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SIMULATION 1

SIMULATION

Simulation-Multiple Clients (Janet Martin & Margaret Stanton)

NR 442 Community Health Nursing

June 12, 2020

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)

What is the purpose of Vancomycin Hydrochloride and what are the side effects/administration protocols?

Vancomycin hydrochloride is used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria (Vallerand, 2015).

The side effects of vancomycin include:

Low blood pressure, flushing, rashes, tachycardia, wheezing, hives, itching, dizziness, muscle spasm of the chest and back (Vallerand, 2015).

Administration protocols 

Adults: vancomycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria

Pediatrics: The usual intravenous dosage of vancomycin is 10 mg/kg per dose given every 6 hours. Each dose should be administered over a period of at least 60 minutes

Neonates: In neonates, an initial dose of 15 mg/kg is suggested, followed by 10 mg/kg every 12 hours for neonates in the 1st week of life and every 8 hours thereafter up to the age of 1 month. Each dose should be administered over 60 minutes.

What are some of the risks that diabetics face as a result of uncontrolled blood sugars? 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?

Some of the risks that diabetics can face as a result of uncontrolled blood sugars are Cardiovascular disease, nerve damage (neuropathy), kidney damage (nephropathy), eye damage (retinopathy), foot damage, skin conditions, hearing impairment, and Alzheimer's disease

In type 1 diabetes, the immune attacks and destroys the insulin-producing cells in the pancreas. This leaves with little or no insulin. Instead of glucose to be transported into the cells, it builds up in the bloodstream. While as in type 2 diabetes, the cells become resistant to the action of insulin, and the pancreas is unable to make enough insulin to overcome this resistance. The glucose builds up in your bloodstream.

Diets for diabetes patients includes healthy carbohydrate such as fruits, vegetables, whole grains, legumes (Beans and peas), low-fat dairy products (Milk and cheese). A diabetes patient should eat heart-healthy fish at least twice a week. Fish such as salmon, mackerel, tuna and sardines are rich in omega-3 fatty acids, which may prevent cardiovascular disease (Mayo Clinic, 2019).

What PPE is necessary for a patient who has MRSA? Gloves and gown.

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

Nurse’s role in providing client and family support for the recent loss of a family member include: the nurse will assist the patient and loved ones in their coping with their grief to include anticipatory grief. The nurse will educate them on what is expected to include the stages of grief and what are some normal feelings. Provide referral to support the family. Provide resources to help adjust to this loss they are experiencing. Evaluate how they are handling this experience and address any fears related to grief and loss. Provide comfort and support. Be a good listen to what they have to say. Greif with them. The nurse support for the patient and their family may include chaplain services, their own clergy or spiritual support, psychological referrals, individual therapy, group therapy, and community peer support groups as well as social work referrals. The nurse console the family.

Review the causes and treatment options used for MVP with regurgitation and how they can prevent further heart failure.

Causes are mitral valve prolapse, congenital heart disease, heart attack, cardiomyopathy, trauma, A-fib, heart disease, heart attack, rheumatic fever, and endocarditis.

Treatment options include medications, such as diuretics and blood thinners, surgery, mitral valve repair, and mitral valve replacement.

Prevention: Eating a heart healthy diet, maintaining a healthy weight, avoiding tobacco products, exercise regularly, cutting back on alcohol and keep blood pressure under control (Mayo Clinic, 2019).

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.

The nurse should orient the client the surrounding, provide a calm environment by eliminating noise and stimuli. Give simple direction and allow the patient time to respond. Relocate the patient to a room closer to the nursing station. And provide continuity of care if possible. Like maintaining the same care givers, and avoid changing room (Mayo Clinic, 2019).

References

Mayo Clinic, (2019). Retrieved from https://www.mayoclinic.org/diseases-conditions/mitral-valve-regurgitation/symptoms-causes/syc-20350178.

Vallerand, A. H., (2015) Davis's Drug Guide for Nurses. [VitalSource Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9780803660793/