April 6, 2021

Virtual RLE Simulation

PHASE 1 (AM SHIFT)

Layla Tank a 12years old, female, from Cuta, Vigan City. Born on May 28, 2009. Was admitted ISPH-GS
PEDIA WARD C, 4/6/2021 at 8:05AM. Because 3 days prior to admission, She experienced body malaise,
fever, chills, and cough with phlegm, loose stool, abdominal pain.

ADMITTING DIAGNOSIS: Dengue Fever ruled out Pneumonia

ATTENDING/ADMITTING PHYSICAN: Dr. Rialubin

COMPLAINTS: body malaise, fever, chills, and cough with phlegm, loose stool, abdominal pain

At 8:05AM(Emergency Room) INITIAL VS: BP:100/80 PR: 82 RR:17 TEMP:37.7C o2 saturation: 97%

At 9:30AM (transferred to PEDIA WARD) VS: BP:110/70 PR: 97 RR:17 TEMP:37.6C o2 saturation: 97%

At 1:00PM VS: BP:110/80 PR:95 RR:19 TEMP:38.6C o2 saturation:98%

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DOCTOR’S ORDER

COMPLAINTS: body malaise, fever, chills, and cough with phlegm, loose stool, abdominal pain

INITIAL VS: BP:100/80 PR: 82 RR:17 TEMP:37.7C o2 saturation: 97%

DIET: DAT EXCEPT DARK COLORED FOODS

Diagnostics:

CBC, urinalysis, fecalysis and, Chest xray APL, Dengue Duo

Treatment: IVF D5LRS 1Liter x 8 hours (macroset) (hooked at 8:30AM)

Omeprazole 20mg IV NOW

Paracetamol 500mg/tablet, 1 tablet Q4 PRN for temp:37.5C and above (given at

8:10AM)

Paracetamol 300mg IV Q4 PRN for temp: 38.5 and above

Stimuno 1 tab TID

To start cefuroxime 600mg IV q8 ANST (skin test due at 9:25AM)

Probiotics 1 cap OD AM (given at 12PM)

Increase Oral Fluid Intake

I and O q shift

Refer accordingly
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At 2PM you visited Layla and asked if how is she now. Layla answered that she is now better than other
day, no fever, no chills, sometimes with cough, abdominal pain is now relieved but still loose stool. You
have taken the vital signs: BP: 110/80 PR: 83 RR: 19 TEMP: 36.7C O2 SAT: 98%

At 3PM you ask the patient’s intake and output:

Intake: IVF consume: (Compute) Oral intake:1190cc

Output: Urine:6x(1320cc) stool: 2x

Latest VS: BP: 120/70 PR: 78 RR: 19 TEMP: 37.1C O2 SAT: 98%

Some of Diagnostics are done:

Urinalysis:
 Color: light yellow
 Character: slightly turbid
 pH: 6.0
 Specific Gravity: 1.020
 Pus/WBC cells: 0-3 normal value: 0-3
 RBC: 0-2 normal value: 0-3
 Mucus Thread: few
 Bacteria: few
 Albumin: rare

CBC:
 WBC: 25 (high) normal:7-10
 HGB: 110 g/L(low) normal range: 120-160
 HCT: 34% (low) normal range: 35-49
 PLT: 80 (low) x 10^9/L normal range: 100-300
Dengue Duo Result:
FECALYSIS:
 Consistency: Watery
 Remarks: no ova seen

Chest xray APL view:

 To follow result
 DOCTOR’S ORDER
Name:_______________________________________Age/Sex/CS:___/m/s________Ward/R
oom:
Date C A R E D TIME POSTED
Progress AND
And Doctor’s Order
Notes SIGNATURE
time
4/6/21 COMPLAINTS: >Admit to room of choice 
8:05AM body malaise, >Consent of Admission
fever, chills, >DIET: DAT EXCEPT DARK COLORED FOODS
and cough with >Diagnostics:
phlegm, loose CBC, urinalysis, fecalysis and, Chest xray
stool, APL, Dengue Duo
abdominal pain
Treatment:
 IVF D5LRS 1Liter x 8 hours (macroset) Hooked at
8:30AM
INITIAL VS: (hooked at 8:30AM)
BP:100/80  Omeprazole 20mg IV NOW (given at
PR: 82 8:34AM)
RR:17  Paracetamol 500mg/tablet, 1 tablet Q4
TEMP:37.7C PRN for temp:37.5C and above (given at
o2 saturation: 8:10AM)
97%  Paracetamol 300mg IV Q4 PRN for temp:
38.5 and above
 Stimuno 1 tab TID (given at 12PM)
 To start cefuroxime 600mg IV q8 ANST
(skin test due at 9:25AM)
 Probiotics 1 cap OD AM (given at 12PM)
 Increase Oral Fluid Intake
 I and O q shift
 Refer accordingly
DR. RIALUBIN

C-Carried-out

A-Administered

R- Requested

E-Endorsed

D-Discontinued