Multi-Client SIM Pre-Briefing Questions
Multi-Client SIM Pre-Briefing Questions
1. The health care provider ordered 500 mg Vancomycin Hydrochloride IVPB every 6
hours. The maximum safe dose range is 40mg/kg/day. The client weighs 165lb. What is
the maximum therapeutic dose the nurse will administer per day?
a. 3,000mg/day is the maximum safe dose that can be given per day.
b. Per the order the nurse will administer 2,000mg/day as 500mg is to be admin q6
hours or 4 times per day.
2. What is the purpose of Vancomycin Hydrochloride and what are the side effects
and administration protocols?
a. Vancomycin is an antibiotic with bactericidal action that inhibits cell-wall
synthesis. Primarily used for gram-positive organisms.
b. Side effects can include thrombophlebitis or necrosis/sloughing at IV insertion
site, nausea, ototoxicity, nephrotoxicity, hypotension with flushing and
erythematous rash on face and upper body or “Red-neck syndrome”, and
sudden drop in BP with rapid IV infusion. Patient should notify provider of any
ringing in the ears immediately.
c. Reconstitute 500mg with 10, 15, or 20mL of sterile water for injection. Dilute
500mg with at least 100mL of NS, D%W, or LR. Avid rapid infusion. Assess
HR, BP, and hearing prior to administration. Monitor WBC, kidney functions,
peak and trough. Serum levels of 60-80mcg/mL is associated with ototoxicity.
3. What are some of the risks that diabetics face as a result of uncontrolled blood sugars?
Explain the difference between Type 1 and Type 2 Diabetes. Discuss a diet that is
appropriate for a diabetic. How is it different from a general diet?
a. Cardiovascular and cerebrovascular complications such as hypertension, stroke,
and myocardial infarction. Diabetic retinopathy can result in impaired vision and
blindness. Neuropathy will affect and cause damage to the sensory nerve fibers
that will result in pain and numbness, especially affecting the feet, and peripheral
vascular disease. Nephropathy can also occur due to damage to kidney tissues
that can result in kidney failure and the need for dialysis.
b. Type I diabetes is an autoimmune dysfunction that destroys beta cells responsible
for insulin production in the pancreas. Usually occurs at a young age. Type II
diabetes results due to an increased inability of cells to respond to insulin or
insulin resistance. This results in a decreased production of inulin by the beta
cells. Usually occurs later in life due to obesity, inactivity, or genetic factors.
c. Diabetic patients should monitor diet closely. Limit the intake of sugars and
saturated and trans fats such as fried food items. Take in right amount of
carbohydrates, fiber, protein, and unsaturated fats. 1 carbohydrate serving is he
amount of food that contains 15g. Aim for 20-35g of fiber per day s soluble fiber
can help lower cholesterol and insoluble fiber adds bulk to stool, keeping client
regular. Consume about 3 – 6 ounces of protein per meal.
4. What PPE is necessary for a patient who has MRSA?
Multi-Client SIM Pre-Briefing Questions
1. The health care provider ordered 500 mg Vancomycin Hydrochloride IVPB every 6
hours. The maximum safe dose range is 40mg/kg/day. The client weighs 165lb. What is
the maximum therapeutic dose the nurse will administer per day?
a. 3,000mg/day is the maximum safe dose that can be given per day.
b. Per the order the nurse will administer 2,000mg/day as 500mg is to be admin q6
hours or 4 times per day.
2. What is the purpose of Vancomycin Hydrochloride and what are the side effects
and administration protocols?
a. Vancomycin is an antibiotic with bactericidal action that inhibits cell-wall
synthesis. Primarily used for gram-positive organisms.
b. Side effects can include thrombophlebitis or necrosis/sloughing at IV insertion
site, nausea, ototoxicity, nephrotoxicity, hypotension with flushing and
erythematous rash on face and upper body or “Red-neck syndrome”, and
sudden drop in BP with rapid IV infusion. Patient should notify provider of any
ringing in the ears immediately.
c. Reconstitute 500mg with 10, 15, or 20mL of sterile water for injection. Dilute
500mg with at least 100mL of NS, D%W, or LR. Avid rapid infusion. Assess
HR, BP, and hearing prior to administration. Monitor WBC, kidney functions,
peak and trough. Serum levels of 60-80mcg/mL is associated with ototoxicity.
3. What are some of the risks that diabetics face as a result of uncontrolled blood sugars?
Explain the difference between Type 1 and Type 2 Diabetes. Discuss a diet that is
appropriate for a diabetic. How is it different from a general diet?
a. Cardiovascular and cerebrovascular complications such as hypertension, stroke,
and myocardial infarction. Diabetic retinopathy can result in impaired vision and
blindness. Neuropathy will affect and cause damage to the sensory nerve fibers
that will result in pain and numbness, especially affecting the feet, and peripheral
vascular disease. Nephropathy can also occur due to damage to kidney tissues
that can result in kidney failure and the need for dialysis.
b. Type I diabetes is an autoimmune dysfunction that destroys beta cells responsible
for insulin production in the pancreas. Usually occurs at a young age. Type II
diabetes results due to an increased inability of cells to respond to insulin or
insulin resistance. This results in a decreased production of inulin by the beta
cells. Usually occurs later in life due to obesity, inactivity, or genetic factors.
c. Diabetic patients should monitor diet closely. Limit the intake of sugars and
saturated and trans fats such as fried food items. Take in right amount of
carbohydrates, fiber, protein, and unsaturated fats. 1 carbohydrate serving is he
amount of food that contains 15g. Aim for 20-35g of fiber per day s soluble fiber
can help lower cholesterol and insoluble fiber adds bulk to stool, keeping client
regular. Consume about 3 – 6 ounces of protein per meal.
4. What PPE is necessary for a patient who has MRSA?
