Real Life 3.0 Scenario PN
Medical Surgical: Kidney Disease
Objectives
After completion of the lesson, the student will be able to:
• Recognize alterations in fluid balance, regulation of electrolytes, and blood pressure in a client who has renal impairment.• Prioritize care of the client who has postoperative complications.• Implement client teaching for clients with renal biopsy.• Accurately identify and calculate oral and parenteral medication doses.• Respond with empathy to clients with life-changing conditions.• Describe the purpose of various diagnostic tests for kidney function
Individual Student Assignments
INDIVIDUAL STUDENT ASSIGNMENT
Complete Active Learning Templates:
• Diagnostic Procedure: Renal biopsy, PT INR, PTT, Type and screen
• Medication: Lisinopril, captopril, lorazepam
• System Disorder: Renal Failure
INDIVIDUAL STUDENT ASSIGNMENT
▪ Prior to the clinical day, spend at least 60 minutes in the Real Life Scenario.▪ Complete the SBAR as the nurse receives report on Ms. Vale in the scenario.Patient
Name:
Anna Vale Patient
Age:
41 Height: 5’3
Allergies:
vancomycin and IV contrast Weight: 125 Diagnosi
s:
renal failure Situation Briefly describe the current situation.Give a clear, succinct overview of pertinent issues. Describe the concern.Anna was scheduled for renal biopsy this morning but it has been delayed so she needs to be kept overnight for observation Background Briefly describe the pertinent history.What has got us to this point? Can include medications, diagnostics, and treatment.anna is in renal falure of unknown etilogy. She was healthy prior to a motor vechicle accident that happend 4 months ago where she sustained some acute chest Assessment Summarize the facts and give your best assessment. Can include vital signs.What is going on? Use your best judgment.anna is A&O x3, T 98.2, HR 106, R 20, O2 stat 95%, BP 150/96. blood samples were taken and the results are pending.Urinalysis shows protein in urine. There is a PRN order for elevated BP. No IVs or BP taken on left arm. lost weight after injuries, pt says she doesnt have an appetite,
Recommendation What actions are you asking for?What do you want to happen next?administer bp medication as ordered, monitor vital signs and answer any questions or address concerns the pt may have about the procedure 1 / 3
get pt an ID bracelet adminster bp medication address pt questions or concerns about procedure
INDIVIDUAL STUDENT ASSIGNMENT
While completing the SBAR, identify three (3) top priorities and an action plan for these priorities (what can you do, as a nurse, to address these priorities).
• Priorities:
▪ Action Plan:
INDIVIDUAL/POST CONFERENCE ASSIGNMENT
After completing the Real Life Scenario, answer these discussion points. Be prepared to
discuss in post-conference:
▪ What were some of the challenging decisions you made as a nurse? Describe the rationale behind these decisions.▪ If you made a wrong decision during the scenario, what were you thinking that lead you down the incorrect path?
▪ What are some aspects of client care that you did not feel prepared to make clinical decisions for in the scenario?the only one i got wrong was letting the charge nurse know that she didnt have a bracelet. I thought this would be the right choice due to the bracelet being important but that was not the case. I should have just got her a bracelet get the pt a ID bracelet to have the proper idenfication for distrubting meds.admister the pt bp meds and monitor the vital signs after because anna showed some stress about the proedure and has asked for meds to relieve the anxiety call MD and ask about a perscription to help not letting anna get up and go to the bathroom instead of using the bedpan. After being told so much early ampublation is key i was hard to pick the bedpan option. With her being a fall risk though i understood why she couldnt get up and use the restroom.I really didnt have any moments where i thought i was going to be wrong. I actually did really well on this senerio. 2 / 3
▪ Describe an “Aha” moment you experienced during this learning experience and how it will expand your nursing care?▪ List 5 concepts you learned from the scenario. How will you apply your knowledge of each concept to a future patient?
▪ Be prepared to discuss the medications available in this scenario.
▪ What are three (3) nursing diagnoses you could use for the plan of care on this patient?▪ What is the difference between acute renal failure and chronic renal failure?
that a pt is at risk for falls after renal biopsy the s/s of shock after renal biopsy the proper procedure for pt without an ID bracelet the adminstration of IV fluids before getting a urine sample that you can get an order for anexity meds if you feel it would benfit the pt When i figured out she was a fall risk and couldnt go to the bathroom herself, really just about this whole scenerio had aha moments because everything ive learned up to this point was really clicking risk for decreased c/o impaired urinary elimination risk for infection fall risk r/t procedure acute renal failure is sudden and a full recovery is a possibilty chronic renal failure is gradual, progressive, and fatal
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