SIMULATION PREP SHEET

STUDENT Click or tap here to enter text. DATE: Click or tap here to enter text.
NAME:
SIMULATED Click or tap here to enter text. PATIENT Click or tap here to enter text.
PATIENT NAME: AGE:
CODE STATUS: Click or tap here to enter text. ADVANCE Click or tap here to enter text.
D
DIRECTIVE:

ADMITTING DIAGNOSIS PATHOPHYSIOLOGY OF ADMITING DIAGNOSIS

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PAST MEDICAL HISTORY/DIAGNOSIS PATHOPHYSIOLOGY OF DIAGNOSIS

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POTENTIAL COMPLICATIONS: LIST HERE HEALTH CARE PROVIDERS ORDERS: LIST HERE

COLLABORATIVE CARE
Laboratory Orders/Results: Reason ordered Diagnostic Procedures/Results: Reason ordered
LIST HERE LIST HERE

LIST OTHER HEALTH CARE PROVIDERES INVOLVED AND WHY THEY ARE INVOLVED OR CONSULTED

What is patient allergic to? (med, food, environment, object) What is their reaction to allergen?

SIMULATED PATIENT MEDICATION SHEET

MEDICATION CLASSIFICATION WHY IS YOUR CLIENT NURSING ADVERSE AFFECTS
GENERIC & TRADE PRESCRIBED THIS CONSIDERATIONS/ (MINIMUM OF 3)
DOSAGE & ROUTE MEDICATION IMPLICATIONS TO
ADDRESS PRIOR TO
GIVING MEDICATION
(MINIMUM OF 3)