Case 2: Scenario Briefing and Pre-Learning
Work through this chapter to prepare for the virtual case-based scenario. The estimated time for completing these activities varies depending on the knowledge students have prior to engaging in the scenario. Completing all activities in their entirety may take up to 2.5 hours.
Scenario Briefing
Use the following client information to guide your preparation.
- Setting: Acute Medical Unit
- Name: Piara Sandhu
- Age: 74 years old
- Sex: Male
- Allergies: Penicillin
- Medical History: Vascular dementia, rheumatoid arthritis, hypertension
- Social History: Lives in his own home with his 70-year-old wife (Manu).
Piara Sandhu is a 74-year-old man who lives in his own home with his 70-year-old wife (Manu). He was diagnosed with vascular dementia 1.5 years ago and has a 5-year history of hypertension and rheumatoid arthritis. Late yesterday afternoon, he was admitted to an acute care medical unit due to increased confusion and bacterial pneumonia.
It is now 0730 the next morning, and you have been assigned to care for Mr. Sandhu.
Prerequisite Knowledge
For this case, it is anticipated that you would have basic competence in the following areas:
- Psychomotor Skills
- Basic vital signs assessment (adult)
- Basic head-to-toe assessment (adult)
- Cognitive Skills
- Vascular dementia, delirium, depression pneumonia, urinary tract infection
- SBAR communication
- Medication administration and pharmacology (antibiotics)
- Oxygen therapy
- Cultural safety
- BCCNM Practice Standards
- Affective Skills
- Therapeutic communication with a client
Self-Assessment
Complete this Case 2 Self-Assessment [Word] of your competence in the learning objectives for this case. At the end of the scenario, you can return to this rubric to identify any changes.
Pre-Learning Resources and Activities
Complete the following 5 activities (including associated readings, videos, and guiding questions) in order to fully engage in the scenario. You will be prompted to document your activities with an option to export your documentation to save for your own records.
1. Clinical Decision-Making
2. Diagnosis in Focus
Knowledge of the client’s current medical diagnoses and history is a key component of patient care. Use the following resources to prepare to provide care for the client. In the documentation activity, articulate your knowledge based on the client introduction provided.
Watch this video about delirium (5 mins).[1]
Watch this video about a client's experience with delirium (6:49 mins).[2]
Watch this video about vascular dementia.[3]
3. Assessments and Interventions
Read Vital Sign Measurement Across the Lifespan to review normal vital signs applicable to this case.[4]
Read the following resource to review assessments related to this case.[5]
- Neurological Assessment Introduction
- Respiratory Assessment Introduction
- Oxygen Therapy Introduction
- Gastrointestinal and Genitourinary Assessment
Watch this video about breathsounds.[6]
Watch this video about respiratory assessments.[7]
4. Medication in Focus
Prepare for the administration of medications included in the virtual case scenario by reviewing the following resources.
Read about safe medication administration, focus on the section about how to administer medications when a client has an allergy.[8]
Prepare for the administration of the medication nitrofurantoin.[9]
5. Therapeutic Boundaries in Nursing Care
Practice Quiz
NCLEX Moment
Complete the following questions related to your pre-learning for the scenario. The questions are written in NCLEX formatting as an added form of review.
Media Attributions
- Client image by Pxfuel
- Delirium Awareness Video (#icanpreventdelirium) | Creative Connection by Dr Sophia Bennett MRCPsych @DrBennett1985, Dr M S Krishnan FRCPsych @Psychinformatic, and Creative Connection is licensed under a Standard YouTube license.
- Delirium: A Patient Story at Leicester's Hospitals by Leicester's Hospitals is licensed under a Standard YouTube license.
- What is Vascular Dementia? by Alzheimer's Society is licensed under the Standard YouTube license.
- Simple Nursing: Breath Sounds Made Easy by David Woodruff is licensed under a Standard YouTube license.
- University of Manitoba Nursing Skills: Respiratory Assessment by University of Manitoba Nursing Skills is licensed under a Standard YouTube license.
- Woodruff, D.[footnote]Delirium Awareness Video (#icanpreventdelirium) | Creative Connection. (2016, May 17). [Video]. YouTube. https://www.youtube.com/watch?v=BPfZgBmcQB8 ↵
- University of Manitoba Nursing Skills.[footnote]Hospitals, L. (2017, June 20). Delirium: A Patient Story at Leicester’s Hospitals [Video]. YouTube. https://www.youtube.com/watch?v=9G3yJNOGCok&feature=youtu.be ↵
- Alzheimer’s Society (2017, January 26). What is vascular dementia? [Video]. https://www.youtube.com/watch?v=GdkU5vCIpaU ↵
- Lapum, J., Verkuyl, M., Garcia, W., Oona St-Amant, Tan A. (n.d.). Vital Sign Measurement Across the Lifespan – 2nd Canadian Edition. https://opentextbc.ca/vitalsignmeasurement/ ↵
- Ernstmeyer, K., & Christman, E. (Eds.). (2021). Open RN Nursing Skills by Chippewa Valley Technical College is licensed under CC BY 4.0. ↵
- Woodruff, D. (2020, November 21). Simple Nursing: Breath Sounds Made Easy [Video]. YouTube. https://www.youtube.com/watch?v=JUoZCrq25gc&feature=youtu.be ↵
- University of Manitoba Nursing Skills. (2018, November 2). Respiratory Assessment [Video]. YouTube. https://www.youtube.com/watch?v=cX4kMcWYsKo&feature=youtu.be ↵
- Ernstmeyer, K., & Christman, E. (Eds.). (2021). Open RN Nursing Skills by Chippewa Valley Technical College is licensed under CC BY 4.0. ↵
- OpenMD.com (2021). Nitrofurantoin. https://reference.medscape.com ↵