Early Recognition of Impending Stroke
Developed by: Brigham and Women’s Hospital, Simmons College
Patient is a 38 year old Hispanic former college football player who has severe osteo-arthritis of his left knee due to multiple sport-related injuries. Currently admitted for knee replacement surgery. Patient's past medical history includes chronic AF which is treated with coumadin at home. The coumadin has been held for a few days in anticipation of the surgery. Initially, the nurse enters the room to meet the patient and do a brief assessment. She finds the patient awake, alert, oriented, in good spirits with clear speech. She leaves to assess her other patients and returns 15 minutes later to bring the patient is pre-op Ancef. She finds a marked change in the patient. The patient has developed a right facial droop, slurred speech, right pronator drift of the RUE, and inability to raise right leg from the bed.
The intent of the scenario is for the nurse to recognize the risk factors present for a stroke in this young patient. In addition, it is intended that the nurse will perform a focused neurological exam, a blood sugar check to distinguish the changes from hypoglycemia, and provide safety interventions. Finally, it is expected that the nurse will access both the patient's medical team and the Acute Stroke Team, communicating the changes succinctly and effectively using SBAR.
The goal of this simulated experience is to develop and apply problem-solving, critical thinking and current evidence to the care of a patient experiencing an impending stroke. The participant will:
- Perform a focused patient assessment to determine the presence of a stroke.
- Address the maintenance of basic airway, respiratory, and circulatory function.
- Activate the hospital systems for accessing the primary physician and Acute Stroke Intervention Team
Nurse of the Future Nursing Competencies©
- Patient-Centered Care
- Teamwork and Collaboration
- Evidence-Based Practice
- Systems-Based Practice
(You must log in to view/download files)
- Simulation File - Basic Stroke: Nursing Students and Newly Licensed nurses (.sce) (810 downloads)
- Simulation File - Basic Stroke: Experienced Nurse Clinicians (.sce) (312 downloads)
- Scenario Planning Worksheet for Students/Newly Licensed Nurses (.pdf)
- Scenario Planning Worksheet for Experienced RNs (.pdf)
- Goals and Objectives (.doc)
- Script: Early Recognition for Students/New RNs (.doc)
- Script: Early Recognition for Experienced Staff (.doc)
Feedback(You must log in to submit feedback)
Population type: students Number of participants: 1
Comment:what software will I need to play the scenerois ?