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NURSING 3632 VCE- Med Surge 1-End of Life- NURS 3632 Med Surge 1 Complete Study Guide

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Questions 1. Exercise 1 - Virtual Hospital Activity This exercise will take approximately 30 minutes to complete. Sign in to work at Pacific View Regional Hospital for Period of Care 3. (Note: If you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get to the sign-in window.) From the Patient List, select Pablo Rodriguez (Room 405). Click on Go to Nurses' Station. Click on Chart and then on 405. Click on Emergency Department and review the record. Exercise 1 - Question 1 Why was Pablo Rodriguez admitted to the hospital? He was admitted due to nausea and vomiting due to metastatic lung CA. 2. Exercise 1 - Question 2 What are Pablo Rodriguez’s primary and secondary diagnoses? The primary diagnosis: Metastatic lung CA Secondary Diagnosis: Malnutrition, chronic pain, nausea and vomiting, constipation 3. Click on Admissions. Exercise 1 - Question 3 Review the information concerning advance directives in the chart. What is Pablo Rodriguez's current status with regard to this document? Patient has no advance directive and he have been provided with written material on my rights to accept or refuse to formulate an advanced directive.

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Questions
1.
Exercise 1 - Virtual Hospital Activity

This exercise will take approximately 30 minutes to complete.
Sign in to work at Pacific View Regional Hospital for Period of Care 3. (Note: If you are already in the
virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to
get to the sign-in window.)
From the Patient List, select Pablo Rodriguez (Room 405).
Click on Go to Nurses' Station.
Click on Chart and then on 405.
Click on Emergency Department and review the
record. Exercise 1 - Question 1

Why was Pablo Rodriguez admitted to the hospital?

He was admitted due to nausea and vomiting due to metastatic lung CA.

2.
Exercise 1 - Question 2

What are Pablo Rodriguez’s primary and secondary diagnoses?

The primary diagnosis: Metastatic lung CA
Secondary Diagnosis: Malnutrition, chronic pain, nausea and vomiting, constipation

3.
Click on Admissions.
Exercise 1 - Question
3

Review the information concerning advance directives in the chart. What is Pablo Rodriguez's current
status with regard to this document?

Patient has no advance directive and he have been provided with written material on my rights to
accept or refuse to formulate an advanced directive.

4.
Exercise 1 - Question 4

Which are guidelines included in the Patient Self-Determination Act of 1991? Select all that apply.

Patients admitted to health care agencies must be asked if they have executed an advance directive
(AD).
Physician offices must initiate AD inquiries with patients planning to be admitted to a clinical facility.
For those patients who have not executed an AD, health care agencies must provide them with
information regarding the value of ADs.

, For those patients who have not executed an AD, health care agencies must provide them with the
opportunity to complete the state-required forms.
The patient must have written permission from the attending physician to enact a presented AD.
ADs require an attorney for completion.
AD laws vary by
state. 5.
Exercise 1 - Question 5

To retain health care decision-making responsibilities, which criteria must be met by the patient? Select
all that apply.

The patient must be alert and oriented x 4.
The patient must be able to receive information provided by health care providers.
The patient must be able to communicate treatment choices.
The patient must have the cognitive ability to evaluate treatment options.
6.
Click on Return to Nurses’
Station. Click on Kardex.
Click on 405.
Exercise 1 - Question 6

What is Pablo Rodriguez’s code status? Is this appropriate based on the reason for this admission?
Explain.

The patient is on full code. The patient code status is dependent upon the patient's decision
regardless of the medical condition based on self-determination act. The staff can only educate the
patient or the family member for those who has no mental capacity, however if no advance directive
created, patient should be placed in full code.

7.
Click on Return to Nurses’ Station.
Click on 405 at the bottom of your screen.
Click on Patient Care and then on Nurse-Client Interactions.
Select and view the video titled 1530: Decision—End-of-Life Care. (Note: Check the virtual clock to see
whether enough time has elapsed. You can use the fast-forward feature to advance the time by 2-minute
intervals if the video is not yet available. Then click again on Patient Care and Nurse-Client Interactions to
refresh the screen.)
Exercise 1 - Question 7

What is Pablo Rodriguez telling the nurse?

The patient is verbalizing his thoughts about his kids. He told the staff that he does not want those
big machines to be used for him and he wanted to sign a DNR which the staff will provide.

8.
Exercise 1 - Question 8

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