Physical assessment findings nurse may discover on patient ingested acetaminophen

What assessment findings, including your ABC head to toe physical assessment, might the nurse discover on a pediatric patient who has ingested high levels of acetaminophen?

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PURPOSE
The following information is to be used in guiding your preparation and participation in the scenario for this course. This
document will provide applicable course outcomes in preparation for your simulation.
SCENARIO INFORMATION
Johnny Parker is a 4-year-old Hispanic male who ingested an unknown amount of liquid children’s Acetaminophen under the
care of his aunt at 11:30 on Wednesday. Johnny was brought to the emergency department, where he was given activated
charcoal in suspension via nasogastric tube. The scenario takes place on Thursday at 12:10.
STUDENT ROLES DURING SIMULATION:
During pre-briefing, you wil l be assigned one of these roles according to the description below to participate i n
the simulation as a nurse.
Charge Nurse (1):
The charge nurse is responsible for the overall organization of safe, quality patient care. You are the team leader
and serve as a resource to all interdisciplinary members and are responsible for appropriate delegation of
duties. You will serve as the point person for communication and can anticipate speaking with the physician or
other primary care provider, ancillary support services, and others directly involved with the care being
provided.  You must be knowledgeable about the patient’s condition and able to dictate orders obtained and
assist with implementation if needed.  Additionally, be prepared to prioritize care and anticipate future needs.

How nutrition is affected when a child ingest poison

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Documentation Nurse (1):
The documentation nurse is responsible for recording of all patient event activities during the simulation
with the exception of medication administration. You  are responsible for documenting within SimChart®
assessments, interventions, and outcomes on the designated tool (paper or electronic). Be prepared to read
back and verify your documentation when requested and/or clarifying the detail s.  Additionally, you will be
part of the interdisciplinary team and will contribute  observational assessment findings to include but not
limited to changes in vital signs, alerts, psychosocial needs, and anticipated care.

Assessment Nurse (1):
The assessment nurse is responsible for overseeing a comprehensive assessment of the patient.
This includes but is not limited to obtaining vital signs,  head-to-toe assessment of all systems, and
psych/soci al assessment of the patient.   You will be prioritizing care, executing independent
interventions, collaborating with interdisciplinary team members, anticipating the needs of the
patient/family, and re-assessing or continually monitoring the patient for any changes in
condition. You are responsible for implementing all non-medication related interventions,
verbalizing your findings to the team, and recommending any actions/interventions required.
Additionally, you will be providing appropriate education to the patient and family/significant
others.
NR 322 Standardized Simulation
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Medication Nurse (1):

Describe how nutrition may be affected in a child who has ingested a poison

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The medication nurse is responsible for all actions and documentation related to safe
administration of medications. You will identify and correct any medication errors related to
prescribing or distribution. This may include speaking with the physician or primary care
provider. Prior to administering medication, you will assure the “Rights of Medication
Administration”. You must be knowledgeable regarding the action and expected effects of the
medications being administered and are responsible for monitoring and reporting any adverse
reactions or unforeseen consequences of administration. Part of your role includes verifying
medication calculations with a colleague and identifying any incompatible drug combinations.
Observer Nurse:
The observer is a non-parti cipant role and will not communicate directly  with the simul ation
team. The observer nurse will view the simulation in the briefing room through Learning Space
as it is occurring.  There may be multiple observer nurses in each scenario. The observer
nurse will be given an observation guide to complete during the simulation. The data you
collect will help the team during the debriefing process and facilitate an open and active
discussion  regarding the simulation experience. You will be an active parti cipant in the
debriefing and will be encouraged to share your observations and thoughts.   Please keep in
mind that your observations should be conveyed in a respectful, educational manner. The goal
is to work together as colleagues in providing safe and effective care.
COURSE OUTCOMES
The NR322/NR 328 standardized simulation enables the student to meet the following priority course outcomes:
·  CO 2 Provide pediatric care in collaboration with other healthcare providers in health
promotion, illness prevention, health restoration and maintenance, and rehabilitative activities
(PO 2)

Physical assessment findings nurse may discover on patient ingested acetaminophen

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·  CO 3 Utilize communication and relationship skills in providing care to children and families,
and aggregates in a variety of healthcare settings (PO 3)
·  CO 7 Assume responsibility for nursing care of children and their families, and aggregates as a
beginning member of the healthcare team (PO 7)

**Although this scenario can address multiple course outcomes, faculty and students should focus on
the course outcomes listed above**
DUE DATE
The standardized simulation should be conducted anytime during Units 4- 8 to ensure students are prepared
to meet the objectives.
SIMULATION TIMING
·  Pre-brief: 20-25 minutes
·  Run Time: 25-30minutes
·  Debrief: 50-60 minutes
NR 322 Standardized Simulation
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REVIEW AND COMPLETE PRIOR TO THE START OF  PRE-BRIEFING
In order to prepare for the simulation, you should complete your assigned reading for the course. In addition,
they should be prepared to complete and document a thorough nursing assessment along with completing the
following skills:  Pediatric growth and development; and Gastrointestinal system alterations for a pediatric
patient.  Please keep in the mind you will also be required to recognize a variety of signs and symptoms linked
to abnormalities in these skills. Therefore, in order to prepare for the simulation, please review the items below
and submit to faculty facilitating the simulation prior to the start of pre-briefing. If you do not complete the pre-briefing questions below and submit to faculty facilitating the simulation prior to the start of pre-briefing, you
will not be permitted to participate in the simulation.
1.  Identify pediatric populations at risk for poisoning and list 3 agents used for gastrointestinal
decontamination. Describe how nutrition may be affected in a child who has ingested a poison.
2.  List ways in which the nurse can maintain family-centered care during a medical crisis. Can any
aspects of the care being delegated to others?
3.  What assessment findings, including your ABC head to toe physical assessment, might the nurse
discover on a pediatric patient who has ingested high levels of acetaminophen?
Medication Calculation:
The healthcare provider ordered N-acetylcysteine for a pediatric patient who ingested an excessive amount of
acetaminophen.  The medication is ordered for 70mg/kg every 4 hours. The patient weighs 33 lb. How many
milligrams will the nurse administer per dose? ___ mg (If needed, round to the nearest tenth.)
**Immediately following the completion of debriefing, you will complete the evaluation of the simulation
within Learning Space
NR 322 Standardized Simulation

How nutrition is affected when a child ingest poison

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nearest tenth.)

Identify pediatric populations at risk for poisoning

Identify pediatric populations at risk for poisoning

Physical assessment findings nurse may discover on patient ingested acetaminophen

Physical assessment findings nurse may discover on patient ingested acetaminophen

Ways nurse can maintain family-centered care during medical crisis

Ways nurse can maintain family-centered care during medical crisis

Ways nurse can maintain family-centered care during medical crisis

How nutrition is affected when a child ingest poison

How nutrition is affected when a child ingest poison

How nutrition is affected when a child ingest poison

Identify pediatric populations at risk for poisoning

Physical assessment findings nurse may discover on patient ingested acetaminophen

Physical assessment findings nurse may discover on patient ingested acetaminophen

List 3 agents used for gastrointestinal decontamination

List 3 agents used for gastrointestinal decontamination

List 3 agents used for gastrointestinal decontamination
**Immediately following the completion of debriefing, you will complete the evaluation of the simulation
within Learning Space
NR 322 Standardized Simulation

List ways in which the nurse can maintain family-centered care during a medical crisis

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By admin in Blog on April 10, 2020