PREPARE FOR SCENARIO…
1. Complete the sim packet and upload in Brightspace.
2. Review the Patient Information and use your Pearson textbook as necessary
3. Review the Admission Orders
4. Read Pearson Module 16.J & 16. M – (PVD & Stroke)
PURPOSE
In this scenario, participants are expected to provide evidence-based care for a patient
recovering from stroke or experiencing stroke symptoms.
RATIONALE
A stroke is neurologic deficits result from a sudden decrease in blood flow to the brain. On
average someone in the US have a stroke every 40 seconds and someone dies of a stroke
every 4 minutes. Stroke is the 4th leading cause of death and disability. Approximately 795, 000
individual have a stroke each year with 160,000 deaths annually.
LEARNING OUTCOMES
Upon completion of this simulation learning experience (SLE), the participant will be able to:
1. Include patient/family education appropriately.
2. Identify and prioritize patient’s needs.
3. Identify nursing diagnosis and the appropriate nursing interventions in care of the
stroke patient.
4. Perform appropriate neurological assessment in the care of the stroke patient
5. Implement seizure precautions.
6. Prioritize care for increased intracranial pressure.
7. Utilize a communication board.
8. Utilize SBAR communication.
9. Provide safe and competent care
10. Recognize the clinical findings associated with stroke.
11. Implement ordered interventions for the patient with a stroke.
COMPETENCIES ADDRESSED
BSN ESSENTIALS – II, III, IV, VII, VIII, IX
NCLEX-RN
Safe & Effective Care Environment
o Management of Care
o Safety & Infection Control
Health Promotion & Maintenance
Psychosocial Integrity
Physiological Integrity
o Basic Care and Comfort
, o Pharmacological & Parenteral Therapies
o Reduction of Risk Potential
o Physiological Adaptation
QSEN
Patient-centered Care
Safety
Evidence-based Practice
Quality Improvement
Informatics
IPEC
Roles/Responsibilities
Interprofessional Communication
Teams & Teamwork
SKILLS NEEDED FOR PARTICIPATION
Physical assessment
Vital sign assessment
Lab value interpretation
Administration of oral and IV meds
Conduct a neurological assessment
Use of continuous oxygen monitoring
Pen light for PERRLA assessment
Medication administration
ISBAR communication
Therapeutic communication
Use of personal protective equipment
Patient information: Julie Wilson, a 48-year-old female, brought into ER by husband after
she collapsed at home. Patient presented confused, complaining of a severe headache and
blurred vision. Diagnosed with ischemic stroke and treated with rTPA in the ICU. Is currently
being treated on the med/surg floor status post CVA.
I. Data Collection
History of Present Problem:
Julie Wilson, a 48-year-old female, brought into ER by husband after she collapsed at home
this am. Initially was slightly confused. Complaining of severe right temporal lobe headache
and blurred vision. Husband reports that she was complaining of headaches and blurred vision
that “came & went quickly” over the past 3-4 weeks. CT w/o contrast of right temporal lobe
positive for ischemia. Treated in ICU with rTPA. Residual left sided weakness noted. Patient
transferred to med/surg floor to begin rehabilitation and for blood pressure stabilization. Patient
noted with edema of bilateral lower extremity upon assessment by the med-surg nurse.
PMH: HTN, Diabetes – type II, hypercholesterolemia, ½ ppd smoker and peripheral vascular
disease (PVD).
Personal/Social History:
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