Simulation Pre-Case Review
Please complete in entirety. This activity counts for ONE HOUR of lab/simulation/clinical time.
Student Name: Zhe Wei Date: 01/23/2021
Simulation Name: Click or tap here to enter text. Simulation Date: 01/24/2021
T. Graves Age: 16 Weight: 55 kg Height: 175 cm
Case Objectives
• Performs an accurate basic physical assessment of the patient with fluid and electrolyte imbalance (APPLYING)
• Identifies normal and abnormal assessment findings (UNDERSTANDING)
• Documents normal and abnormal assessment findings in relation to fluid and electrolyte imbalance (APPLYING)
• Demonstrates strategies for treating dehydration related to heat exhaustion (APPLYING)
• Identifies teaching opportunities regarding heat-related illnesses (UNDERSTANDING)
• Analyze social and cultural dimensions simulated patient encounters to build understanding and capacity for the
provision of culturally congruent nursing care.
Synopsis
16 year old admitted to ED for dehydration and electrolyte imbalance caused by heat exhaustion. Client passed out in the
afternoon during practice and was brought to ED by the coach. Client’s mother is enroute to hospital.
Patient History
Past Medical History:
Tubes placed in ears at 3-years-old, sport’s physical prior to beginning practices and was cleared to play,
immunization UTD
Allergies:
• No known allergies
Medications:
• None
Code Status:
• Full code
Social/Family History:
• Lives at home with parents and two siblings, Straight “A” student and star player for team, denies smoking, ETOH,
or illicit drug use
Patient Problem: Dehydration, electrolyte imbalance, passed out
Pathophysiology: Exertional heat illness generally occurs when health individual perform physical activity in hot
environments and the balance between body heat production and heat dissipation is upset resulting in excessive body
heat storage.
Risk Factors (if applicable): Strenuous exercise in high ambient temperature and humidity, lack of acclimatization, poor
physical fitness, obesity, dehydration, acute illness, and external load, including clothing, equipment, and protective gear
Questions:
What factors predispose a person to exertional heat illness (EHI)?
Obesity, low physical fitness level, lack of heat acclimatization, dehydration, a previous history of EHS, sleep
deprivation, sweat gland dysfunction, sunburn, viral illness, diarrhea, or certain medications
This study source was downloaded by 100000817935606 from CourseHero.com on 01-31-2022 05:33:19 GMT -06:00 1
https://www.coursehero.com/file/87300393/01-25-Gravesdoc/
, Describe the pathophysiology of dehydration.
Dehydration is a general state in which there is a total-body fluid deficit.
Which types of dehydration are most often associated with heat-related illnesses?
Isotonic dehydration
What electrolyte findings are common with these types of dehydration?
Normal osmolality (285–295 mOsm/kg) and normal serum sodium (135–145 mmol/L)
What assessment findings are consistent with dehydration?
Thirst, headaches, fatigue, dizziness, sunken eyes, dry mucous membranes, confusion, hypotension, tachycardia,
fever, poor skin elasticity, lethargy, oliguria, seizures, shock, coma, orthostatic hypotension, flat neck veins
Describe the differences between heat cramps, heat exhaustion and heat stroke.
Heat cramps are the mildest form of heat illness. These are painful muscle cramps and spasms that occur during
or after intense exercise and sweating in high heat.
Heat exhaustion is more severe than heat cramps. It's caused by a loss of water and salt in the body. It occurs in
conditions of extreme heat and excessive sweating without adequate fluid and salt replacement. Heat exhaustion
happens when the body can't cool itself correctly. If left untreated, it can progress to heat stroke.
What is heat stroke?
Heat stroke is the most severe form of heat illness. It occurs when the body's heat-regulating system is
overwhelmed by excessive heat. The skin may be dry if the ability to sweat has been lost. It is a life-threatening
emergency and requires immediate medical care.
How do symptoms and treatments differ for these three heat-related illnesses?
Condition Symptoms Treatment
Heat cramps Painful cramps, especially in the Move to a cool place and rest. Don't continue the activity.
legs Remove excess clothing and place cool cloths on skin; fan the skin.
Flushed, moist skin Give cool sports drinks containing salt and sugar.
Stretch cramped muscles slowly and gently.
Heat exhaustion Muscle cramps Move to a cool place and rest.
Pale, moist skin Remove excess clothing and place cool cloths on skin; fan the skin.
Often has a fever over 100.4°F (or Give cool sports drinks containing salt and sugar.
38°C) If no improvement or unable to take fluids, take your child to an
Nausea emergency room right away. IV (intravenous) fluids may be needed.
Vomiting
Diarrhea
Headache
Severe tiredness (fatigue)
Weakness
Anxiety
Passing out (fainting)
Heat stroke Warm, dry skin Move to a cool place and rest.
High fever, often over 104°F Call 911or your local emergency medical service. Heat stroke is a
(or 40°C) life-threatening medical emergency and needs to be treated by a
Rapid heart rate doctor.
Loss of appetite Remove excess clothing and drench skin with cool water; fan the
Nausea skin.
Vomiting Place ice bags on the armpits and groin areas.
Headache
Fatigue
Confusion
Agitation
Lethargy
Stupor
Seizures, coma, and death are
possible
This study source was downloaded by 100000817935606 from CourseHero.com on 01-31-2022 05:33:19 GMT -06:00 2
https://www.coursehero.com/file/87300393/01-25-Gravesdoc/
Please complete in entirety. This activity counts for ONE HOUR of lab/simulation/clinical time.
Student Name: Zhe Wei Date: 01/23/2021
Simulation Name: Click or tap here to enter text. Simulation Date: 01/24/2021
T. Graves Age: 16 Weight: 55 kg Height: 175 cm
Case Objectives
• Performs an accurate basic physical assessment of the patient with fluid and electrolyte imbalance (APPLYING)
• Identifies normal and abnormal assessment findings (UNDERSTANDING)
• Documents normal and abnormal assessment findings in relation to fluid and electrolyte imbalance (APPLYING)
• Demonstrates strategies for treating dehydration related to heat exhaustion (APPLYING)
• Identifies teaching opportunities regarding heat-related illnesses (UNDERSTANDING)
• Analyze social and cultural dimensions simulated patient encounters to build understanding and capacity for the
provision of culturally congruent nursing care.
Synopsis
16 year old admitted to ED for dehydration and electrolyte imbalance caused by heat exhaustion. Client passed out in the
afternoon during practice and was brought to ED by the coach. Client’s mother is enroute to hospital.
Patient History
Past Medical History:
Tubes placed in ears at 3-years-old, sport’s physical prior to beginning practices and was cleared to play,
immunization UTD
Allergies:
• No known allergies
Medications:
• None
Code Status:
• Full code
Social/Family History:
• Lives at home with parents and two siblings, Straight “A” student and star player for team, denies smoking, ETOH,
or illicit drug use
Patient Problem: Dehydration, electrolyte imbalance, passed out
Pathophysiology: Exertional heat illness generally occurs when health individual perform physical activity in hot
environments and the balance between body heat production and heat dissipation is upset resulting in excessive body
heat storage.
Risk Factors (if applicable): Strenuous exercise in high ambient temperature and humidity, lack of acclimatization, poor
physical fitness, obesity, dehydration, acute illness, and external load, including clothing, equipment, and protective gear
Questions:
What factors predispose a person to exertional heat illness (EHI)?
Obesity, low physical fitness level, lack of heat acclimatization, dehydration, a previous history of EHS, sleep
deprivation, sweat gland dysfunction, sunburn, viral illness, diarrhea, or certain medications
This study source was downloaded by 100000817935606 from CourseHero.com on 01-31-2022 05:33:19 GMT -06:00 1
https://www.coursehero.com/file/87300393/01-25-Gravesdoc/
, Describe the pathophysiology of dehydration.
Dehydration is a general state in which there is a total-body fluid deficit.
Which types of dehydration are most often associated with heat-related illnesses?
Isotonic dehydration
What electrolyte findings are common with these types of dehydration?
Normal osmolality (285–295 mOsm/kg) and normal serum sodium (135–145 mmol/L)
What assessment findings are consistent with dehydration?
Thirst, headaches, fatigue, dizziness, sunken eyes, dry mucous membranes, confusion, hypotension, tachycardia,
fever, poor skin elasticity, lethargy, oliguria, seizures, shock, coma, orthostatic hypotension, flat neck veins
Describe the differences between heat cramps, heat exhaustion and heat stroke.
Heat cramps are the mildest form of heat illness. These are painful muscle cramps and spasms that occur during
or after intense exercise and sweating in high heat.
Heat exhaustion is more severe than heat cramps. It's caused by a loss of water and salt in the body. It occurs in
conditions of extreme heat and excessive sweating without adequate fluid and salt replacement. Heat exhaustion
happens when the body can't cool itself correctly. If left untreated, it can progress to heat stroke.
What is heat stroke?
Heat stroke is the most severe form of heat illness. It occurs when the body's heat-regulating system is
overwhelmed by excessive heat. The skin may be dry if the ability to sweat has been lost. It is a life-threatening
emergency and requires immediate medical care.
How do symptoms and treatments differ for these three heat-related illnesses?
Condition Symptoms Treatment
Heat cramps Painful cramps, especially in the Move to a cool place and rest. Don't continue the activity.
legs Remove excess clothing and place cool cloths on skin; fan the skin.
Flushed, moist skin Give cool sports drinks containing salt and sugar.
Stretch cramped muscles slowly and gently.
Heat exhaustion Muscle cramps Move to a cool place and rest.
Pale, moist skin Remove excess clothing and place cool cloths on skin; fan the skin.
Often has a fever over 100.4°F (or Give cool sports drinks containing salt and sugar.
38°C) If no improvement or unable to take fluids, take your child to an
Nausea emergency room right away. IV (intravenous) fluids may be needed.
Vomiting
Diarrhea
Headache
Severe tiredness (fatigue)
Weakness
Anxiety
Passing out (fainting)
Heat stroke Warm, dry skin Move to a cool place and rest.
High fever, often over 104°F Call 911or your local emergency medical service. Heat stroke is a
(or 40°C) life-threatening medical emergency and needs to be treated by a
Rapid heart rate doctor.
Loss of appetite Remove excess clothing and drench skin with cool water; fan the
Nausea skin.
Vomiting Place ice bags on the armpits and groin areas.
Headache
Fatigue
Confusion
Agitation
Lethargy
Stupor
Seizures, coma, and death are
possible
This study source was downloaded by 100000817935606 from CourseHero.com on 01-31-2022 05:33:19 GMT -06:00 2
https://www.coursehero.com/file/87300393/01-25-Gravesdoc/
