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Skyler Hansen VSIM
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- PNUR125
This document provides post scenario analysis of Skyler Hansen's case in VSIM Nursing with APA citation.
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Case: Skyler HansenVSIM Post Scenario Analysis and Reflection Activity (Adapted from VSim For Nursing & Wolters-Kluwer)
s
Review 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 Classification and action Indication Side Effects Nursing Implications
and Trade Names (reasons why this medication is (pre and post assessments a nurse should be aware
prescribed for?) of prior to and after giving this medication)
1. Glucagon Classifications: Side effects: GI: Nausea and Assessment
Antihypoglycemic; Diagnostic Uses: Hypoglycemia, radiologic vomiting; Skin: Stevens-Johnson − Be prepared to give IV glucose if patient fails to
Test Aid studies of GI tract; UNLABELED: syndrome (erythema respond to glucagon. Notify prescriber
GI disturbances associated with multiforme). Metabolic: immediately.
Action: spasm, cardiovascular Hyperglycemia, hypokalemia; − Note: Patient usually awakens from (diabetic)
− Recombinant glucagon emergencies, and to overcome SYS: Hypersensitivity reactions hypoglycemic coma 5–20 min after glucagon
identical to glucagon cardiotoxic effects of (Shields et al., 2019, p. 755). injection. Give PO carbohydrate as soon as
produced by alpha cells of betablockers, quinidine, tricyclic possible after patient regains consciousness.
islets of Langerhans. antidepressants; as an aid in − Note: After recovery from hypoglycemic
− Stimulates uptake of amino abdominal imaging; choking due reaction, symptoms such as headache, nausea,
acids and their conversion to to esophageal foreign body and weakness may persist (Shields et al., 2019,
glucose precursors. impaction (Shields et al., 2019, p. 755).
− Promotes lipolysis in liver and p. 755).
adipose tissue with release of Patient & Family Education
free fatty acid and glycerol, − Note: Prescriber may request that a responsible
which further stimulates family member be taught how to administer
ketogenesis and hepatic glucagon subcutaneously or IM for patients with
gluconeogenesis. frequent or severe hypoglycemic reactions.
− Action in hypoglycemia relies − Notify prescriber promptly whenever a
on presence of adequate liver hypoglycemic reaction occurs so the reason for
glycogen stores. the reaction can be determined. Review package
− Increases blood glucose insert and directions (see DMINISTRATION)
secondary to gluconeogenesis, (Shields et al., 2019, p. 755).
which is the breakdown of
glycogen to glucose in the liver
(Shields et al., 2019, p. 755).
2. Dextrose Classifications: Caloric, Uses: Increases intake of Side effects: CNS: Confusion, loss Assessment
parenteral solution calories; increases fluids in of consciousness, dizziness; CV: − Electrolytes (potassium, sodium, calcium,
Action: Needed for adequate patients unable to take adequate Hypertension, CHF, pulmonary chlorine, magnesium), blood glucose, ammonia,
utilization of amino acids; fluids, calories orally; acute edema, intracranial hemorrhage; phosphate
decreases protein, nitrogen loss; hypoglycemia (Skidmore- Roth, ENDO: Hyperglycemia, rebound − Inj site for extravasation: redness along vein,
prevents ketosis (Skidmore- 2017, p. 397). hypoglycemia, hyperosmolar edema at site, necrosis, pain; hard, tender area;
Roth, 2017, p. 397). syndrome, hyperglycemic site should be changed immediately
nonketotic syndrome, aluminum
1
, Case: Skyler Hansen
VSIM Post Scenario Analysis and Reflection Activity (Adapted from VSim For Nursing & Wolters-Kluwer)
toxicity, hypokalemia, − Monitor: temp for increased fever, indicating
hypomagnesium; GI: Nausea; infection; if infection suspected, discontinue inf,
GU: Glycosuria, osmotic diuresis; culture tubing, bottle, catheter tip cultured;
INTEG: Chills, flushing, warm glucose level, I&O, weight, fluid overload
feeling, rash, urticaria, − Nutritional status: calorie count by dietitian
extravasation necrosis; RESP: − Evaluate 🡪 Therapeutic response: increased
Pulmonary edema (Skidmore- weight (Skidmore- Roth, 2017, p. 397).
Roth, 2017, p. 397).
Patient & Family Education
− About the reason for dextrose inf
− To review hypoglycemia/hyperglycemia
symptoms
− To review blood glucose monitoring procedures
(Skidmore- Roth, 2017, p. 397).
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