Download Longwood University Simulation Admission Ticket Scenario: Patricia

Longwood University
Simulation Admission Ticket
Scenario: Patricia Simmons – Electrolyte Imbalance –Med-Surg
Student Learning Objectives:
1. Provides care to a patient with fluid/electrolyte imbalances to include management of potential
complications.
2. Implements the “6 rights” of medication administration
3. Assesses clients physical, emotional, and spiritual well being and cultural heritage
4. Recalls complications related to chemotherapy and implements treatment to manage care.
5. Care of client with Neutrapenic Precautions
6. Implements safety measures and demonstrates effective teamwork and collaboration.
Demographics:
Client Name: Patricia Rosenblatt Simmons
Age: 34
Weight: 68kg
Allergies: Cipro
Physician: Dr. Mammary
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Gender: Female
Race: Caucasian
Height: 67”
Location: OPS
Immunizations: UTD
Client Information:
December 9th during routine GYN visit Dr. Livingood found a lump in the left breast located at 2 o’clock
marble size mobile, non-tender. She followed up with a mammogram and ultrasound both of which confirmed
presence of mass. January 15th Dr. Mammary performed a fine-needle aspiration of the tumor confirming
breast cancer.
February 8th, the patient had a left modified radical mastectomy with adjunctive therapy to include chemo and
radiation therapy decided upon results of pathology and histology reports (Stage 3 ductal breast carcinoma).
On March 29 she had a portacath placed for chemotherapy treatments to begin April 1st.
The pt has completed 2 rounds of chemotherapy treatment with Adriamycin, Cytoxan, and Vincristine (last
treatment 5 days ago). She is currently experiencing nausea/vomiting, loss of appetite, alopecia, weight loss,
depression, and fatigue s/p chemotherapy treatment. The oncologist has admitted her to the med-surg unit
with diagnosis of Dehydration and fluid/electrolyte imbalance s/p Chemotherapy.
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Social History: Patricia is married with two small children: one son - Alex 10 years-old; one daughterSummer 4 years-old. Tricia is a bank account manager at BB&T. Her husband, Robert, is the owner of a
local construction company. Religion: Jewish. Socioeconomic status: Middle Class
Potential Skills for Scenario:
It is strongly recommended that you read your textbook content related to clients with fluid electrolyte
imbalance Chapter 41 and review any skills indicated on your patient information card.
Answer these questions to help prepare for your clinical simulation. We will discuss prior to entering the
Simulation lab. Under Sim Chart My-Clinicals there is a patient P. Simmons V3-FVD. Please complete
the Pre-Clinical Manager components which include diagnosis, pathophysiology, therapeutic regimen,
current health problems, medications, and labs with diagnostic rationales (result significance).
1. Ms. Simmons is being admitted with electrolyte imbalance/dehydration related to the side effects of
chemotherapy agents: Adriamycin, Vincristine, & Cytoxan. What are the possible complications the
patient may face after a chemotherapy?
2. In addition to information provided what additional assessment data should you obtain?
3. What possible assessment findings do you anticipate in caring for a client with fluid/electrolyte
imbalance (dehydration) secondary to chemothearpy treatment.
4. Review Ms. Simmons CBC & C7 that is provided. Provide rationale for values that abnormal (what is
physiologically going on that is causing these abnormal values and what s/s do you expect to see r/t
these lab findings)-include under Sim Chart
5. Identify 3 possible nursing diagnosis for Ms. Simmons and what nursing interventions are necessary
to manage Ms. Simmons care?
6. What psychosocial, emotional, spirtual, & financial concerns may Ms. Simmons be facing?