Multi-client Simulation
There are two cases in this scenario: The first one is Janet Martin, a 75-year old female
whose daughter called stating that Janet was complaining of coughing and she was not feeling
well and unable to get off the couch because she is weak and fatigued. The daughter brought her
into the Emergency Department because of fever and chills for two days, decreased appetite,
green productive cough, and fatigue. Janet was admitted to the telemetry unit with a diagnosis of
bilateral pneumonia. Janet also had an open wound on her left great toe that turned out to have
MRSA after a wound culture was completed. The wound has closed.
The second scenario is Margaret Stanton, a 75-year old female admitted to the
telemetry unit late last night for MVP (Mitral valve prolapse) and is scheduled for surgery this
morning at 0730.
To prepare and to be able to participate in the simulation, the following questions need
to be completed.
The healthcare provider ordered 500mg Vancomycin Hydrochloride IVPB every six hours.
The maximum safe dose range is 40mg/kg/day. The client weighs 165 lb. What is the
maximum therapeutic dose the nurse will administer per day? mg/day (If needed,
round to the nearest whole number)
Answer: 3,000 mg/day
40 mg/ kg/day X kg 165 lbs./2.2 = 3000 mg/day
What is the purpose of Vancomycin Hydrochloride and what are the side
effects/administration protocols?
Vancomycin Hydrochloride is an anti-infective drug that is used to treat potentially
life- threatening infections particularly staphylococcal infections such as MRSA. It is used
against
, Multi-client Simulation
susceptible organisms that include streptococci, Streptococcus pneumonia, Corynebacterium,
Clostridium difficile, Enterococcus faecalis, and Enterococcus faecium.
The side effects of this drug are nephrotoxicity, phlebitis, ototoxicity, hypotension,
nausea, vomiting, rashes, eosinophilia, leukopenia. Vancomycin can cause two types of
hypersensitivity reactions that include chills, fever, and anaphylaxis. The other hypersensitivity
reaction is the “red man” syndrome that is associated with rapid infusion of this drug. Thus, the
infusion should be monitored.
To prevent toxicity and overdose of this drug, peak and trough concentrations should be
monitored. Renal function tests such as BUN and creatinine must be monitored to avoid
nephrotoxicity.
What are some of the risks that diabetics face as a result of uncontrolled blood sugars?
Explain the difference between Type I & Type II Diabetes. Discuss a diet that is
appropriate for a person with diabetes. How is it different from a general diet?
Diabetic patients with uncontrolled blood sugars risk several complications of having the
disease: Foot Complications such as numbness in the feet called neuropathy, DKA
(Ketoacidosis) and increased urine ketones, kidney disease (Nephropathy), high blood pressure
(Hypertension) that increase the risk of having heart disease, stroke, eye problems (Retinopathy).
Skin problems such as unhealed wounds, dental issues and susceptibility to infections.
Diabetes mellitus or diabetes is a chronic condition that affects the body's ability to use the
energy found in food. The two types to be differentiated in this simulation is Type 1 diabetes and
Type 2 diabetes.
Type 1 Diabetes also called insulin-dependent diabetes and used to be referred to
as juvenile-onset diabetes, because it frequently begins in childhood. Type 1 diabetes is an
There are two cases in this scenario: The first one is Janet Martin, a 75-year old female
whose daughter called stating that Janet was complaining of coughing and she was not feeling
well and unable to get off the couch because she is weak and fatigued. The daughter brought her
into the Emergency Department because of fever and chills for two days, decreased appetite,
green productive cough, and fatigue. Janet was admitted to the telemetry unit with a diagnosis of
bilateral pneumonia. Janet also had an open wound on her left great toe that turned out to have
MRSA after a wound culture was completed. The wound has closed.
The second scenario is Margaret Stanton, a 75-year old female admitted to the
telemetry unit late last night for MVP (Mitral valve prolapse) and is scheduled for surgery this
morning at 0730.
To prepare and to be able to participate in the simulation, the following questions need
to be completed.
The healthcare provider ordered 500mg Vancomycin Hydrochloride IVPB every six hours.
The maximum safe dose range is 40mg/kg/day. The client weighs 165 lb. What is the
maximum therapeutic dose the nurse will administer per day? mg/day (If needed,
round to the nearest whole number)
Answer: 3,000 mg/day
40 mg/ kg/day X kg 165 lbs./2.2 = 3000 mg/day
What is the purpose of Vancomycin Hydrochloride and what are the side
effects/administration protocols?
Vancomycin Hydrochloride is an anti-infective drug that is used to treat potentially
life- threatening infections particularly staphylococcal infections such as MRSA. It is used
against
, Multi-client Simulation
susceptible organisms that include streptococci, Streptococcus pneumonia, Corynebacterium,
Clostridium difficile, Enterococcus faecalis, and Enterococcus faecium.
The side effects of this drug are nephrotoxicity, phlebitis, ototoxicity, hypotension,
nausea, vomiting, rashes, eosinophilia, leukopenia. Vancomycin can cause two types of
hypersensitivity reactions that include chills, fever, and anaphylaxis. The other hypersensitivity
reaction is the “red man” syndrome that is associated with rapid infusion of this drug. Thus, the
infusion should be monitored.
To prevent toxicity and overdose of this drug, peak and trough concentrations should be
monitored. Renal function tests such as BUN and creatinine must be monitored to avoid
nephrotoxicity.
What are some of the risks that diabetics face as a result of uncontrolled blood sugars?
Explain the difference between Type I & Type II Diabetes. Discuss a diet that is
appropriate for a person with diabetes. How is it different from a general diet?
Diabetic patients with uncontrolled blood sugars risk several complications of having the
disease: Foot Complications such as numbness in the feet called neuropathy, DKA
(Ketoacidosis) and increased urine ketones, kidney disease (Nephropathy), high blood pressure
(Hypertension) that increase the risk of having heart disease, stroke, eye problems (Retinopathy).
Skin problems such as unhealed wounds, dental issues and susceptibility to infections.
Diabetes mellitus or diabetes is a chronic condition that affects the body's ability to use the
energy found in food. The two types to be differentiated in this simulation is Type 1 diabetes and
Type 2 diabetes.
Type 1 Diabetes also called insulin-dependent diabetes and used to be referred to
as juvenile-onset diabetes, because it frequently begins in childhood. Type 1 diabetes is an
