she is diaphoretic. The patient is Muslim. Her husband is not present at the time of your assessment.

Hemoglobin is 8 from 11 on yesterday

Hematocrit is 28 from 32 yesterday

What will you do next, while being culturally sensitive?

Which patient requires attention First and how might you accomplish this? Please explain the rationale for your decision:
Which patient will you see next, and how might you accomplish this BEST? Please explain the rationale for your decision.
Which patient will you see next? Please explain the rationale for your decision.
Which patient will you see next? Please explain the rationale for your decision.
Which patient will you see last? Please explain the rationale for your decision.
Place yourself in this situation, with this patient assignment. Reflect on what your BEST course of action would be and how you might ensure patient-centered care. Please Explain.

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