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Sarah Lin VSIM
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- PNUR125
This document provides post scenario analysis of Sarah Lin's case in VSIM Nursing.
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Case: Sarah LinVSIM Post Scenario Analysis and Reflection Activity (Adapted from VSim For Nursing & Wolters-Kluwer)
sReview the medication list from the Electronic Health Record (HER) and please complete the medication research table below based on the medication listed in the assigned VSIM.
Medications – Generic and Classification and action Indication Side Effects Nursing Implications
Trade Names (reasons why this medication (pre and post assessments a nurse should be aware
is prescribed for?) of prior to and after giving this medication)
1. Levofloxacin Classifications: Quinolone Uses: CNS: headache, insomnia, Assessment
Antibiotic Treatment of the ff.: dizziness; GI: nausea, diarrhea, − Withhold therapy and report to prescriber
Action: maxillary sinusitis, Acute constipation, vomiting, abdominal immediately any of the following: signs of
− A broad-spectrum exacerbations of bacterial pain, dyspepsia; INTEG: rash, hypersensitivity reaction (skin rash, hives, rapid
fluoroquinolone antibiotic bronchitis, Community- pruritus; UROGEN: vaginitis; heartbeat, difficulty swallowing/breathing) , CNS
that inhibits DNA-gyrase, an acquired pneumonia, SPECIAL SENSES: decreased vision, symptoms (seizures, restlessness, confusion,
enzyme necessary for Uncomplicated skin/skin foreign body sensation, transient hallucination, depression), Skin eruption ff. sun
bacterial replication, structure infections, UTI, ocular burning, ocular pain, exposure, Symptoms of colitis (persistent
transcription, repair and Acute pyelonephritis caused photophobia; SYS: injection site diarrhea), join pai, inflammation, rupture of
recombination. by susceptible bacteria, Acute pain/inflammation, chest/back tendon
− Effective against many bacterial sinusitis, Chronic pain, pharyngitis; Other: cartilage − Monitor: diabetics on oral hypoglycemic agents
aerobic gram-positive and bacterial prostatitis, Bacterial erosion for loss of hypoglycemic control; lab tests (C&S
gram-negative organisms conjunctivitis, pneumonic and test prior to beginning therapy, serum
septicemic plague; creatine/BUN, LFTs)
UNLABELLED: Epididymitis,
Infective carditis, Tuberculosis Patient & Family Education
− discontinue drug and notify prescriber if S&S of
hypersensitivity occur; if tendon pain occurs
− consume fluids liberally while taking this
medication. Failure to do so can lead to
crystallization of urine
− allow a mi of 2h between drug dosage and taking
any of the ff.: aluminum/magnesium antacids,
iron supplements, multivitamins with zin,
sucralfate
− Avoid exposure to excess sunlight of artificial UV
light
− Closely monitor blood glucose if taking oral
hypoglycemic agents for diabetic control
2. Oxycodone Classifications: Narcotic (Opiate Uses: Relief of moderate to CNS: Euphoria, dysphoria, light- Assessment
Hydrochloride Agonist); Analgesic moderately severe pain, headedness, dizziness, sedation. − Monitor: respiratory status; patient’s response
Action: neuralgia. Relieves GI: Anorexia, nausea, vomiting, closely, especially to sustained-release
− Semisynthetic derivative of postoperative, constipation, jaundice, preparations; Lab Tests: Periodic LFTs and
an opium agonist that binds postextractional, postpartum hepatotoxicity (combinations hematologic parameters in patients on high
with stereospecific receptors pain. containing acetaminophen). dosage
in various sites of CNS to Respiratory: Shortness of breath, − Withhold drug and notify prescriber if:
alter both perception of pain respiratory depression; INTEG: respiratory depression occurs.
and emotional response to Pruritus, skin rash. CV: − Consult prescriber if: nausea continues after first
pain. Bradycardia; SYS: Unusual few days of therapy.
1
, Case: Sarah Lin
VSIM Post Scenario Analysis and Reflection Activity (Adapted from VSim For Nursing & Wolters-Kluwer)
Medications – Generic and Classification and action Indication Side Effects Nursing Implications
Trade Names (reasons why this medication (pre and post assessments a nurse should be aware
is prescribed for?) of prior to and after giving this medication)
− Active against moderate to bleeding or bruising. Urogenital: − Note: Light-headedness, dizziness, sedation, or
moderately severe pain. Dysuria, frequency of urination fainting appear to be more prominent in
− Appears to be more effective ambulatory than in non-ambulatory patients and
in relief of acute than long may be alleviated if patient lies down; Serious
standing pain. Overdosage of any oxycodone presents
problems associated with a narcotic overdose
(respiratory depression, circulatory collapse,
extreme somnolence progressing to stupor or
coma).
− Evaluate: patient’s continued need for
oxycodone preparations (psychic and physical
dependence
and tolerance may develop with repeated use
and potential for drug abuse is high)
Patient & Family Education
− DO NOT: alter dosage regimen by increasing,
decreasing, or shortening intervals between
doses (habit formation and liver damage may
result); drink large amounts of alcoholic
beverages while using oxycodone preparations
(risk of liver damage is increased); Do potentially
hazardous activities such as driving a car or
operating machinery
− Check with prescriber before taking OTC drugs
for the ff.: for colds, stomach distress, allergies,
insomnia, or pain.
− Inform surgeon or dentist: that you are taking
an oxycodone preparation before any surgical
procedure is undertaken.
3. Ceftriaxone Classifications: Antibiotic; Third- Uses: Infections caused by GI: Diarrhea, abdominal cramps, Assessment
Sodium generation cephalosporin susceptible organisms in the pseudomembranous colitis, biliary − Before therapy is initiated, determine history of
Action: ff.: lower respiratory tract, sludge; UROGEN: Genital pruritus; the ff.: hypersensitivity reactions to
− Preferentially binds to one or skin and skin structures, moniliasis; SYS: Pruritus, fever, cephalosporins and penicillins; Other allergies,
more of the penicillin-binding urinary tract, bones and chills, pain, induration at IM particularly to drugs
proteins (PBP) located on cell joints, intra-abdominal; pelvic injection site; phlebitis (IV site). − Inspect injection sites: note for signs of
walls of susceptible inflammatory disease, inflammation (e.g. phlebitis → redness, swelling,
organisms. uncomplicated gonorrhea, pain), for induration
− This inhibits third and final meningitis, surgical − Monitor and Report promptly: For
stage of bacterial cell wall prophylaxis. manifestations of hypersensitivity (urticaria,
synthesis, thus killing the pruritus, wheezing, edema, redness,
bacterium. anaphylaxis), For Petechiae, ecchymotic areas,
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