Skills Validation PNCI

Eliana Ruiz
Age: 86 Weight: 55 kg Base: Standard Adult

Overview
Synopsis
The learner will be providing care to an 86-year-old Hispanic female admitted to the MedicalSurgical Unit with a non-healing wound on her right upper leg where a femoral-popliteal bypass graft was performed two weeks ago. She is diabetic and injured her left ankle by tripping on a curb on the way to the hospital. She is anxious about not being able to care for herself when she returns home. She lives alone but has a daughter close by, and has no insurance. This Simulated Clinical Experience™ (SCE™) has five states, that are transitioined manually. With manual transitions, the instructor should advance to the applicable state when appropriate interventions are performed. Initially, in State 1 0900 Hours Assessment, the learner is presented with a patient who is febrile and exhibiting other signs of infection. Initial assessment reveals a temperature of 38.6o Celsius, HR in the 80s, BP in the 140s/80s, RR in the low 20s and SpO2 in the mid 90s on room air. Breath sounds demonstrate crackles bilaterally. The patient is anxious and incontinent of urine. She has a non-productive cough and reports tenderness over the left ankle. Initial treatment includes application of an elastic bandage to the left ankle, assessment of pain level, administration of pain medications, insertion of a urinary catheter and a sterile wet-to-moist dressing change to the graft site. If learners request results of blood glucose, the facilitator should role-play the laboratory technician and report that admission blood glucose was 105. Two hours post admission at 1100, patient complains of “throbbing” pain at the graft site. She rates the pain 6/10. If learners request results of a chest x-ray, it shows right lower lobe pneumonia. The learner is expected to notify the healthcare provider of the