VSim Health Assessment Case 9: Edith Jacobson. Case Study.

vSim Health Assessment Case 9: Edith Jacobson Documentation Assignments 1. Document your findings related to the focused assessment regarding Mrs. Jacobson’s neurologic status. Include her responses to your assessment. ● When I checked her pupils, they were round and reactive to light. ● During her mini-cog assessment, she did great. She was able to repeat the words I told her to remember and drew the correct time on the clock. ● While checking her GCS assessment, she got a 15, which is normal. 2. Document your findings related to the Mini-Cog and falls assessments of Mrs. Jacobson. Include her responses to your assessments. ● She was aware of her risks for falling. She showed me that she understood by telling me that she will use the call light when trying to go to the bathroom or to get out of the bed at all. She was able to recall the 3 words I asked her to remember and was able to draw the accurate time on ● the clock. 3. Referring to your feedback log, document all nursing care provided and Mrs. Jacobson’s response to this care. ● I assessed her pain level (which was a 2 in her left leg that worsens with movement); I educated her on fall risks and asking for help to get up, pain management and plan of care; She had previous knowledge on each of the things I educated her on. ● I performed a focused neuro assessment (mini-cog & GCS), and she was able to recall the words I asked her to remember and drew the correct time on the clock. She got a 15 on her GCS, which is normal.