akaur212

hi dishes, I have a question. If nurse need to do her own assessment then it means she cannot trust the other RN OR staff which was working previously? Please suggest what can be done in nurses own assessment. Assessment for need of health teaching can be assessed by asking the patient if he is aware about the life style modifications to control hypertensive crisis. For example - if patient is a smoker then a nurse can help the patient to quit smoking by providing contacts of different counselling groups. and then patient starts asking questions and answers them . DISCHARGE PLANNING - Teach the patient : Hold the med when BP is 90/60 mm?hg Go to the emerge when your systolic BP is over 180 after monitoring three times in a 30 minute period. Contact the family physician when he notes in his log a continuos high BP or fluctuations and he is feeling symptoms of headache or dizziness . Patient evaluation-asking him do you understand the risk and complications of not adhering to medication regimen and treatment plan ? do you have any questions? Patient - No i think i am ok . and then start discharge procedure. competencies tested in above scenario- Knowledge based practice Ongoing comprehensive assessment Health care planning providing nursing care

Lucky you :) :)

Yes you are right.Or we can say that so and so medication was ordered by the physician and in nursing assessment we can say that the medication is administered and headache is resolved. I think all other answers are good. Moving on to new scenario and i will show it to you.Your role would be to design the questions for me according to the aspects on which i will be tested on during simulation lab test.I will answer all of them and submit :) :)

hi Dishes, I am done with my homework.Please check and see if something need to be modified or corrected? my questions __ when patient is still complaining for headache, what need to be done at that moment? because the health teaching is not priority . May be add more to the scenario . Case: Hypertensive Emergency Synopsis: 67 year old patient headache. Number of Participants: one patient, nurse(you) and health care staff Objectives: Patient will be able to manage hypertensive urgency and it's complications. Stem: You are the Nurse working in the ER. A 67 year old patient with headache and hypertension is admitted to the Emergency. Patient's initial BP was 220/105. Patient is newly diagnosed with hypertension and was recently seen in the ER for workup for secondary causes of hypertension. The emergency physicians performed a CT head which was normal. Roles: Senior 67 year old female Nurse Script for Roles: Nurse:Since arrive to ER you've placed the patient on monitor. Patient's had a CT head which the ER doc tells you that was normal. The patient continues to complain of a headache. Patient - What is Hypertension and what causes it? Nurse - Hypertension is a term used for high blood pressure. Blood pressure is the force of blood against your artery walls as it circulates through your body. Blood pressure normally rises and falls throughout the day, but it can cause health problems if it stays high for a long time. High blood pressure can lead to heart disease and stroke. Patient - What are the signs and symptoms? Nurse -Symptoms vary depending on the severity of the condition and progression of the disease. You may experience no symptoms, or your symptoms may include: chest pain (angina) tightness or pressure in the chest shortness of breath fatigue pain in the neck, back, arms, or shoulders persistent cough loss of appetite leg or ankle swelling Patient - What are the risk factors associated with hypertension? Nurse - I can tell you the risk factors which could be being overweight or obese, Intake of too much salt in your diet, too little potassium, not being physically active, drinking too much alcohol and stress. HTN can be caused due to certain drugs such as NSAIDS or cough and cold medications. Patient - How can i check my blood pressure at home? Nurse - You can purchase a manual or digital blood pressure monitor, follow the instructions in the booklet carefully. There are certain factors you need to consider that can temporarily rise your blood pressure. For example - stress, smoking, cold temperatures, exercise, caffeine, and certain medications. Try to avoid as many of these factors as you can when taking your blood pressure. Also, try to measure your blood pressure at about the same time each day. Your doctor may want you to check your blood pressure several times during the day to see if it fluctuates. Patient - How is it treated ? Nurse - If you have high blood pressure, your doctor may prescribe medication to treat it. Lifestyle changes can be just as important as taking medicines. Patient - How should i know that i need to go to the Emergency? Nurse - You need emergency care if your heart is suddenly beating rapidly or irregularly. Seek emergency care immediately or call 911 if you faint or have severe pain in your chest. Regular physical exams will indicate whether you suffer from high blood pressure. If you do have high blood pressure, take extra care to look out for symptoms of heart disease.

The patient is 67 year old female and assessed in emergency after complaining about chest pain

Hi Dishes I am doing all what you have mentioned.Can we create a scenario on Hypertension for today?

I will do all of the above you said.You are a great resource to me . Can you please help me creating scenarios too? Like we can do one everyday.This thread will be really helpful for others who are preparing for SLA:) Thanks Dishes

I think reading textbooks will not help me.i am done with everything and whenever i study,it feels like i know all that stuff. so better prepare for the procedures because i have studied everything in my 4 year degree plus i have done most of the books before my Computer Based Assessment.i need more knowledge about practicals:)

Hi dishes These are the procedures i have prepared. please add more : Chest tube care Foley catheter insertion Feeding tubes PEG tubes , G tube feeding skills Unwitnessed fall Hanging IV minibag Priming IV line IV medication administration Nursing IV calculations Wound care Sterile dressing change Wound irrigation 5minute head to toe assessment Blood pressure measurement manually and with stethoscope Please give me atleast 5 procedures everyday so that i make sure i covered everything. My SLA will be in January 2018. Lets start with Mental Health Nursing today :) :) yeaaahhhhh

You are right dishes but the issue is doing 7 textbooks are not easy so i was looking for one or two to do thorough review.

THAnks a lot dishes.now atleast i know a textbook which i can study. Thanks

Hi Lilian I haven't done the test yet.and yes its a big secret. i physically visited the facility and asked them for resources and they behave like its a big big secret and they told me nothing. I would definitely want to study with you. You can email me at [email protected]

If you have not submitted all the documents yet ,you can call NNAS and they will make changes for you.

Hi Parasol Can you give me an example of what were the procedures you did in SLA?i have no idea what to prepare? My email is [email protected] Please inbox or send me an email .i need help with preparation .

I am doing NCLEX RN this year but before that I need to go through simulation lab and computer based assessment through NCAS .i am so scared because there is no information about SLA . i visited the college in person , where I am scheduled for SLA.THe staff gave no information except that it will be all for entry level nurses. could anybody suggest me any procedures to prepare ? there will be four parts : medical surgical nursing community health nursing mental health nursing gynaecology I am not sure if that's correct becoz somebody gave me this above info . MY question is -will I be expected to perform fundal examination on a pregnant women ?that sounds like a little advanced for a entry level nurse. i have done advanced procedures in INdia as a RN ,but in Canada A nurse need certification to be a IV nurse , which was absolutely normal in my country .i did hundreds of IV's on real patients when I was only in second year of my nursing college ,only 20 years old . I use to have a practical book which had all the procedures I have done in my nursing college but I am missing that one .can anybody help me with what to expect in the exam ?