Focused Exam: Type 1 Diabetes Patient: Chelsea Warren

Focused Exam: Type 1 Diabetes Patient: Chelsea Warren Digital Clinical Experience Score 100% Subjective Data Collection: 25 of 25 (100.0% Category Finding: Assessed patient status Finding: Reports feeling "way better" (Found) Pro Tip: Assessing a pediatric patient's status involves asking about their current comfort, needs, and chief complaint. It's important to check in with a patient's status, because it may reveal insight into their current condition. Example Question: How do you feel? Finding: Reports eagerness to go home (Found) Pro Tip: Assessing a pediatric patient's status involves asking about their current comfort, needs, and chief complaint. It's important to check in with a patient's status, because it may reveal insight into their current condition. Example Question: How do you feel? Finding: Asked about patient's comfort Finding: Reports feeling comfortable (Found) Pro Tip: Assessing a pediatric patient's status involves asking about their current comfort, needs, and chief complaint. It's important to check in with a patient's status, because it may reveal insight into their current condition. Example Question: Are you having pain right now? Finding: Asked about patient's needs Finding: Denies needing anything (Found) Pro Tip: Assessing a pediatric patient's status involves asking about their current comfort, needs, and chief complaint. It's important to check in with a patient's status, because it may reveal insight into their current condition. Example Question: Do you need anything? Finding: Asked patient about symptoms of DKA Finding: Denies remembering incident very well (Found) Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: Why were you admitted? Finding: Reports feeling nauseated at a horseback riding lesson (Found) Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: Why were you admitted? Finding: Reports vomiting (Found) Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: Why were you admitted? Finding: Asked about patient's other symptoms prior to DKA Finding: Reports frequent urination prior to DKA (Found) Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: Have you been urinating more often than usual? Finding: Reports excessive thirst prior to DKA (Found) Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: Have you been feeling more thirsty lately? Finding: Reports fatigue prior to DKA (Found) Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: Are you always fatigued? Finding: Reports lack of appetite prior to DKA (Available) Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: How is your appetite? Finding: Asked about onset of prior symptoms Finding: Reports other symptoms began around 10 days prior (Found) Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: When did you start feeling sick? Finding: Assessed patient's knowledge of type 1 diabetes Finding: Reports knowledge of type 1 diabetes (Found) Pro Tip: Assessing a pediatric patient's knowledge of their preexisting conditions helps you determine how to educate both guardian and patient. Example Question: What type of diabetes do you have? Finding: Asked about diet at mother's house Finding: Reports mother is a "health nut" (Found) Pro Tip: Assessing a pediatric patient's diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their chief complaint. Details of their current diet will help you to educate the patient on a diet that will help in the treatment and management of their condition. Example Question: What is your diet like? Finding: Reports typical breakfast at mother's home is yogurt and fruit (Available) Pro Tip: Assessing a pediatric patient's diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their chief complaint. Details of their current diet will help you to educate the patient on a diet that will help in the treatment and management of their condition. Example Question: What's your usual breakfast? Finding: Reports typical lunch is a salad with chicken (Available) Pro Tip: Assessing a pediatric patient's diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their chief complaint. Details of their current diet will help you to educate the patient on a diet that will help in the treatment and management of their condition. Example Question: What do you usually eat for lunch? Finding: Reports typical dinner is grilled meat and vegetables (Available) Pro Tip: Assessing a pediatric patient's diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their chief complaint. Details of their current diet will help you to educate the patient on a diet that will help in the treatment and management of their condition. Example Question: What's a typical dinner? Finding: Asked about social activities Finding: Reports riding horses 2-3 times a week after school (Found) Pro Tip: A pediatric patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet and exercise. Even though you are working with pediatric patients, it is important to ask about sexual activity and substance use. These factors can influence their current health and wellness. Asking about a pediatric patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: How often do you ride horses? Finding: Asked about substance use Finding: Denies tobacco use (Available) Pro Tip: A pediatric patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet and exercise. Even though you are working with pediatric patients, it is important to ask about sexual activity and substance use. These factors can influence their current health and wellness. Asking about a pediatric patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: Have you ever experimented with smoking? Finding: Denies vaping (Available) Pro Tip: A pediatric patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet and exercise. Even though you are working with pediatric patients, it is important to ask about sexual activity and substance use. These factors can influence their current health and wellness. Asking about a pediatric patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: Have you ever vaped or used an ecigarette? Finding: Denies alcohol use (Available) Pro Tip: A pediatric patient's social history encompasses their family and support system, living situation, and daily behaviors such as diet and exercise. Even though you are working with pediatric patients, it is important to ask about sexual activity and substance use. These factors can influence their current health and wellness. Asking about a pediatric patient's social history can also unveil the influence of their present illnesses in their social lives. Example Question: Do you drink alcohol? Finding: Asked about general symptoms Finding: Denies current excessive thirst (Found) Pro Tip: Understanding a pediatric patient's health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Example Question: Have you been feeling more thirsty lately? Finding: Asked about gastrointestinal symptoms Finding: Denies current nausea (Found) Pro Tip: Understanding a pediatric patient's health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Example Question: Did your nausea improve? Finding: Denies current vomiting (Found) Pro Tip: Understanding a pediatric patient's health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Example Question: Are you going to be sick? Finding: Reports normal bowel movements (Available) Pro Tip: Understanding a pediatric patient's health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Example Question: Are you feeling constipated? Finding: Asked about urinary symptoms Finding: Denies current frequent urination (Found) Pro Tip: Understanding a pediatric patient's health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Example Question: How long have you been urinating more frequently? Finding: Denies high volume of urine (Found) Pro Tip: Understanding a pediatric patient's health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Example Question: Do you urinate a lot? Finding: Asked about neurological system Finding: Denies neurological symptoms (Found) Pro Tip: Understanding a pediatric patient's health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Example Question: Do you feel tingling anywhere? Finding: Confirmed guardian's relationship to patient Finding: Reports he is patient's father (Found) Pro Tip: Determining the guardian's relationship to a pediatric patient confirms the appropriate family members are present. Knowing who is with the pediatric patient will help you to develop the best approach to gathering information on the patient's condition. Example Question: what is your relationship to the patient Finding: Asked about patient's diagnosi Finding: Reports patient is diagnosed with type 1 diabetes (Found) Pro Tip: Asking a pediatric patient's guardian about the duration and onset of the patient's current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: What is your daughter's diagnosis Finding: Followed up on history of present illness leading to diagnosis Finding: Reports patient was admitted to hospital two days prior (Found) Pro Tip: Asking a pediatric patient's guardian about the duration and onset of the patient's current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: When was your daughter hospitalized Finding: Reports patient had diabetic ketoacidosis when admitted (Found) Pro Tip: Asking a pediatric patient's guardian about the duration and onset of the patient's current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: Did your daughter have complications with her diabetes? Finding: Asked guardian about symptoms of DKA Finding: Reports thinking she had a "stomach bug" at first (Found) Pro Tip: Asking a pediatric patient's guardian about the duration and onset of the patient's current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: How was your daughter feeling? Finding: Reports taking daughter to ED when he realized she was "out of it" (Found) Pro Tip: Asking a pediatric patient's guardian about the duration and onset of the patient's current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: How was your daughter feeling? Finding: Asked about patient's symptoms prior to DKA Finding: Reports weight loss (Found) Pro Tip: Asking a pediatric patient's guardian about the duration and onset of the patient's current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: Has your daughter's weight changed lately? Finding: Followed up on weight loss Finding: Reports patient lost 5 pounds (Found) Pro Tip: Asking a pediatric patient's guardian about the duration and onset of the patient's current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: How much weight has your daughter lost? Finding: Reports weight loss happened in the two weeks since he last saw the patient (Found) Pro Tip: Asking a pediatric patient's guardian about the duration and onset of the patient's current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Example Question: How much weight has your daughter lost? Finding: Assessed knowledge of type 1 diabetes Finding: Reports knowledge of type 1 diabetes (Found) Pro Tip: Assessing a pediatric guardian's knowledge of the patient's preexisting condition helps you determine how to educate both guardian and patient. Example Question: Do you know anything about type 1 diabetes? Finding: Asked about guardian's knowledge of patient's diet Finding: Reports patient's favorite breakfast is pancakes and fruit (Available) Pro Tip: Asking a pediatric patient's guardian about their diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their current chief complaint. Details of their current diet will help you to educated the guardian on a diet that will help in the treatment and management of their condition. Example Question: What does your daughter usually eat for breakfast? Finding: Reports typical lunch is a sandwich and chips (Available) Pro Tip: Asking a pediatric patient's guardian about their diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their current chief complaint. Details of their current diet will help you to educated the guardian on a diet that will help in the treatment and management of their condition. Example Question: What does your daughter usually eat for lunch? Finding: Reports going out to dinner often (Available) Pro Tip: Asking a pediatric patient's guardian about their diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their current chief complaint. Details of their current diet will help you to educated the guardian on a diet that will help in the treatment and management of their condition. Example Question: What does your daughter usually eat for dinner? Finding: Denies knowledge of high carb intake (Available) Pro Tip: Asking a pediatric patient's guardian about their diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their current chief complaint. Details of their current diet will help you to educated the guardian on a diet that will help in the treatment and management of their condition. Example Question: How many carbohydrates does your daughter eat a day Finding: Reports belief in a low sugar intake (Found) Pro Tip: Asking a pediatric patient's guardian about their diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their current chief complaint. Details of their current diet will help you to educated the guardian on a diet that will help in the treatment and management of their condition. Example Question: How many carbohydrates does your daughter eat a day Finding: Asked guardian about social history Finding: Reports being divorced from patient's mom (Found) Pro Tip: A patient's and their guardian's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. These factors can influence their current health and wellness. Asking a guardian about a pediatric patient's social history can also unveil the influence of their present illnesses on their social lives. Example Question: Are you married? Finding: Reports patient splits time evenly between homes (Found) Pro Tip: A patient's and their guardian's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. These factors can influence their current health and wellness. Asking a guardian about a pediatric patient's social history can also unveil the influence of their present illnesses on their social lives. Example Question: Are you married? Finding: Reports patient alternates between homes every 2 weeks (Found) Pro Tip: A patient's and their guardian's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. These factors can influence their current health and wellness. Asking a guardian about a pediatric patient's social history can also unveil the influence of their present illnesses on their social lives. Example Question: Have you been divorced? Finding: Reports a stable home life (Found) Pro Tip: A patient's and their guardian's social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. These factors can influence their current health and wellness. Asking a guardian about a pediatric patient's social history can also unveil the influence of their present illnesses on their social lives. Example Question: How is your daughter's relationship with her mother? Finding: Asked about past hospitalizations Finding: Denies past hospitalizations (Found) Pro Tip: Asking a guardian about the pediatric patient's relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient's existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Example Question: Has your daughter been hospitalized before? Finding: Denies past surgeries (Found) Pro Tip: Asking a guardian about the pediatric patient's relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient's existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment. Example Question: Has your daughter been hospitalized before? Finding: Asked about relevant family medical history Finding: Reports patient's paternal grandmother has type 2 diabetes Objective Data Collection: 2 of 2 (100%) • Correct • Partially correct • Incorrect • Missed Temperature (1/5 point) • Normothermic • Hyperthermic • Hypothermic Blood Pressure (1/5 point) • Normotensive • Hypertensive • Hypotensive Heart Rate (1/5 point) • No abnormal findings • Tachycardia • Bradycardia Respiratory Rate (1/5 point) • No abnormal findings • Tachypnea • Bradypnea Oxygen Saturation (1/5 point) • No abnormal findings • Hypoxemia Bmi For Age (1/2 point) • Underweight • Normal Weight • Overweight • Obese • Question 1: You Scored a 1 out of 1 • Educate Chelsea in the most therapeutic manner on what supplies she will need to administer insulin. • Student Response • 1st Try - Correct • Chelsea, before you administer insulin, you will need a new, packaged syringe, a vial of insulin, alcohol wipes, and access to a special container for storing your used syringe. Do you have any questions? • Feedback: Okay, got it. • Question 2: You Scored a 1 out of 1 • Educate in the most therapeutic manner on how to prepare a syringe for injection. • Student Response • 1st Try - Correct • Chelsea, take the syringe out of its packaging, and pull the cap off of the needle on the syringe. Pull the plunger of syringe back until it is level with the correct dose. The numbers are printed on the side of the syringe. • Feedback: Take the syringe out of the package, get the cap off the needle, pull the plunger back to my correct dose. Roger, dodger. • Question 3: You Scored a 1 out of 1 • Educate Chelsea on the first steps in filling the syringe with insulin. • Student Response • 1st Try - Correct • Put the bottle of insulin on a flat surface, and hold it steady with one hand. With your other hand, push the needle straight into the insulin bottle and slowly push the plunger down. This will inject the air in the syringe into the bottle. Don't pull the syringe out yet. Any questions? • Feedback: No questions. So far, so good. • Question 4: You Scored a 1 out of 1 • Educate Chelsea on completing the process of filling the syringe with insulin. • Student Response • 1st Try - Correct • With the needle still in the insulin vial, turn both upside down, so that the bottom of the vial is pointing at the ceiling. Slowly draw the plunger down so that insulin fills the syringe. Keep the tip of the needle in the insulin, and make sure you don't bend the needle. Do you have any questions? • Feedback: I still get it. • Question 5: You Scored a 1 out of 1 • Educate Chelsea on how to evacuate air bubbles from the syringe. • Student Response • 1st Try - Correct • The needle is still in the bottle at this point. Tap the side of the syringe with your finger to make any bubbles rise to the top. Then, you can push the plunger just enough to force the air out through the needle. • Feedback: Makes sense to me. • Question 6: You Scored a 1 out of 1 • Educate Chelsea on prepping the insulin injection site. • Student Response • 1st Try - Correct • After removing the needle from the vial, use an alcohol pad to clean the injection site. Let the site dry, otherwise it might sting a little. Pinch approximately 1 inch of skin, not too hard. Insert the needle into the pinched skin at the proper angle and slowly push the plunger in until it is empty. Leave the needle in your skin for five seconds. Any questions? • Feedback: Huh, okay. • Question 7: You Scored a 1 out of 1 • Educate Chelsea on how to complete the injection process. • Student Response • 1st Try - Correct • Once you take the needle out, keep an eye on the area you injected. If you see any bleeding, use a tissue to clean it up. If you see any insulin leak out, check back with your provider to go over the injection process again. • Feedback: Watch out for leaks, and clean up the blood. I got it. Documentation / Electronic Health Record Model Documentation Chelsea’s current condition is stable. She is feeling better than she has been lately. No current nausea or vomiting. Chelsea is alert and curious, and expressed an eagerness to go home. She said that she has not administered her own insulin yet, or done her own glucose monitoring. Chelsea expressed some confusion about the pathophysiology of type 1 diabetes. She said she had not done her own insulin administration or glucose monitoring. Her father also expressed some misunderstandings over carbohydrates. Model Documentation Chelsea is very socially active and engaged. She horseback rides several times a week, attends Sunday school, and has a healthy group of friends. She denies alcohol or tobacco use. She divides her time 50/50 between her father and mother’s homes, but she seems to be well-adjusted to the arrangement. Care Plan : 11.5 of 11.5 (100.0%) Nursing Diagnoses: Definitions & Classifications © NANDA-International, 2017 used by arrangement with Thieme Medical Publishers, Inc., a division of the Thieme Group. All rights reserved. Authorized translation from the English language edition published by Thieme Medican Publishers Inc. No part of this material may be reproduced in any form without the written permission of the agent of the copyright holder, NANDA-International. Direct inquires to . Link for more information: Status Student Response Model Answer Explanation Points Earned exhibits exhibits The correct status for the nursing diagnosis is "exhibits," because Chelsea's current behavior shows readiness to learn more about managing her health. This is not a risk but is present. 0.5 out of 0.5 Diagnosis Student Response Model Answer Explanation Points Earned readiness for enhanced health management readiness for enhanced health management Chelsea's behavior indicates she is ready to learn more about managing her newly diagnosed chronic illness. 0.5 out of 0.5 Etiologies Student Response Model Answer Explanation Points Earned new onset chronic disease new onset chronic disease Chelsea is ready for enhanced health management as it relates to her newly onset chronic disease. 0.5 out of 0.5 Signs & Symptoms Student Response Model Answer Explanation Points Earned expresses interest in learning expresses interest in learning Chelsea expresses a desire to better manage her chronic illness by expressing a desire to enhance management of her illness, expressing a desire to enhance management of prescribed regimens, expressing a desire to enhance management of risk factors, and expressing an interest in learning. 0.5 out of 0.5 expresses desire to enhance management of expresses desire to enhance management of Chelsea expresses a desire to better manage her chronic illness by expressing a desire to enhance 0.5 out of 0.5 illness illness management of her illness, expressing a desire to enhance management of prescribed regimens, expressing a desire to enhance management of risk factors, and expressing an interest in learning. expresses desire to enhance management of risk factors expresses desire to enhance management of risk factors Chelsea expresses a desire to better manage her chronic illness by expressing a desire to enhance management of her illness, expressing a desire to enhance management of prescribed regimens, expressing a desire to enhance management of risk factors, and expressing an interest in learning. 0.5 out of 0.5 expresses desire to enhance management of prescribed regimens expresses desire to enhance management of prescribed regimens Chelsea expresses a desire to better manage her chronic illness by expressing a desire to enhance management of her illness, expressing a desire to enhance management of prescribed regimens, expressing a desire to enhance management of risk factors, and expressing an interest in learning. 0.5 out of 0.5 Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor. Prompt Model Answer Explanation Why would a While it can be Your nursing diagnosis should always take nursing diagnosis uncomfortable for a newly into account what condition is most serious, of impaired diagnosed type 1 diabetic receiving the greatest benefit from your comfort be to learn how to use a help. This diagnosis may not be the most incorrect, glucometer or inject obvious physical symptom to you or your compared to insulin, the most effective patient, so always consider what is readiness for nursing care you can jeopardizing a patient's health the most. enhanced health provide for Chelsea is a management? comprehensive approach to her health management. This is supported by her desire to learn more about managing her chronic illness. Short-Term Goal Student Response Model Answer Explanation Points Earned To have the patient and her guardian verbalize and agree to their instructions on how to manage type 1 diabetes until care is established with an endocrinologist, by end of the hospital stay To have the patient and her guardian verbalize and agree to their instructions on how to manage type 1 diabetes until care is established with an endocrinologist, by end of the hospital stay Enhancing Chelsea and her family's knowledge of managing her type 1 diabetes will have the highest impact on the patient's chronic illness. 0.5 out of 0.5 Interventions Student Response Model Answer Explanation Points Earned Instruct family and Instruct family and Many of these instructions work 0.5 out patient on patient on toward enhancing the patient's of 0.5 carbohydrate counting carbohydrate counting and family's knowledge of and a diabetic diet and a diabetic diet health management, which can lead to better care for the patient's chronic illness. Instruct family and patient on how to create an "action plan" at school Instruct family and patient on how to create an "action plan" at school Many of these instructions work toward enhancing the patient's and family's knowledge of health management, which can lead to better care for the patient's chronic illness. 0.5 out of 0.5 Instruct family and patient on the causes of type 1 diabetes Instruct family and patient on the causes of type 1 diabetes Many of these instructions work toward enhancing the patient's and family's knowledge of health management, which can lead to better care for the patient's chronic illness. 0.5 out of 0.5 Instruct family and patient on the differences between type 1 and type 2 diabetes Instruct family and patient on the differences between type 1 and type 2 diabetes Many of these instructions work toward enhancing the patient's and family's knowledge of health management, which can lead to better care for the patient's chronic illness. 0.5 out of 0.5 Instruct family and patient on the signs and symptoms of hyperglycemia Instruct family and patient on the signs and symptoms of hyperglycemia Many of these instructions work toward enhancing the patient's and family's knowledge of health management, which can lead to better care for the patient's chronic illness. 0.5 out of 0.5 Instruct family and patient on the signs and symptoms of hypoglycemia Instruct family and patient on the signs and symptoms of hypoglycemia Many of these instructions work toward enhancing the patient's and family's knowledge of health management, which can lead to better care for the patient's chronic illness. 0.5 out of 0.5 Instruct family and Instruct family and Many of these instructions work 0.5 out patient on what to do during sick days patient on what to do during sick days toward enhancing the patient's and family's knowledge of health management, which can lead to better care for the patient's chronic illness. of 0.5 Instruct patient on how and when to administer insulin Instruct patient on how and when to administer insulin Many of these instructions work toward enhancing the patient's and family's knowledge of health management, which can lead to better care for the patient's chronic illness. 0.5 out of 0.5 Instruct patient on how frequently to use the glucometer Instruct patient on how frequently to use the glucometer Many of these instructions work toward enhancing the patient's and family's knowledge of health management, which can lead to better care for the patient's chronic illness. 0.5 out of 0.5 Intervention Rationale Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor. Prompt Model Answer Explanation In 1 or 2 These interventions Managing type 1 diabetes requires a multi-faceted sentences, will teach Chelsea and approach, so it's important that your patient and explain how her guardian how to family teaching covers a thorough and specific your selected manage her type 1 array of health management habits. interventions diabetes in a variety work to of ways, so that accomplish your Chelsea can enhance goal. her knowledge of her own health management. Data Collections Student Response Model Answer Explanation Points Earned Ask patient and family members to state back and agree to a plan for type 1 diabetes management Ask patient and family members to state back and agree to a plan for type 1 diabetes management It is important that your patient and her family agree to their instructions, as changing lifestyle habits can be intimidating but necessary for the patient's health. Having Chelsea and her father verbalize back their instructions also assures they remember and understand the details. 0.5 out of 0.5 Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor. Prompt Model Answer Explanation Explain the Ned, Chelsea's A guardian should understand the patient's nursing rationale diagnosis is readiness diagnosis and the rationale behind it in order to behind your for enhanced health increase their sense of involvement and to identify nursing management related to areas for future improvement. diagnosis. her new onset chronic illness. This diagnosis is evidenced by her desire to learn more about managing her illness, managing her prescribed regimens, managing risk factors, and an interest in learning. When Chelsea gets established with her endocrinologist, you and your family can continue to learn about managing Chelsea's type 1 diabetes. Our goal today is to get you and your daughter prepared for managing her diabetes over the next few days. Explain to Ned your goal and the interventions and data collections through which you will achieve it. Ned, I'm going to have a conversation with you and Chelsea about ways that everyone in Chelsea's family can help her manage her diabetes. We'll work together in this discussion, and then you will both agree to your goals. Then I'm going to have you and Chelsea repeat back what you've learned, so we can make sure you understand. You should communicate the Care Plan to the patient's guardian, allowing them to exercise involvement and agency in their own healthcare. Explicitly ask for Ned's consent to the Care Plan. Does this plan I just talked about sound good to you? A guardian must consent to all interventions in their Care Plan. Disagreements are opportunities to provide further patient education and to consider alternative options. Inform Ned you will now begin educating them. It's time to begin your education interventions, so let your patient's guardian know. Ned, if you don't have any other questions, I'm going to speak with Chelsea now. Explain the rationale behind your Chelsea, I think you’re ready to learn more about type 1 diabetes, A patient should understand their nursing diagnosis and the rationale behind it to increase their sense of involvement and to identify areas for future nursing and I’d like to give improvement. diagnosis. you some valuable skills and knowledge before you leave the hospital, so that you can learn how to manage your diabetes over the next few days. When you get established with your endocrinologist they can help you more, but I’m going to go over some basic information so that you can leave here feeling comfortable about managing your diabetes. I know that a new diagnosis can be overwhelming, but you’ve expressed an interest in learning more, and I think you can handle it. Explain your Ok, Chelsea, here’s You should communicate the Care Plan to the goal for the plan! I am going to patient, allowing them to exercise involvement and Chelsea and have a conversation agency in their own healthcare. the with you and your interventions father about the things and data you can do to manage collections your diabetes. All of through which us will work together you will in this discussion, and achieve it. then you have to agree to your goals. Then I’m going to have you and your father repeat what you’ve learned, so we can make sure you’ve got it down. Explicitly ask for Chelsea's consent to the Care Plan. Does this plan I just talked about sound good to you? A patient must consent to all interventions in their Care Plan. Disagreements are opportunities to provide further patient education and to consider alternative options. Inform Chelsea, if you don't It's time to begin your education interventions, so Chelsea you have any other let your patient know! will now begin questions, we can start educating her our discussion now! and her guardian. Student Response Model Answer Explanation Points Earned Partially Partially While Chelsea and Ned correctly state back most of the instructions related to diabetes management, Chelsea still expresses apprehension about managing her insulin administration by herself. Ned agrees to help her administer the insulin. Chelsea is old enough to learn how to administer her own insulin and should take an active role in managing her diabetes. Your goal has been partially achieved. 2.5 out of 2.5 Your answer is not automatically evaluated by the simulation, but may be reviewed by your instructor. Prompt Model Answer Explanation Did you achieve While Chelsea and Even with progress being made in almost all your goal for Ned correctly state aspects of your patient teaching, you must your patient and back most of the adhere to your goal and consider your work her guardian by instructions related to incomplete if certain agreements have not been the end of the diabetes management, reached. visit, getting each Chelsea still expresses of them to agree apprehension about to and verbalize managing her insulin your instructions administration by for enhancing herself. Ned agrees to their knowledge help her administer the of how to manage insulin. Chelsea is old Chelsea's newly enough to learn how to onset chronic administer her own illness? insulin, and should take an active role in managing her diabetes. Your goal has been partially achieved.