NR 340 Week 6 Assignment Clinical Simulation Essay Assignment

Directions:  This assignment is to be completed independently (it is not a group assignment!) and turned in on your assigned clinical simulation day. The purpose of this assignment is to prepare you to complete the corresponding clinical simulation scenarios related to coronary artery disease and hypertensive crisis respectively.  Resources to complete this assignment include the following:

1. Lewis Medical-Surgical Nursing, 9^th Prevention of osteoporosis (p. 1555) and hip replacement post-operative management (p.1526-1527).
2. Sole textbook Pulmonary Embolism (p. 423-425) and thrombolytic candidates (p. 382).
3. Stroke/TPA articles posted on shell

Susan Weil Simulation Scenario

1. What is the nurse’s role in providing family centered care during and after a crisis?

2. What pharmacological and non-pharmacological comfort measures can be used for a post-operative patient?
3. What vital nursing assessment data should be gathered on a patient post hip replacement surgery?
4. Describe the major complications that can arise for patients who are post-operative hip injury/replacement?
5. Describe the pathophysiologic process of a pulmonary embolism. Include the typical origin site of a pulmonary embolism.
6. What are 3 signs and symptoms associated with a pulmonary embolism?
7. What medical treatments can be used to treat a pulmonary embolism?
8. What immediate nursing interventions should the nurse perform for a patient who is experiencing a pulmonary embolism?
9. Describe the actions, indications, contraindications, adverse effects, dose range and method of administration for the following medications:

Naomi Reed Simulation Scenario

10. Differentiate the pathophysiological processes and treatment options used in the 2 major types of stroke.
11. What is the National Institutes of Health Stroke Scale (NIHSS)? Briefly explain in 2-3 sentences what is assessed on the NIHSS and the scoring system.
12. Provide 3 nursing considerations for administration of tissue plasminogen activator (rTPA). What may result if administration of TPA is too fast or too slow?
13. List 5 contraindications for the administration of TPA.
14. Sample TPA calculation. 9 mg/kg over 60 minutes (not to exceed 90 mg) with 10% of the total dose administered as an initial IV bolus over one minute.  Patient weighs 130 lbs.  TPA comes in a premixed bag: 75mg in 75 ml. Calculate the infusion dose (in mg) and the bolus dose (in mg).
15. How often are vital signs and neuro checks performed once TPA has been started?

16. What nursing interventions need to be avoided once TPA administration has started?
17. What are potential complications of TPA therapy the nurse will need to assess for?
18. What is the desired outcome of TPA?
19. Describe the actions, indications, contraindications, adverse effects, dose range and method of administration for the following medications: