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Real Life 3.0 Scenario as Substitute for Bedside Clinical Practice

Medical Surgical: COPD

After completion of the lesson, the student will be able to:

 Contrast the pathophysiology of restrictive vs. infectious airway disease.

 Plan and prioritize evidence-based care for a client who has COPD.
 Apply the knowledge, skills, and clinical reasoning required to positively affect outcomes for a client who has COPD
 Identify important nursing considerations for medications used in treating clients who have COPD.
 Intervene safely, effectively, and therapeutically with a client experiencing a rapidly deteriorating condition.
 Identify educational needs for discharge planning for a client who has COPD.
 Complete an accurate and effective SBAR communication.
 Communicate effectively and therapeutically with the client experiencing airway disease and his family

A grade of Satisfactory/Unsatisfactory will be given for the completion of post simulation assignments.
Student Assignment Activities Include:

1. Review the following diagnoses before completing Real Life Scenario: COPD
2. Review medications related to patient diagnoses
3. Complete Real Life Scenario
4. Complete Real Life Scenario with Optimal Decisions
5. Complete Assignments below: System Disorders, Medications, Procedures, and Teaching Plan
6. Complete SBAR Recorded Assignment-directions on page 8

SUBMIT IN BLACKBOARD LEARN-Under Assignment Tab

1. ATI Real Life Module Report
2. Submit this document completed pages 3-7.
3. Submit PowerPoint of SBAR Communication
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Case Study:
This scenario focuses on a 68-year-old male client who has a history of COPD and is admitted with pneumonia.
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System Disorders

System Disorders Pathophysiology/Clinical Diagnostic Tests/Labs Medications/Treatments Nursing Management with

manifestations RATIONALE provide
citations
COPD

Pleural Effusion

Malnutrition

Asthma

Bronchitis

Hypertension is chronic Assess for consistent Lifestyle changes Administer medications as

Hypertension high blood pressure that increased blood pressure ACE inhibitors prescribed.
increases risk for above 130 mmHg systolic. ARBs Educate patient on lifestyle
developing organ Tests for electrolyte levels, Diuretics changes to lower blood
damage, especially glucose, thyroid function and Beta blockers pressure.
cardiac. kidney function are done to CCB Monitor vitals and BP
help determine causes. Renin inhibitors during admission.
Alpha blockers Educate how to take own
BP when at home.
Educate on complications
that may occur due to
hypertension.
(Morton & Fontaine, 2018)
Education maintenance is
most important here to
prevent complications due
to hypertension. Helping
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the patient to understand

risk factors and how to
reduce them is necessary.
Pneumonia

MEDICATIONS

Medication Name with Therapeutic Action/Indications Contraindications/ Specific Benefit of this Specific Nursing
Classification Identified for use Precautions medication for this Implications/Interventions
patient for medication
Ceftriaxone

Albuterol (rescue)
Bronchodilator

Acetaminophen

Oxygen

Budesonide/Formotero
l

Atrovent
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Fluticasone/Salmeterol

Roflumilast

PROCEDURES

Procedures Indications for Procedure Preparation for Procedure Complications related to Nursing Management
procedure Pre/Intra/Post Procedure
CXR

ABG’s

Intake & Output

Pulse oximetry

CPT/BPH
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Cough and Deep

Breathing
Instruction

Educational Plan for patient Hector Gomez

Topic Specific Information Teaching Methods

Diagnosis

Medications

Nutrition

Life-Style Modifications

Symptom Management &

Recognition

Breathing Techniques

Pulmonary Rehabilitation
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Reflection

Guidelines for Reflection:

 What were you thinking about as the situation was unfolding?

 What were the questions you wish you had answers for circling in your head during this scenario?
 What you could have done better with the care of Mr. Gomez and why:
 What you have done correct in the patient care for Mr. Gomez:
 What were your priorities at the time?
 Did your priorities change the situation? When and How?
 Did anything take you by surprise during the situation?
 Were there some things you learned from previous class knowledge that guided you in this situation?

Reflection:
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This is literally the dumbest shit I could be doing and I just want to say fuck you and fuck this.

SBAR Communication Tool-Submit Presentation in Blackboard

1. Create a SBAR report (using template below), emphasizing what you perceive to be the client’s primary problem.
2. Once the SBAR is completed, use the template as a guide and develop 1-2 slides (PPT template provided below) and record your SBAR report in
PPT, just as if you were calling the primary care clinician.
o PPT template can be used as is or edited
3. Submit the voiced over PPT to the assignment drop box

TEMPLATE:
Situation Description of Events
•Accurately explains the situation/condition
the patient was in
•Chief compliant

Background
•History of present illness
•Other pertinent health history
•Cultural or family issues or concerns, if
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applicable

Assessment
•Relay objective and subjective findings that
support the situation

Recommendation
•State 2-3 suggestions needed to
continue/provide safe quality patient care