Download COMSLIVE Simulation Student Work book

Arthur Hart Workbook
Google Docs:
This simulation uses a document sharing application called Google docs. This application can
be accessed via a number of web browsers placed within the simulation space. Using Google
docs, you will be able to record your answers to the. workbook activities and access key
information about Arthur e.g. charts etc…
After you have entered information into a Google doc you need to click on the refresh icon.
You can then view this new information from any other Google Doc viewer in the simulation
space.
You will use Google docs to:


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Complete your workbook activities as a group;
Access medical notes and charts
Complete an SBAR proforma.

Review, during your telephone referral, the informationwonderland
you have recorded at the patient’s bed space via a Google docs viewer in the reception
area.
Wonderland Exercise 1
At the reception area click on the nurse and listen carefully to the handover report about
Arthur. Record the key information in the space below.
55 year old male, ryles tube in situ, hourly aspirations, IVI, nauseous and vommitting, theatre 3
hiours, abdominhal pain.
Abdominal ?? diagnosis.
Exercise 2
In order to find out more information about Arthur write in the space below any questions you
would ask during handover or later on during your shift?
Any past medical history, current medications, what were his obs on admission, last time he ate
or drank, any allergies, current observations,next of kin, have they been informed. what tests has
he had, mental state?? AVPU, GCS. How aware is he of his context. Pain score, fuller desription
of the pain, any pain killers, when last given, what impact have they had.
Plan of action. Theatre in 3 hours
Pre-op checklist,
Consent form
Any pre-meds need to be given,
Has he been seen by an aneathetist.
Exercise 3
Read through Arthur’s medical notes located in the Google doc’s application close to Arthur’s
bed space. In the space below record each abbreviation that you are unsure of.
In the Education room there is a web browser which contains useful information about medical
abbreviations.
Write in the space below the meaning of the abbreviations you have listed above.
Exercise 4
Now you need to refresh your knowledge on the Acute Abdomen. Go to the Education room on
the ward and locate the speaker and listen to the key information.
Exercise 5
Now it’s time to assess the patient.. Use the information in the patient’s bed space to prioritise
and conduct an ABCDE assessment. You will need to click on the patients monitor as indicated
to get the patients observations.
Record your choices and justification of why you have chosen them here. You may also decide
to ask the patient specific questions in relation to their condition. If so record these questions
below.
Assessment Choice Justification
Airway
.
Breathing
Circulation
Disability
Exposure
.
Exercise 7
Access Arthur’s patient notes using the Google Docs viewer in his bed space. Access his
Observation and Fluid Balance Charts and record the key information you have obtained.
1.
Calculate his current fluid balance and record it in his notes
2.
Calculate a MEWS Score for Arthur and record it in his notes. (You can review
MEWS assessment in Google doc’s)
Exercise 8
What actions or interventions should you take following your assessment of Arthur?
You may wish to inform a senior member of staff. To do this you must be prepared to hand
over key information.
Look at the resources in the Education Room in relation to SBAR. Use the template located
within Google Docs to construct a handover.
One member of the team must then be elected to go to the reception desk and call the doctor
on call.
Exercise 9
You must prepare Arthur for surgery. Use the theatre preparation document located in Google
Docs to do so. Don’t forget to record the key information.
Exercise 10
How would you explain the significance of an intestinal obstruction to Arthur and his relatives?
i.e. what is an intestinal obstruction? See the presentation in the Education room. Record what
you have decided to tell the patient in the patient’s notes. You may also wish to keep your own
record in the space below.
Exercise 11
1.
How may an intestinal obstruction near the border of the small and large
intestine affect Arthur’s ability to maintain a fluid balance? i.e. what is the role of the large
intestine?
2.
What other factors relating to his condition may affect Arthur’s ability to
maintain a fluid balance i.e. what else could cause him to become dehydrated?
Exercise 12
With reference to fluid balance, circulating blood volume and the control of arterial blood
pressure explain the following changes:
1.
Arterial blood pressure and Heart Rate
2.
Skin colour and temperature
You may wish to review the slides from the module’s shock session located in the learning
space.
Exercise 13
What signs may indicate that Arthur is compensating for a reduced volume of circulating blood?
Explain their role in the regulation of blood pressure
Exercise 14
Assess Arthur’s Pain using the approach discussed in the Pain session. Record your findings in
the patient’s notes and if you wish in the space below.
Exercise 15
Arthur has been given an opiate such as morphine for pain relief. How does this drug affect pain
pathways in order to reduce the sensation of pain?
Exercise 16
List the common side effects of Morphine and detail how these side effects may occur. You can
refresh your memory of opiates by accessing the BNF website from the Education Room.