Nursing

NR341 Max Cook Student Instructions
© 2021 Chamberlain University. All Rights Reserved.

Revised 4.1.2021 1

Student Instructions for i-Human Virtual Simulation
NR341 Max Cook

PURPOSE:
The following information is to be used in guiding your preparation and participation in the virtual simulation
scenario for this course. This document will provide applicable course outcomes in preparation for your
simulation.

SCENARIO OVERVIEW:
Max Cook is a 74-year-old male who presented to the emergency department (ED) 24 hours ago with
complaints of shortness of breath, decreased energy level, and fever. He had not been feeling well for several
days when he went to primary care provider who began treatment for pneumonia. Patient reported that he
did not feel that antibiotic was helping him, so he stopped taking his med 2 days ago. His overall health
declined rapidly over past 48 hours. Mr. Cook’s wife called the ambulance for transport to ED at Chamberlain
Hospital. He was admitted to the Medical Intensive Care Unit (ICU).

LEARNER OBJECTIVES:

1. Utilize clinical reasoning skills to perform a health history and physical assessment on an adult patient.
(CO 1, 3, 4, 6)

2. Construct a plan of care based by prioritizing assessment findings and nursing diagnoses (CO 1, 3, 4, 6, 7)
3. Evaluate patient outcomes to determine the effectiveness of nursing interventions and need for ongoing

care (CO 1, 4, 6)
4. Communicate and collaborate with the patient, family and interdisciplinary healthcare team members

(CO 1, 3, 6, 7)

STUDENT ROLES DURING SIMULATION:

You are the staff nurse at the hospital who will be conducting a comprehensive assessment. After completing
your assessment, you are expected to document your findings as a nurses note in SBAR format.

KEY FEATURES OF i-HUMAN:

• As the nurse, you are expected to complete the case scenario using the following tabs: EHR,
History, Physical, Nursing Notes, Summary

• Gear Heads: These are icons that open required questions and/or additional information
related to the case. The questions, information, and videos must be reviewed prior to
progressing to the next tab.

• Nursing Notes: At the end of the simulation, you will document your assessment findings using ISBAR.

NR341 Max Cook Student Instructions
© 2021 Chamberlain University. All Rights Reserved.

Revised 4.1.2021 2

Confidentiality:
To preserve the educational value, integrity and safety of the learning environment, you agree to maintain strict
confidentiality about the proceedings of the simulation session, details of the training scenarios and the
performance of all participants. You acknowledge that this expectation aligns with the guidelines related to the
Health Insurance Portability and Accountability Act (HIPAA) as well as laws governing Protected Health
Information (PHI) in client care environments.

You will not view, discuss, share, record or disclose any confidential information pertaining to the
session. You understand that lapses in confidentiality are considered academic misconduct and could result in
dismissal from the academic program.

Fiction Agreement:
You will suspend judgment of realism for any given simulation in exchange for the promise of learning new
knowledge and skills, treating the simulated patients with the same care due an actual patient, act with a
genuine desire to learn even when it may be difficult to do so.

DUE DATE:
The virtual simulation is assigned to be completed during Week 4 prior to your scheduled debriefing with
faculty/peers.

SIMULATION TIMING:

• Pre-simulation preparation: 30-60 minutes
• Pre-brief: 30 minutes
• Run Time: 2-2.5 hours
• Debriefing: 60 minutes

NR341 Max Cook Student Instructions
© 2021 Chamberlain University. All Rights Reserved.

Revised 4.1.2021 3

ASSESSMENT & EVALUATION
Faculty will utilize your participation measurements in the i-Human case, and debriefing discussions to identify
areas of opportunity for enhancement of your clinical growth. Your experiences in i-Human will contribute to
your overall completion of clinical requirements for the course as documented on the Clinical Learning Evaluation
tool.

i-Human Evaluation – What does my total score mean?

NR341 Max Cook Student Instructions
© 2021 Chamberlain University. All Rights Reserved.

Revised 4.1.2021 4

REVIEW AND COMPLETE PRIOR TO THE START OF THE VIRTUAL SIMULATION:

In order to prepare for the simulation, you are required to complete the pre-simulation questions below and
submit this prework to the faculty via uploading your responses in Canvas prior to the start of the virtual
simulation. If you do not complete the pre-simulation questions and upload them, you will not be able to
access or participate in the simulation.

1. Compare/contrast systemic inflammatory response syndrome (SIRS) and sepsis.

2. What are key nursing interventions when caring for patient on a ventilator?

3. Describe the purpose for the following types of vascular access devices: central venous catheter &
arterial line.

4. A patient is experiencing worsening hypotension and is prescribed norepinephrine continuous
infusion.

a. Prescription: Start Norepinephrine (levophed) 0.5 mcg/min and titrate to maximum of 12
mcg/min to maintain mean arterial pressure great than 65.

b. Pharmacy has mixed the drip as Norepinephrine 4mg in 250mL of D5W.
c. How many mL/hr should the nurse program the pump to deliver 0.5mcg/min?

**Immediately following the completion of the virtual simulation, you will complete the evaluation of the
simulation using the link provided.

  • SCENARIO OVERVIEW:
  • LEARNER OBJECTIVES:
  • You are the staff nurse at the hospital who will be conducting a comprehensive assessment. After completing your assessment, you are expected to document your findings as a nurses note in SBAR format.
  • ASSESSMENT & EVALUATION
  • Faculty will utilize your participation measurements in the i-Human case, and debriefing discussions to identify areas of opportunity for enhancement of your clinical growth. Your experiences in i-Human will contribute to your overall completion of cl…
  • i-Human Evaluation – What does my total score mean?
  • REVIEW AND COMPLETE PRIOR TO THE START OF THE VIRTUAL SIMULATION:

Article Critique

DUE October 11, 2023

7 cl

 

discuss a very brief description (one paragraph for the group session– do NOT include the actual 12-steps) to include the following

EXPLORING EBP QUALITY IMPROVEMENT

To prepare: the key requirements are to identify a hypothetical practice problem as the focus of an evidence-based quality improvement project; a hypothetical health care setting for the project based on investigating actual sites; stakeholders for project approval and implementation within health care settings; and a presentation outlining the basic steps of a specific framework/model for translating research and evidence to improved practice.

The Assignment:Part 1: Key Project Elements

Complete your p a p e r of 6–8 pages, plus cover page and references page, explaining your investigation of three hypothetical practice sites for an Evidence based practice QI project.

Part 2: Implementation Science Presentation

Complete your PowerPoint presentation of 3–5 slides, plus cover and reference slides, to inform hypothetical stakeholders.

Ipsum

Select a nursing theorist of choice and research him/her. Identify their key contribution to nursing and explain its importance in healthcare. 500 – 550 words and 3 or more scholarly sources.

Theoretical and Scientific Foundations of Nursing

  

DISCUSSION RESPONSE

CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE

Renal

Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities and you may need to discuss the other diseases impact on the pathophysiology and care of the patient.  Three (3) resources after 2008 are required along with APA format. 

Renal Failure

Patient Profile:

J.M. is a 37-year-old woman transferred to a large medical center from a small rural hospital for further evaluation of lower abdominal pain, nausea, vomiting, and progressive deterioration of urinary output.

Subjective Data:

-Long history of ETOH Abuse with a drinking binge two days ago

-Arthritis with heavy use of ibuprofen

-HTN for three years, treated with hydrochlorothiazide and a calcium channel blocker

-Borderline NIDDM for three years, does not want to take medications and has been trying

to lose weight and “watch her sugar intake.”

Objective Data:

B/P: 160/110 K: 6.3 mEq/L Urinary output: <15ml/hr Na: 149 mEq/L Lethargic Hgb A1C: 9.2%

Creatinine: 9.6 mg/dL BUN: 121 mg/dL

CRITICAL THINKING QUESTIONS…

1. Address how the various factors in her past medical history could have contributed to her present renal problem.

2. Is her acute renal failure likely to be prerenal, intrarenal, postrenal, or a combination? Why?

3. Discuss each of the laboratory values and how they reflect the pathophysiology that occurs in renal failure. What is the significance of her Hgb A1C level?

4. What are the specific priorities of treatment for J.M.?

5. Explain the types of dialysis available, their indications, and their advantages/ disadvantages. What type of dialysis will most likely be used for J.M?

6. After two weeks of intensive support and dialysis, J.M’s urinary output returns. Explain the diuretic phase of recovery in Acute Renal Failure, and what complications can occur.

7. Do you think she needs intervention for her diabetes? What guidelines did you consult? How would you start in treating a patient with newly diagnosed Type 2 diabetes? Which medication(s) might you want to start first? What patient education issues would you emphasize in the initial period?

Discuss the role nurse plays in COVID vaccination mandate, telemedicine, and prescription drug pricing as advocates in the healthcare system.

 

Nurses are well positioned for reforming health care in ways that promote a healthier public and reduce healthcare cost. Discuss the role nurse plays in COVID vaccination mandate, telemedicine, and prescription drug pricing as advocates in the healthcare system.

The discussion must address the topic.

Rationale must be provided

May use examples from your nursing practice ( pain management )

Minimum of two references in APA format within the last five years published

500 words with 2 scholarly references wiht in text citations less than 5 years old.

Case Study

 Scenario/Summary

Adam and his family decided to take a trip to the mountains for the weekend in late February. They had a small cabin and looked forward to a weekend away from the big city. The family had a wonderful time together on Saturday morning hiking in the woods and enjoying nature. However, Saturday afternoon a storm rolled in bringing snow and subfreezing temperatures.

Since the heater in the cabin wasn’t working well, Adam’s mother and sister decided to drive into the nearest town to spend the night. Adam and his father, not being sissies, stayed at the cabin where they started a gas heater to keep them warm.

The next morning Adam’s mother and sister returned to find both Adam and his father unconscious. An ambulance was called and they were both transported to the nearest hospital. Adam had arterial blood gases drawn with the following results:

pH 7.2
PaCO2 31.4,
PaO2 40.7 mmHg
His oxygen saturation was 72%. Adam was diagnosed with carbon monoxide poisoning.

Deliverables
Answer the following questions and save your responses in a Microsoft Word document. Provide a scholarly resource to support your answers.

With respect to hemoglobin loading, please explain the relationship between binding of oxygen (O2) and carbon monoxide (CO) to the hemoglobin molecules.
During the ambulance ride, a pulse oximeter showed 100% O2 saturation. Why is that different from the 72% measured at the hospital?
One course of treatment is a hyperbaric oxygen treatment. How does a hyperbaric chamber work?
Adams blood work shows him to be in an acidosis (normal blood pH is 7.35-7.45). Explain how this will shift the hemoglobin dissociation curve and why. 

Spending and the Healthcare Economy

 

Healthcare spending in the United States has continued to increase over the past several decades at a rate that far exceeds that of other nations. People have seen these increases on everything, from the cost of insurance premiums going up, to the costs of drug prices and office visits increasing. To familiarize yourself with some of the many areas and ways costs and spending are increasing, please review the NHE fact sheet.

  • Discuss 1 area that you or someone close to you have seen these increases in costs.
  • Examine these increased costs from the perspective of the leader of a healthcare organization. Consider the following:
    • Why do you feel there was an increase in the cost?
    • What, if anything, could have been done to react to the rise in costs and decrease their impact on the organization?
    • What can the organization do to help avoid these increases in the future?