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Kim Johnson VSIM
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This document provides post scenario analysis of Kim Johnson's case in VSIM Nursing with APA citation.
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Case: Kim JohnsonVSIM Post Scenario Analysis and Reflection Activity (Adapted from VSim For Nursing & Wolters-Kluwer)
Review the medication list from the Electronic Health Record (HER) and please complete the medication research table below based on the medication listed in the assigned VSIM.
Medications – Classification and action Indication Side Effects Nursing Implications
Generic and (reasons why this medication is (pre and post assessments a nurse should be aware of
Trade Names prescribed for?) prior to and after giving this medication)
1. Oxybutynin Classifications: Uses: Side effects: CNS: Drowsiness, Assessment
Chloride (Pr) Anticholinergic; • To relieve symptoms associated dizziness, weakness, insomnia, • Periodic interruptions of therapy are recommended to
Antimuscarinic; Gu with voiding in patients with restlessness, psychotic behavior determine patient’s need for continued treatment.
Antispasmodic Therapeutic: Gu uninhibited neurogenic bladder (overdosage). CV: Palpitations, Tolerance has occurred in some patients.
Antispasmodic (Shields et al., and reflex neurogenic bladder. tachycardia, flushing. Special • Keep prescriber informed of expected responses to drug
2019, p.1204) • Also has been used to relieve pain Senses: Mydriasis, blurred vision, therapy (e.g., effect on urinary frequency, urgency, urge
of bladder spasm following cycloplegia, increased ocular incontinence, nocturia, completeness of bladder
Action: transurethral surgical procedures; tension; GI: Dry mouth, nausea, emptying).
• Exerts a direct antispasmodic • UNLABELED: treatment of vomiting, constipation, bloated • Monitor patients with colostomy or ileostomy closely;
effect on smooth muscle and hyperemesis gravidarum: alcohol feeling; INTEG: Pruritus at abdominal distention and the onset of diarrhea in these
inhibits the muscarinic action dependence; pruritus application site, rash, application patients may be early signs of intestinal obstruction or of
of acetylcholine on smooth (Shields et al., 2019, p. 1205) site reactions, erythema; UROGEN: toxic megacolon Shields et al., 2019, p.1206).
muscle. Urinary hesitancy or retention,
• Relaxes bladder smooth impotence; SYS: Severe allergic Patient & Family Education
muscle and increases bladder reactions including urticaria, skin • Do not drive or engage in potentially hazardous activities
capacity rashes, suppression of lactation, until response to drug is known.
(Shields et al., 2019, p.1204- decreased sweating, fever (Shields • Exercise caution in hot environments. By suppressing
1205) et al., 2019, p. 1205). sweating, oxybutynin can cause fever and heat stroke.
(Shields et al., 2019, p.1206)
2. Omeprazole Classifications: Proton Pump Uses: Side effects: CNS: Headache, Assessment
(Pr) Inhibitor; Antisecretory; •Duodenal and gastric ulcer. dizziness, fatigue; GI: Diarrhea, • Monitor lab tests: Periodic LFTs with prolonged use
Therapeutic: Antiulcer Gastroesophageal reflux disease abdominal pain, nausea, mild
including severe erosive transient increases in liver Patient & Family Education
Action: esophagitis (4 to 8 wk treatment). function tests; UROGEN: • Report any changes in urinary elimination such as pain or
•An antisecretory compound •Long-term treatment of pathologic Hematuria, proteinuria; INTEG: discomfort associated with urination, or blood in urine;
that is a gastric acid pump hypersecretory conditions such as Rash (Shields et al., 2019, p.1181) severe diarrhea; drug may need to be discontinued
inhibitor. Zollinger-Ellison syndrome, (Shields et al., 2019, p.1181).
•Suppresses gastric acid multiple endocrine adenomas, and
secretion by inhibiting the H+, systemic mastocytosis.
K+-ATPase enzyme system [the •In combination with clarithromycin
acid (proton H+) pump] in the to treat duodenal ulcers associated
parietal cells. with Helicobacter pylori. Dyspepsia
•Suppresses gastric acid occurring more than twice weekly.
secretion relieving •UNLABELED USES: Healing or
gastrointestinal distress and prevention of NSAID-related
promoting ulcer healing. ulcers; stress gastritis prophylaxis.
(Shields et al., 2019, p.1180)
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