They need to be understood by patients and patients’ relatives, as well as by doctors and other members of the care team. Further, cortisol promotes gluconeogenesis, which contributes to hyperglycemia noticed in KDA. Skills Needed Communication. You want to know if raising the head of the bed lowers the chance of the patient contracting pneumonia compared to letting the patient lie flat on their back. It's so cold in here! She is visibly upset because the patient informed her that she is to be discharged that morning. Please note - this is a mock OSCE example for education and training purposes only. Patient falls is one of the biggest patient safety concerns for hospitals, and it is the onus of the nursing staff to ensure they protect their patients from falls in all situations, even when there is a physician order stating otherwise. 6.35 Answers to nursing interview questions #5 - always give examples. The patient factors that lead to the development of thyroid include manifestations of symptoms such as racing heartbeat, perspiration, hyperactivity, and severe palpitation, and heat intolerance. Nurses must also be willing to challenge higher authorities in defense of the patient’s needs, regardless of … Hopes this article removes your fear about Nursing care plans in the Planning section of OSCE in NMC Test of Competence Part 2 exam . Even though I was falling behind in my scheduled care of other patients, I sat down with him to ask how he was feeling. 79 y/o African American lady with long standing, well controlled HTN and questionable pulmonary disease. She is visibly upset because the patient informed her that she is to be discharged that morning. This is my scenario: You are a registered nurse employed by a residential aged care facility to undertake comprehensive nursing assessments, develop plans of care and monitor the implementation and evaluation of this care in the facility. Tell stories about your punctuality, ability to meet deadlines and how you remain organized through it all. EXAMPLE ANSWER: Patient has no significant PMH, no medications, does not smoke, drink alcohol or use any other drugs. with this she persistently c/o subjective shortness of breath and nocturnal cough.Sshe is on optimal COPD meds, intermittent lasix, albuterol all offering some relief. Prioritizing his medical issues in the context of his complaint (he was worried about his legs, so was I but I was also worried about his shortness of breath and CKD!). I’ve had to deal with many difficult cases. You have to choose between standard moist wound therapy and using a wound vac. Did the learner give the correct dose, and did it help the patient’s pain or did the learner give too much pain medication and the patient became more sedated and harder to rouse? Potential Tools Check-back . Objective … HHNKS or HHNS is an emergency that is caused by extremely high blood sugar, often over 600 mg/gL. The physician wanted the patient to get 2 units of blood before going downstairs to the procedure. Genetic factors include a family history of diabetes. Both environmental and genetic factors play a significant role in the development of diabetes. Patient: What do you think? Why does this come in at #3 on … Throughout the scenario, the facilitator will need to provide data for the patient’s vital signs (see “Scenario Steps” on You don’t understand why she is giving this to you and cut her off. The following scenarios will help you start developing the thought process of critical thinking. Myxedema coma can result from any cause of untreated hypothyroidism, with the most common being chronic autoimmune thyroiditis. There are many instances where a risk diagnosis can be the diagnosis with the highest priority for a patient. Cushing’s syndrome is caused by any condition that causes the adrenal gland to produce excess cortisol regardless of the cause. Polyphagia is characterized by weight loss. Scenarios Patient Examples Free Nursing CEUs. Hypothyroidism occurs when the body fails to produce enough thyroid hormones, which help the body to regulate and utilize energy. Karen commends him on his success, giving examples of aspects of the task that he performed well. Subsequent consults to neuro feel that patient may have Lewy body dementia but they are not certain. Scenario Number 1. However, before the surgery, one is given specific blood pressure medications that block the actions of the high-adrenaline hormones to reduce the risk of developing severe high blood pressure during surgery. Patient should also be advised to monitor the body weight regularly and inform GP if weight gain is more than 1.5kg in 2 days. Patients are able to describe their symptoms, or show doctors things like rashes or bumps. Pheochromocytoma causes the classic symptoms the patient presented through the overproduction of the epinephrine and norepinephrine hormones that increase the blood pressure, which causes severe headache and palpitation. For example, nurses must honor patients’ wishes before assuming what is best for them and overriding their choices. In a nursing interview, you’ll need to prove you’ve got very specific skills. The pathophysiology of fatigue in Typ2 1 diabetes can be explained by the onset of Tape 1 diabetes, which results from the inability of the body to get enough glucose from the blood into body cells to meet the energy requirements. StudentShare. When this incidence happens, the body begins to burn fat and muscle for energy, thus leading to a reduction in the overall body weight. NURSING CARE FOR A PATIENT SCENARIO 7 3. Patient claims to occasionally see small gnomes on the front lawn for which she has called the police. Ensure Safety. What do you find difficult about being a nurse? Normal Childbirth with a Symptomatic Covid-19 woman. male with a hx of pulm htn, CHF, lymphedema with chronic wounds, HTN, and CKD presenting in WI clinic for follow up on his multiple medical issues. Miscommunication can easily lead to frustration and a perceived power imbalance between the patient and healthcare provider. Diabetes insipidus is caused by problems with a chemical known as vasopressin (AVP), which is also referred to as antidiuretic hormone (ADH). Critical care nursing is a complicated and rewarding field in which to work. Your charge nurse just told you that you’re getting another patient. She can no longer comb her hair, and refuses any blood draws and most medication, though is otherwise cognitively intact. He has a h/o HTN and Hyperlipidemia, and he is on galantamine for his dementia. Assessment can be called the “base or foundation” of the nursing process. The nurse also notices that Mary is not breathing, and her EKG shows a heart rate of less than 30. He drives to Barracks Road for lunch every day, and has never had an accident. Nursing simulation scenarios allow students to provide real patient care For a truly unparalleled clinical education, Lippincott partnered with the National League for Nursing (NLN) to develop evidence-based nursing simulation patient scenarios for nursing students so they can receive the most realistic clinical education imaginable. The patient should also be counselled on lifestyle management to reduce the development of fluid overload. These include reduce the salt intake to 6g per day as well as restrict the fluid intake. is a 75 y.o. Psychiatry feels that patient should see them regularly and start Seroquel. This scenario is a classic example of check-back. Mr Bonnici is 68 years of age and was admitted to the aged care facility two days ago. 9 days ago, he met with his son who has now been tested positive for 2019-nCoV. It eliminates the potential to assume various inappropriate and including it in the research as it is likely to skew the results to the extent of making them dysfunctional. Fusion theme by digitalnature | powered by WordPress Polydipsia is the increase in thirst as a result of high blood glucose that raises the osmolarity of the blood, thus making it more concentrated. Nurse: You feel a bit warm. Sorting through the concerns that were voiced- daughter, wife and patient all seemed to have differing opinions. Scenario 6. Impaired glucose tolerant is induced by a decrease in glucose responsiveness in the early phase of insulin secretion. Those may cover patient care, crisis management, patient education, and more. The condition is caused by dysregulation, which results in the process of ketosis and the release of ketones into the blood. Go assess your patient. I was new to the hospital at the time, so I checked in with his nurse before deciding to provide it myself. The last time he did go – he cursed at people and was told he is not welcome anymore if he continues to exhibit this behavior. As a result, the glucose from the blood cannot enter the cells due to either a lack of insulin or insulin resistance- so the body cannot convert the food eaten into energy. hard to tell who was most important to listen to. Pharmaceutical Care Issues The patient called the healthcare triage call center, with high fever, coughing, chest pain, and respiratory difficulty. The hormone epinephrine participates in the development of KDA aiding the liver to convert stored glycogen to glucose and release it, thus raising blood sugar levels leading to KDA. We are also giving a video about top tips in nursing interventions for NMC OSCE Planning station which you can watch here.. about the patient, including prior INRs and relevant medications. The patient exhibited classic signs of Type 1 diabetes. Her cxr’s look fine. In the scenario, the patient complained of frequently visiting the bathroom and feels very weak. The nurse calls for a code blue response while the team involved in the procedure begins to administer CPR. Free scenarios currently for simulation in healthcare currently include: GI Bleed or “Blood & Guts” “It's all in the Head” Meti-meningitis/seizure Femur Fracture with Pulmonary Embolism Ischemic Stroke with Increased ICP IV … How do I evaluate him for this? Mr. A is a 78 year old retired Anglican Priest with mild Alzheimer’s dementia. When I inherited her she had a diagnosis of COPD but given her disposition/age, she has been unable to perform PFTs. The patient exhibited classic signs of Type 1 diabetes. To prevent those kind of scenarios, we have created a cheat … You are the critical care nurse about to receive Mr. Sweet, a 24-year-old DKA (diabetic ketoacidosis) patient from the ED. In this case scenario, the patient was diagnosed with hypothyroidism, which had not been treated, thus leading to myxedema coma. The woman is persistently coughing, feels warm, and is generally showing mild symptoms of Covid-19. The onset of diabetes mellitus causes the blood sugar levels to get too high, increasing the concentration of blood sugar and make one feel thirsty, respective of how much water one drinks. Multiple people in an exam room, a restless child, or a controlling spouse can adversely affect the patient encounter. OSCE Scenario One YouTube. Nurses are masters at multitasking - for example, managing multiple patients, administering medication on time while maintaining detailed notes. You must get in touch with her physician to see what should be done about her warfarin. Notably, the individuals with Polydipsia urinate frequently and pass large volumes of urine- more than 3 liters daily compared to the normal urine output in adults of approximately 1 to 2 liters a day. All Rights Reserved, © 2021 NursingAssignments.org. Another one of your patients is in the bathroom and just hit the call bell. Sample Case Scenarios. 10+ Nursing Case Study Examples in PDF | DOC. applied across all fields of nursing practice – including Nursing Associates, irrespective of the clinical setting and should be applied to the care needs of all patients. The nurse from the ER calls to give you report. The risk increases with the number of affected family members due to shared genetic factors such as insulin resistance. Patient: Nurse, I think I might have a fever. The treatment goals for managing pheochromocytoma include the removal of the tumor and control of blood pressure. What makes this question simple is that there’s technically only one right answer. Case: 70 year … OSCE Best Practice Guidelines—applicability For Nursing. This way, the concentration of the hormone in the blood is maintained. Below is a collection of donated scenarios for you to use or modify. About three minutes into the scenario, the patient stated that she was not feeling well and that she felt weak and short of breath. In the scenario, the patient lost weight despite eating more, an indication that there is insufficient insulin that prevents the body from absorbing the necessary glucose that can be broken down into energy. You know to yourself that something is wrong about your study methods because even if you study hard, you don’t see the fruit of your labor. They love if you give loads of examples of how you do it. She was living in downtown cville and was interested in going to an assisted living facility, but her sons refused to support her in that decision due to poor outcome with another family member. He refuses to take his … What They Want to Know: Many aspects of … The Objective Structured Clinical Examination Nursing Times. In this scenario, the patient has a family history of diabetes. In the case study, the patient has been experiencing unquenchable thirst, an indication of an imbalance in the osmotic concentration due to the loss of a significant amount of fluid. Impaired insulin secretion leads to a reduction in glucose responsiveness. The patient experienced racing heartbeat accompanied by perspiration, hyperactivity, and palpitation, an indication of a lack of hormonal control. How do you prioritize tasks while maintaining excellent patient care? GERD Case Study Scenario A 54 year old male patient has been admitted to the unit you are working on. This is particularly difficult when nurses help make end-of-life decisions. Myxedema coma often occurs as a result of long-standing, undiagnosed or untreated hypothyroidism and is often precipitated by a systemic disease. Scenario 6. Toward the end of the procedure, the nurse notices that Mary has turned blue and stops the procedure. Get in touch with her physician to see what should be done about her warfarin who... 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