NUR 3227 Junetta Cooper Vsim Feedback LOG 100% Verified
Junetta Cooper is a 65-year-old African American female admitted for a stroke (CVA). She has
right-sided hemiplegia and expressive aphasia. The simulation focuses on assessing her
neurological status, providing safe care, and initiating rehabilitation therapies.
Pre-Simulation Preparation
• Review Orders: Carefully read all provider orders. Key orders will include:
o Vital signs frequency (e.g., every 4 hours).
o Neurological assessments frequency.
o Aspiration precautions / NPO status.
o Consults for Physical Therapy (PT), Occupational Therapy (OT), and Speech-
Language Pathology (SLP).
o Medications (e.g., Aspirin, Atorvastatin).
o Activity level (e.g., Bed rest with assistance for transfers).
• Review Patient Chart:
o Diagnosis: Ischemic Stroke (CVA).
o Key Deficits: Right-sided weakness/paralysis (hemiplegia) and difficulty
speaking (expressive aphasia).
o Allergies: Note any listed allergies.
o Code Status: Full Code.
Simulation Walkthrough: Actions & Rationales (Verified 100%)
Step 1: Initial Actions & Safety (First 2 minutes)
• Action: Perform hand hygiene.
, [Type here]
• Action: Introduce yourself to the patient ("Hello, I'm [Your Name], and I'll be your nurse
today.")
• Action: Identify the patient using two identifiers (check wristband and ask her to state
her name).
o Expected Finding: Patient may be unable to respond verbally or may only say
her name with difficulty due to expressive aphasia. The key is to attempt verbal
confirmation while verifying the wristband.
• Action: Assess for any allergies.
• Action: Ensure the bed is in the lowest position, side rails are up (x2 or as per policy),
and the call light is within the patient's left-sided (unaffected) reach.
o Rationale: These are universal safety measures. Placing the call light on her
unaffected side is a critical adaptation for a patient with hemiplegia.
Step 2: Focused Neurological Assessment
• Action: Assess Level of Consciousness (LOC). Ask orientation questions (person, place,
time).
o Expected Finding: Patient is likely alert but will struggle to answer. She may nod
or use gestures. She is oriented. This assesses her receptive understanding.
• Action: Assess pupillary response (PERRLA).
o Expected Finding: Pupils are Equal, Round, and Reactive to Light and
Accommodation. This is a crucial finding to rule out new or worsening
neurological events like increased intracranial pressure.
• Action: Assess motor strength in all four extremities.
o Expected Finding:
▪ Left Arm/Leg: Full strength (5/5). She can grip your hand and push/pull
against resistance.
Junetta Cooper is a 65-year-old African American female admitted for a stroke (CVA). She has
right-sided hemiplegia and expressive aphasia. The simulation focuses on assessing her
neurological status, providing safe care, and initiating rehabilitation therapies.
Pre-Simulation Preparation
• Review Orders: Carefully read all provider orders. Key orders will include:
o Vital signs frequency (e.g., every 4 hours).
o Neurological assessments frequency.
o Aspiration precautions / NPO status.
o Consults for Physical Therapy (PT), Occupational Therapy (OT), and Speech-
Language Pathology (SLP).
o Medications (e.g., Aspirin, Atorvastatin).
o Activity level (e.g., Bed rest with assistance for transfers).
• Review Patient Chart:
o Diagnosis: Ischemic Stroke (CVA).
o Key Deficits: Right-sided weakness/paralysis (hemiplegia) and difficulty
speaking (expressive aphasia).
o Allergies: Note any listed allergies.
o Code Status: Full Code.
Simulation Walkthrough: Actions & Rationales (Verified 100%)
Step 1: Initial Actions & Safety (First 2 minutes)
• Action: Perform hand hygiene.
, [Type here]
• Action: Introduce yourself to the patient ("Hello, I'm [Your Name], and I'll be your nurse
today.")
• Action: Identify the patient using two identifiers (check wristband and ask her to state
her name).
o Expected Finding: Patient may be unable to respond verbally or may only say
her name with difficulty due to expressive aphasia. The key is to attempt verbal
confirmation while verifying the wristband.
• Action: Assess for any allergies.
• Action: Ensure the bed is in the lowest position, side rails are up (x2 or as per policy),
and the call light is within the patient's left-sided (unaffected) reach.
o Rationale: These are universal safety measures. Placing the call light on her
unaffected side is a critical adaptation for a patient with hemiplegia.
Step 2: Focused Neurological Assessment
• Action: Assess Level of Consciousness (LOC). Ask orientation questions (person, place,
time).
o Expected Finding: Patient is likely alert but will struggle to answer. She may nod
or use gestures. She is oriented. This assesses her receptive understanding.
• Action: Assess pupillary response (PERRLA).
o Expected Finding: Pupils are Equal, Round, and Reactive to Light and
Accommodation. This is a crucial finding to rule out new or worsening
neurological events like increased intracranial pressure.
• Action: Assess motor strength in all four extremities.
o Expected Finding:
▪ Left Arm/Leg: Full strength (5/5). She can grip your hand and push/pull
against resistance.
