Joyce University Hospital

PEDIATRICS

OBSTETRICS

MED SURG

ICU

EMERGENCY

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Room 103

Initial client assessment

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Initial client assessment

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Initial client assessment

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Client Intake Feedback

Greet and Assess: Welcome the client, introduce yourself, and ask about their presenting symptoms.

Obtain Information: Gather essential details like name, age, contact information, medical history, allergies, and current medications.

Initial Assessment: Conduct a brief triage assessment, noting the severity of the symptoms. Assess whether the client needs immediate intervention.

Documentation: Record all the information accurately into the hospital’s system.

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Client Vital Signs

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Client Intake

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Vital Sign Analysis

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Vital Sign Feedback

For a client with chest pain and shortness of breath, measuring blood pressure, heart rate, respiratory rate, oxygen saturation, and pain level is essential. These vital signs provide critical information about the client’s cardiovascular and respiratory status. Getting the client’s weight will be helpful when you are ready for medication dosing.

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Client Vital Signs

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Vital Sign Analysis

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After Vitals Priorities

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Vital Sign Next steps

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Vital Sign Next steps

Heart rate & rhythm.

Parameters to Monitor

Monitor & reassess vital signs frequently.

Actions to Take

Acute coronary syndrome.

Conditions Most Likely Experiencing

Blood pressure trends.

Parameters to Monitor

Administer diuretics as ordered.

Actions to Take

Actions to Take

Potential Conditions

Parameters to Monitor

Heart rate & rhythm.

Administer diuretics as ordered.

Acute coronary syndrome.

Worsening heart failure.

Blood pressure trends.

Monitor & reassess vital signs frequently.

Fluid volume overload.

Respiratory rate & oxygen saturation.

Assess respiratory status & administer oxygen as needed.

Weight and fluid balance (intake/output).

Notify the healthcare provider immediately.

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Vital Signs

Medication Administration Client Review

Your 58-year-old client with heart failure who is presenting a variety of clinical symptoms related to his heart's decreased ability to pump blood effectively. Now that you've taken his vitals and assessed his condition, let's administer his medication. Symptoms:

• Dyspnea (shortness of breath): Especially on exertion or when lying down (orthopnea).
• Fatigue and weakness: Due to reduced cardiac output and oxygen delivery.
• Edema (swelling): Commonly seen in the lower extremities due to fluid retention.
• Nocturia (frequent urination at night): Caused by fluid shifting from the lower limbs when lying down.
• Weight gain: Resulting from fluid retention.

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Preparation

Do you have what it takes to administer medication?

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Medication Preparation

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Review the Medication Order

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Perform Client Assessment

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The Six Rights of Medication Administration

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Well done!

You have completed the first level and are ready to calculate the client's medication. Click on the arrow to discover the hidden number and continue the step.

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You've got the first number for the key!

The Medication

What do you know about the medicaiton?

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The Medication

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The Medication

Furosemide (Lasix) 40 mg IV

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Let's go!

You're getting closer to helping this client recover! Click the arrow, check the next number, and let the challenge continue.

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You've got the second number for the code!

Dosage Calculation

Are you ready to calculate the medication dosage?

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The Dosage Calculation

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The Dosage Calculation

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The Dosage Calculation

Click each item to reveal the formula for the dosage calculation.

Ordered Dose

Volume to Administer (mL)

Concentration (mg/mL)

Volume to Administer (mL)

Concentration (mg/mL)

Ordered Dose

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The Dosage Calculation

You have confirmed that the available concentration is 10 mg/ML. Plug in the correct values to calculate the dosage.

40 mg

Volume to Administer (mL)

10 mg mL

40 mg

10 mg mL

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The Dosage Calculation

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Nice job!

You have calculated the correct dose and now it's time to administer the medication. Click the arrow to see the next steps in med administration.

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You've got the third number for the key!

Monitoring the Client

Do you know what it takes to monitor this client after the med was given?

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Monitoring Client

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Monitoring Client

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Monitoring Client

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Mission Accomplished!

You successfully administered Furosemide 40 mg IV to Mr. James, stabilizing his condition and relieving his fluid overload. By carefully calculating the dosage, performing vital pre-assessments, and monitoring his response to the medication, you prevented dangerous complications such as hypotension, electrolyte imbalances, and dehydration. Your vigilance in patient care ensured that Mr. James is now on the road to recovery. Your quick thinking and teamwork saved the day, proving that with precision and dedication, lives can be transformed. Great job—mission accomplished! Click on the arrow and enter the password to access your reward.

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You've got the last number OF the code!

Enter the password

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What is the key?

Medication Administration

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Nitroglycerin (Sublingual)

Prescription: 0.4 mg SL every 5 minutes as needed for chest pain, up to 3 doses Medication Available: 0.4 mg per tablet

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Metoprolol (IV or PO)

Prescription: 5 mg IV push every 2 minutes, up to 3 doses Medication Available: 5 mg/5 mL vials for IV use

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Heparin (IV)

Prescription: 60 units/kg IV bolus followed by continuous infusion Medication Available: 70 kg

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Medication Administration

The physican prescribed the following medications:

• Nitroglycerin (Sublingual)
• Aspirin (Oral)
• Metoprolol (IV or PO)
• Heparin (IV)
• Morphine (IV)

Click next to begin calculating each med.

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Aspirin (Oral)

Prescription: 325 mg PO once Medication Available: 325 mg tablets

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Morphine (IV)

Prescription: 2 mg IV every 2-4 hours as needed for pain Medication Available: 4 mg/mL

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Possible side effects

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Possible Side Effects - Nitroglycerin

The possible side effects of Nitroglycerin include, __________, dizziness, and ___________.

fatigue

hypotension

sedation

hypotension

headache

depression

bleeding

headache

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Possible Side Effects - Nitroglycerin

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Possible Side Effects - Asprin

The possible side effects of Asprin include, ________ and ______________.

gastrointestinal upset

bleeding

dizziness

fatigue

bleeding

gastrointestinal upset

bleeding

depression

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Possible Side Effects - Metoprolol

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Possible Side Effects - Metoprolol

The possible side effects of Metoprolol include, _____________ , _________,and hypotension.

Bradycardia

dizziness

bleeding

fatigue

Bradycardia

fatigue

depression

diarrhea

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Documentation & Communication

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Documentation & Communication

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Using SBAR

Let's practice SBAR! You have administered the medications and are monitoring the client. You notice the client’s blood pressure dropped significantly after administering nitroglycerin. Click next to document using the SBAR format to document.

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SBAR DOCUMENTATion - Practice

Situation

Background

Assessment

Recommendation

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SBAR DOCUMENTATion - Practice

Situation

Background

Assessment

Recommendation

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SBAR DOCUMENTATion - Practice

Situation

Background

Assessment

Recommendation

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SBAR DOCUMENTATion - Practice

Situation

Background

Assessment

Recommendation

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Documentation & Communication

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Documentation & Communication

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Scenario 1

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Scenario 1

Client Vital Signs

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Scenario 1

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Scenario 1

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Scenario 1

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Scenario 1 Documentation

• Medication: Nitroglycerin administered at _______.
• Pain Level: Initial pain was __/10, now __/10.
• Vitals: Blood pressure is __/__, heart rate is __ bpm, oxygen saturation is ___% on room air.
• Positioning: The client is positioned in ______ - Fowler's position.

14: 0 0

07:00

14:00

13:30

8/10, now 4/10

9/10, 0/10

10/10, 1/10

8/10, 4/10

Semi

Semi

Full

High

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Scenario 1 - Reflection

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DISCHARGE

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Client Discharge

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Client Discharge

Nitroglycerin

Asprin

When taking _____________, call 911 if chest pain continues after 3 doses within 15 minutes.

Nitroglycerin

Morphine

Metoprolol

When taking _____________, watch for signs of bleeding, such as dark stools or unusual bruising.

Asprin

Morphine

Asprin

vaccinated

Be sure to get ______________, by attending an appointment with a cardiologist within 1-2 weeks after discharge.

follow-up care

your bill paid

follow-up care

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Client Discharge

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Client Vital Signs