Skill Validation Essay

4645 words - 19 pages

Skills Validation PNCI

Eliana Ruiz
Age: 86 Weight: 55 kg Base: Standard Adult

Overview
Synopsis
The learner will be providing care to an 86-year-old Hispanic female admitted to the MedicalSurgical Unit with a non-healing wound on her right upper leg where a femoral-popliteal bypass graft was performed two weeks ago. She is diabetic and injured her left ankle by tripping on a curb on the way to the hospital. She is anxious about not being able to care for herself when she returns home. She lives alone but has a daughter close by, and has no insurance. This Simulated Clinical Experience™ (SCE™) has five states, that are transitioined manually. With manual transitions, the instructor ...view middle of the document...

Two-and-a-half hours post admission at 1130, the patient rates pain 2/10 after administration of morphine. Upon changing the dressing at the graph site, learners discover the presence of greenish drainage on the old dressing. The learner is expected to administer antibiotic medications as prescribed by healthcare provider. In State 2 2000 Hours, occurring 11 hours post-admission, the patient becomes hypoglycemic. HR is in the 90s and BP is in the 140s/80s. Skin is cool and clammy. The patient complains of feeling hungry and nervous and having a headache. She states, “I just don’t feel right.” She reports she did not eat much dinner because she was not hungry and in pain. Blood glucose is 58. The learner is expected to recognize the signs and symptoms of hypoglycemia and implement appropriate treatment.

Program for Nursing Curriculum Integration (PNCI®) Skills Validation
© 2009 METI, Sarasota, FL

1

Skills Validation PNCI
With appropriate treatment, the patient’s hypoglycemia is resolved. In State 3 2030 Hours Patient Treated, the HR decreases to the 70s and BP decreases to the 140s/70s. Skin is warm and dry. The patient reports feeling “better.” Blood glucose is 105. State 4 0730 AM Report to Next Shift begins on the morning after admission with a change of shift report. Assessment reveals HR is in the 70s and regular, BP is in the 120s/60s, RR is in the teens and temperature is 37.9o Celsius. Breath sounds are clear. The blood glucose level is 254. Based on this result, the prescribed amount of insulin should be mixed and administered to the patient. Catheter care should be performed. This SCE concludes five days later with State 5 Day Five Discharge when discharge orders have been received. The patient’s vital signs have stabilized, with HR in the 70s, BP is in the 120s/60s, regular RR and 37.6o Celsius temperature. Graft site wound bed is pink with tissue granulation noted. The learner is expected to prepare the patient for discharge. This SCE prepares the learner for the following items of the NCLEX-RN test format:

NCLEX-RN Test Plan:

X Safe and Effective Care Environment X Management of Care X Safety and Infection Control X Health Promotion and Maintenance X Psychosocial Integrity X Physiological Integrity X Basic Care and Comfort X Pharmacological and Parental Therapies X Reduction of Risk Potential X Physiological Adaptations

Author
Nancy McMenamy and Dr. Judy Johnson-Russell, Texas Woman’s University - Dallas, TX Reviewed by Nancy McMenamy, Texas Woman’s University - Dallas, TX, 2008 and Wendy Jo Wilkinson, METI - Sarasota, FL, 2009

Program for Nursing Curriculum Integration (PNCI®) Skills Validation
© 2009 METI, Sarasota, FL

2

Skills Validation PNCI

Background
Patient History
Past Medical History: Although the patient is Hispanic, she can speak English and provides her history to the nurse. She reports that two weeks ago she was in the hospital for a femoralpopliteal bypass graft that was performed...

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