Clinical communication & documentation
Educational Use Only. This app is not intended to replace instructor guidance, institutional policies, clinical judgment, or professional medical training.
You are caring for Mr. Chen, a 68-year-old male who had a hip replacement 4 hours ago. His blood pressure has dropped from 130/80 to 88/52 over the last hour. Heart rate is 112, respiratory rate 22, SpO2 94% on room air. The incision site dressing is dry and intact. He reports feeling dizzy when he tries to sit up.
Mrs. Patel, a 72-year-old female with COPD, was admitted 2 days ago for an exacerbation. She has been on 2L oxygen via nasal cannula. You notice she has become increasingly confused over the last 30 minutes. Her respiratory rate is 32, SpO2 is 88% on 2L, and she is using accessory muscles. ABG from 2 hours ago showed pH 7.34, PaCO2 58, PaO2 62.
At 03:00, the lab calls with a critical potassium result of 6.8 mEq/L for Mr. O'Brien, a 75-year-old male admitted with acute kidney injury. He is currently asymptomatic but has a history of heart failure and is on lisinopril and spironolactone. You need to call the on-call provider immediately.
It is 19:00 shift change. You are giving report on Mr. Rodriguez, a 64-year-old post-op day 1 from an open cholecystectomy. He has a PCA morphine pump, a Jackson-Pratt drain, and an indwelling Foley catheter. His pain is well-controlled at 2/10. You need to give a concise, organized SBAR handoff to the oncoming nurse.
At 09:15, you realize you administered 10 units of regular insulin instead of the ordered 5 units to Mrs. Chen, a 58-year-old female with type 2 diabetes. She is alert and oriented, currently eating breakfast. Her last blood glucose was 145. You need to call the provider to report the medication error.
You are caring for Mr. James, a 72-year-old male admitted 2 days ago for pneumonia. At 14:30 during your rounds, you notice he has become increasingly restless and confused. His respiratory rate has increased from 18 to 28, oxygen saturation dropped from 96% to 89% on 2L nasal cannula, and his blood pressure is 88/52 (was 118/72 this morning). The rapid response team needs to be called.