NR 340 Clinical Simulation Prep Packet
Name Date .
Directions: This assignment is to be completed independently (it is not a group assignment!) and turned
in on your assigned clinical simulation day. Late submissions will not be accepted. The purpose of this
assignment is to prepare you to complete the corresponding clinical simulation scenarios related to
coronary artery disease and hypertensive crisis respectively. Resources to complete this assignment
include the following:
A. Lewis Medical-Surgical Nursing, 9th edition. Prevention of osteoporosis (p. 1555) and hip
replacement post-operative management (p.1526-1527).
B. Sole textbook Pulmonary Embolism (p. 423-425) and thrombolytic candidates (p. 382).
C. Stroke/TPA articles posted on shell
This assignment is worth 50 points.
Susan Weil Simulation Scenario
1. What is the nurse’s role in providing family centered care during and after a crisis? (1 point)
The nurse’s role in communication with family members and patients is to be involved
during and after a crisis. The nurse should share information with family and patient that
is clear and avoid using medical jargon, the nurse should also be truthful and show
respect for the family and patients needs and listen to what information they have to
provide. The nurse should also provide comfort and support to the family members, be
aware of family strengths, and have respect for different methods of coping.
2. What pharmacological and non-pharmacological comfort measures can be used for a post-
operative patient? (2 points)
Pharmacological: Opoids - morphine, dilaudid, fentanyl
Non-pharmacological: Guided imagery, relaxation or breathing techniques, active
listening, re-positioning, and therapeutic touch, sedative music, limit noise and lighting,
explanation of all procedures and interventions.
3. What vital nursing assessment data should be gathered on a patient post hip replacement
surgery? (3 points)
Pain level (0-10), vital signs, check surgical site dressing for drainage and signs of
infections, bowel sounds, lungs sounds and perfusion
4. Describe the major complications that can arise for patients who are post-operative hip
injury/replacement? (3 points)
DVT, PE, stroke, infection, falls
5. Describe the pathophysiologic process of a pulmonary embolism. Include the typical origin
site of a pulmonary embolism. (3 points)
, NR 340 Clinical Simulation Prep Packet
Name Date .
There is a blockage in a blood vessel that forms a blood clot (thrombus). The thrombus
dislodges from the blood vessel and travels through the blood until it becomes stuck in a
blood vessel in the lungs and occludes blood flow. Pulmonary embolism happens most
commonly due to mobilization of a clot from deep venous thrombosis in the lower leg.
6. What are 3 signs and symptoms associated with a pulmonary embolism? (2 points)
Shortness of breath (SOB), chest pain, coughing (possibly bloody)
7. What medical treatments can be used to treat a pulmonary embolism? (2 points)
Treatment includes anticoagulants (heparin), thrombolytics (tpa), or possibly surgery.
8. What immediate nursing interventions should the nurse perform for a patient who is
experiencing a pulmonary embolism? (3 points)
Rapid Response
Bed Rest
Order for stat chest x-ray
Give supplemental oxygen
9. Describe the actions, indications, contraindications, adverse effects, dose range and method
of administration for the following medications: (6 points)
Drug Actions Indications Contraindicati Adverse effects Dose range Method of
ons administration
Heparin Potentiates the Prophylaxis Hypersensitivity, Bleeding, heparin- IV: Intermittent IV, Sub-Q
inhibitory effect of and treatment uncontrolled induced bolus 10,000
antithrombin on of various bleeding, severe thrombocytopenia units followed by
factor Xa and thromboembol thrombocytopeni , pain at injection 5,000-10,000
thrombin. In low ic disorders. a site, fever units q 4-6 hr.
doses, prevents the Ex: PE, A fib Continuous
conversion of infusion 5,000
prothrombin to units (35-70
thrombin by its units/kg)
effects on factor followed by
Xa. Higher doses 20,000-40,000
neutralize units infused
thrombin, over 24 hrs.
prevention the
conversion of
fibrinogen to fibrin.
Therapeutic effect:
Prevention of
thrombus
formation.
Name Date .
Directions: This assignment is to be completed independently (it is not a group assignment!) and turned
in on your assigned clinical simulation day. Late submissions will not be accepted. The purpose of this
assignment is to prepare you to complete the corresponding clinical simulation scenarios related to
coronary artery disease and hypertensive crisis respectively. Resources to complete this assignment
include the following:
A. Lewis Medical-Surgical Nursing, 9th edition. Prevention of osteoporosis (p. 1555) and hip
replacement post-operative management (p.1526-1527).
B. Sole textbook Pulmonary Embolism (p. 423-425) and thrombolytic candidates (p. 382).
C. Stroke/TPA articles posted on shell
This assignment is worth 50 points.
Susan Weil Simulation Scenario
1. What is the nurse’s role in providing family centered care during and after a crisis? (1 point)
The nurse’s role in communication with family members and patients is to be involved
during and after a crisis. The nurse should share information with family and patient that
is clear and avoid using medical jargon, the nurse should also be truthful and show
respect for the family and patients needs and listen to what information they have to
provide. The nurse should also provide comfort and support to the family members, be
aware of family strengths, and have respect for different methods of coping.
2. What pharmacological and non-pharmacological comfort measures can be used for a post-
operative patient? (2 points)
Pharmacological: Opoids - morphine, dilaudid, fentanyl
Non-pharmacological: Guided imagery, relaxation or breathing techniques, active
listening, re-positioning, and therapeutic touch, sedative music, limit noise and lighting,
explanation of all procedures and interventions.
3. What vital nursing assessment data should be gathered on a patient post hip replacement
surgery? (3 points)
Pain level (0-10), vital signs, check surgical site dressing for drainage and signs of
infections, bowel sounds, lungs sounds and perfusion
4. Describe the major complications that can arise for patients who are post-operative hip
injury/replacement? (3 points)
DVT, PE, stroke, infection, falls
5. Describe the pathophysiologic process of a pulmonary embolism. Include the typical origin
site of a pulmonary embolism. (3 points)
, NR 340 Clinical Simulation Prep Packet
Name Date .
There is a blockage in a blood vessel that forms a blood clot (thrombus). The thrombus
dislodges from the blood vessel and travels through the blood until it becomes stuck in a
blood vessel in the lungs and occludes blood flow. Pulmonary embolism happens most
commonly due to mobilization of a clot from deep venous thrombosis in the lower leg.
6. What are 3 signs and symptoms associated with a pulmonary embolism? (2 points)
Shortness of breath (SOB), chest pain, coughing (possibly bloody)
7. What medical treatments can be used to treat a pulmonary embolism? (2 points)
Treatment includes anticoagulants (heparin), thrombolytics (tpa), or possibly surgery.
8. What immediate nursing interventions should the nurse perform for a patient who is
experiencing a pulmonary embolism? (3 points)
Rapid Response
Bed Rest
Order for stat chest x-ray
Give supplemental oxygen
9. Describe the actions, indications, contraindications, adverse effects, dose range and method
of administration for the following medications: (6 points)
Drug Actions Indications Contraindicati Adverse effects Dose range Method of
ons administration
Heparin Potentiates the Prophylaxis Hypersensitivity, Bleeding, heparin- IV: Intermittent IV, Sub-Q
inhibitory effect of and treatment uncontrolled induced bolus 10,000
antithrombin on of various bleeding, severe thrombocytopenia units followed by
factor Xa and thromboembol thrombocytopeni , pain at injection 5,000-10,000
thrombin. In low ic disorders. a site, fever units q 4-6 hr.
doses, prevents the Ex: PE, A fib Continuous
conversion of infusion 5,000
prothrombin to units (35-70
thrombin by its units/kg)
effects on factor followed by
Xa. Higher doses 20,000-40,000
neutralize units infused
thrombin, over 24 hrs.
prevention the
conversion of
fibrinogen to fibrin.
Therapeutic effect:
Prevention of
thrombus
formation.
