{"presentation":{"slides":[{"elements":[{"x":3.7359900373599007,"y":22.11302211302211,"width":47.45341614906832,"height":61.27450980392157,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Biographical data:<\/strong> Adult client<\/li>\n\t
Reason for seeking care:<\/strong> Vomiting and diarrhea<\/li>\n\t
History of presenting illness:<\/strong> Vomited \u00d7<\/span><\/span> 4 daily \u00d7<\/span><\/span> 3 days, diarrhea \u00d7<\/span><\/span> 6 daily \u00d7<\/span><\/span> 3 days, currently severely nauseated and dizzy, tolerating sips of clear fluid<\/li>\n\t
Past history:<\/strong> No medications, no illnesses<\/li>\n<\/ul>\n\n
<\/p>\n"},"subContentId":"87bac94f-7fad-4de5-9d2f-b2109bed85ab","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":58.53051058530511,"y":22.11302211302211,"width":33.125778331257784,"height":42.99754299754299,"action":{"library":"H5P.Image 1.1","params":{"contentName":"Image","file":{"path":"images\/file-5f972dba3d3d9.jpg","mime":"image\/jpeg","copyright":{"license":"U"},"width":3696,"height":2448},"decorative":false},"subContentId":"ad0663ad-e39d-4ec2-8d48-b0f8cc4300a1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"keywords":[{"main":"Initial Assessment Data"}],"slideBackgroundSelector":{}},{"elements":[{"x":9.962640099626402,"y":12.285012285012284,"width":86.95652173913042,"height":76.47058823529412,"action":{"library":"H5P.SingleChoiceSet 1.11","params":{"choices":[{"subContentId":"b0627336-439b-49f4-8ec2-7ed41e413b6b","question":"
What infection control measures should the healthcare provider implement?<\/strong><\/p>\n","answers":["
Contact Precautions<\/p>\n","
Droplet Precautions<\/p>\n","
Airborne Precautions<\/p>\n","
None<\/p>\n"]},{"subContentId":"6e4e4815-9bcb-4985-9ab9-c576ebe6289f","question":"
What method should be used to measure temperature for this adult client?<\/strong><\/p>\n","answers":["
Tympanic<\/p>\n","
Oral<\/p>\n","
Rectal<\/p>\n"]},{"subContentId":"7f2c04a8-115e-4451-a20d-8c6e73594a3b","question":"
What pulse and blood pressure readings should be taken for this adult client?<\/strong><\/p>\n","answers":["
Orthostatic vital signs<\/p>\n","
Blood pressure and pulse with patient in lying position<\/p>\n","
Blood pressure and pulse with patient in High Fowlers position<\/p>\n"]},{"subContentId":"9a43728b-271a-4c2b-9ec2-89ef4da930c7","question":"
How do you take orthostatic vital signs?<\/p>\n","answers":["
Take baseline blood pressure and pulse with patient at rest in supine position, then take both measurements in the sitting then standing position. <\/p>\n","
Take baseline blood pressure with patient at rest in supine position, then take it again in the sitting and standing position. <\/p>\n","
Take baseline blood pressure and pulse with patient at rest in supine position, then take it again within 1 minute in both the sitting position then the standing position. <\/p>\n"]}],"overallFeedback":[{"from":0,"to":100}],"behaviour":{"autoContinue":true,"timeoutCorrect":2000,"timeoutWrong":3000,"soundEffectsEnabled":true,"enableRetry":true,"enableSolutionsButton":true,"passPercentage":100},"l10n":{"nextButtonLabel":"Next question","showSolutionButtonLabel":"Show solution","retryButtonLabel":"Retry","solutionViewTitle":"Solution list","correctText":"Correct!","incorrectText":"Incorrect!","muteButtonLabel":"Mute feedback sound","closeButtonLabel":"Close","slideOfTotal":"Slide :num of :total","scoreBarLabel":"You got :num out of :total points","solutionListQuestionNumber":"Question :num","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again."}},"subContentId":"d1f359b2-e39e-4012-a797-bac3b85ff4bb","metadata":{"contentType":"Single Choice Set","license":"U","title":"Adult Case Study Vital Signs"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":"
1. Due to the client's diarrhea, the patient should be in contact precautions. <\/p>\n\n
2. Temperature is best taken using the tympanic or axillary route; because the client is nauseated, the oral route could stimulate the gag reflex and the rectal route could stimulate perastalsis.<\/p>\n\n
3.Orthostatic vital signs should be taken because this client is at risk for hypovolemia. The client may be dehydrated as a result of the vomiting and diarrhea and lack of fluid intake. <\/p>\n\n
4. Both pulse and blood pressure are taken when doing orthostatic vital signs. <\/p>\n"}],"keywords":[{"main":"Test your knowledge"}],"slideBackgroundSelector":{}},{"elements":[{"x":3.7267080745341614,"y":4.886642156862745,"width":96.27329192546583,"height":95.09803921568627,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"0800 hours, May 1, 2018<\/strong>\n\n
\n\t
Temperature 37.9 \u00b0C tympanic<\/li>\n\t
Pulse Lying 92 bpm (radial) : regular rhythm, force 1+, weak and thready, equal radial pulses<\/li>\n\t
RR 22 bpm irregular rhythm<\/li>\n\t
BP lying 122\/78 mm Hg<\/li>\n\t
02 saturations 96%<\/li>\n<\/ul>\n\n0802 hours, May 1, 2018<\/strong>\n\n
\n\t
Pulse sitting 110 bpm (radial)<\/li>\n\t
BP sitting 112\/72 mm Hg<\/li>\n<\/ul>\n\n0804 hours, May 1, 2018<\/strong>\n\n
\n\t
Pulse standing 120 bpm (radial)<\/li>\n\t
BP standing 98\/68 mm Hg<\/li>\n<\/ul>\n"},"subContentId":"336387fa-b8a6-4a19-aeb9-e275f684a2c0","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{},"keywords":[{"main":"Vital Sign Measurements"}]},{"elements":[{"x":26.08695652173913,"y":5.422794117647059,"width":38.50931677018633,"height":90.19607843137254,"action":{"library":"H5P.Image 1.1","params":{"contentName":"Image","file":{"path":"images\/file-5fd0d7dd88aa1.jpg","mime":"image\/jpeg","copyright":{"license":"U"},"width":1700,"height":2338},"decorative":false},"subContentId":"ce7297b3-8136-4168-986b-920817fd5b2d","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":22.415940224159403,"y":2.453130052534649,"width":76.3975155279503,"height":97.54901960784314,"action":{"library":"H5P.Dialogcards 1.9","params":{"mode":"normal","description":"","dialogs":[{"tips":{},"text":"
Which findings are considered abnormal for this adult client? <\/strong><\/p>\n","answer":"
The pulse in lying position is within normal limits, but in the sitting and standing position, the pulse is elevated (> than 100 bpm). The pulse increased more than 20 bpm and the systolic BP decreased more than 20 mm Hg when the client moved from lying to standing. The pulse is weak and thready at 1+ force, which is abnormal The respiration rate is high (> 20 bpm)<\/p>\n"}],"behaviour":{"enableRetry":true,"disableBackwardsNavigation":false,"scaleTextNotCard":false,"randomCards":false,"maxProficiency":5,"quickProgression":false},"answer":"Turn","next":"Next","prev":"Previous","retry":"Retry","correctAnswer":"I got it right!","incorrectAnswer":"I got it wrong","round":"Round @round","cardsLeft":"Cards left: @number","nextRound":"Proceed to round @round","startOver":"Start over","showSummary":"Next","summary":"Summary","summaryCardsRight":"Cards you got right:","summaryCardsWrong":"Cards you got wrong:","summaryCardsNotShown":"Cards in pool not shown:","summaryOverallScore":"Overall Score","summaryCardsCompleted":"Cards you have completed learning:","summaryCompletedRounds":"Completed rounds:","summaryAllDone":"Well done! You got all @cards cards correct @max times in a row!","progressText":"Card @card of @total","cardFrontLabel":"Card front","cardBackLabel":"Card back","tipButtonLabel":"Show tip","audioNotSupported":"Your browser does not support this audio","confirmStartingOver":{"header":"Start over?","body":"All progress will be lost. Are you sure you want to start over?","cancelLabel":"Cancel","confirmLabel":"Start over"},"title":"
Considering the patient's vital signs answer the question on the card, then turn the card to see the answer.<\/p>\n"},"subContentId":"d6f0e64d-a303-4598-ba2c-452b4e0cd654","metadata":{"contentType":"Dialog Cards","license":"U","title":"Analysis of vital signs"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"keywords":[{"main":"Test your knowledge "}],"slideBackgroundSelector":{}},{"elements":[{"x":8.695652173913043,"y":9.803921568627452,"width":74.53416149068322,"height":71.56862745098039,"action":{"library":"H5P.MultiChoice 1.16","params":{"media":{"disableImageZooming":false},"answers":[{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"Hypotension\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"Hypertension\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"Orthostatic hypotension\n"}],"overallFeedback":[{"from":0,"to":100}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again.","submitAnswerButton":"Submit"},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
What is the medical name for the BP and P findings?<\/p>\n"},"subContentId":"09e053e5-223a-42b5-9774-c2d3f8945020","metadata":{"contentType":"Multiple Choice","license":"U","title":"Untitled Multiple Choice"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"keywords":[{"main":"Test your knowledge"}],"slideBackgroundSelector":{}},{"elements":[{"x":8.695652173913043,"y":19.56188725490196,"width":74.53416149068322,"height":71.56862745098039,"action":{"library":"H5P.MultiChoice 1.16","params":{"media":{"disableImageZooming":false},"answers":[{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"Bradycardia\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"Tachypnea\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"Tachycardia\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"Apnea\n"}],"overallFeedback":[{"from":0,"to":100}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again.","submitAnswerButton":"Submit"},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
What is the medical term for a pulse rate over a hundred in an adult client?<\/p>\n"},"subContentId":"d3adf62d-00a4-414e-b710-97d95869e807","metadata":{"contentType":"Multiple Choice","license":"U","title":"Untitled Multiple Choice"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"keywords":[{"main":"Test your knowledge"}],"slideBackgroundSelector":{}},{"elements":[{"x":17.434620174346204,"y":12.285012285012284,"width":74.78260869565217,"height":85.7843137254902,"action":{"library":"H5P.Dialogcards 1.9","params":{"mode":"normal","description":"","dialogs":[{"tips":{},"text":"
What is the medical term for respirations over 20 bpm in an adult client?<\/p>\n","answer":"
Tachypnea<\/p>\n"}],"behaviour":{"enableRetry":true,"disableBackwardsNavigation":false,"scaleTextNotCard":false,"randomCards":false,"maxProficiency":5,"quickProgression":false},"answer":"Turn","next":"Next","prev":"Previous","retry":"Retry","correctAnswer":"I got it right!","incorrectAnswer":"I got it wrong","round":"Round @round","cardsLeft":"Cards left: @number","nextRound":"Proceed to round @round","startOver":"Start over","showSummary":"Next","summary":"Summary","summaryCardsRight":"Cards you got right:","summaryCardsWrong":"Cards you got wrong:","summaryCardsNotShown":"Cards in pool not shown:","summaryOverallScore":"Overall Score","summaryCardsCompleted":"Cards you have completed learning:","summaryCompletedRounds":"Completed rounds:","summaryAllDone":"Well done! You got all @cards cards correct @max times in a row!","progressText":"Card @card of @total","cardFrontLabel":"Card front","cardBackLabel":"Card back","tipButtonLabel":"Show tip","audioNotSupported":"Your browser does not support this audio","confirmStartingOver":{"header":"Start over?","body":"All progress will be lost. Are you sure you want to start over?","cancelLabel":"Cancel","confirmLabel":"Start over"},"title":"
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What further assessment should the healthcare provider do based on this adult client\u2019s findings?<\/strong><\/p>\n","answer":"
Continue to assess for signs of dehydration:<\/p>\n\n
dry mucous membranes, poor skin turgor, decreased and concentrated urine output<\/p>\n"}],"behaviour":{"enableRetry":true,"disableBackwardsNavigation":false,"scaleTextNotCard":false,"randomCards":false,"maxProficiency":5,"quickProgression":false},"answer":"Turn","next":"Next","prev":"Previous","retry":"Retry","correctAnswer":"I got it right!","incorrectAnswer":"I got it wrong","round":"Round @round","cardsLeft":"Cards left: @number","nextRound":"Proceed to round @round","startOver":"Start over","showSummary":"Next","summary":"Summary","summaryCardsRight":"Cards you got right:","summaryCardsWrong":"Cards you got wrong:","summaryCardsNotShown":"Cards in pool not shown:","summaryOverallScore":"Overall Score","summaryCardsCompleted":"Cards you have completed learning:","summaryCompletedRounds":"Completed rounds:","summaryAllDone":"Well done! You got all @cards cards correct @max times in a row!","progressText":"Card @card of @total","cardFrontLabel":"Card front","cardBackLabel":"Card back","tipButtonLabel":"Show tip","audioNotSupported":"Your browser does not support this audio","confirmStartingOver":{"header":"Start over?","body":"All progress will be lost. Are you sure you want to start over?","cancelLabel":"Cancel","confirmLabel":"Start over"},"title":""},"subContentId":"8de6de9e-e8ad-485f-aa9c-d9f144becf35","metadata":{"contentType":"Dialog Cards","license":"U","title":"Adult Patient Analysis of Vital Signs"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"keywords":[{"main":"Test your knowledge"}],"slideBackgroundSelector":{}},{"elements":[{"x":11.982570806100219,"y":4.405286343612334,"width":87.57763975155278,"height":93.13725490196079,"action":{"library":"H5P.Dialogcards 1.9","params":{"mode":"normal","description":"
Answer the question on the card then turn to see if you were correct.<\/p>\n","dialogs":[{"tips":{},"text":"
What actions should the healthcare provider take based on this adult client\u2019s findings?<\/strong><\/p>\n","answer":"
Notify the most responsible provider such as the physician or nurse practitioner, and communicate the issues you have identified using the ISBAR model.<\/p>\n"}],"behaviour":{"enableRetry":true,"disableBackwardsNavigation":false,"scaleTextNotCard":false,"randomCards":false,"maxProficiency":5,"quickProgression":false},"answer":"Turn","next":"Next","prev":"Previous","retry":"Retry","correctAnswer":"I got it right!","incorrectAnswer":"I got it wrong","round":"Round @round","cardsLeft":"Cards left: @number","nextRound":"Proceed to round @round","startOver":"Start over","showSummary":"Next","summary":"Summary","summaryCardsRight":"Cards you got right:","summaryCardsWrong":"Cards you got wrong:","summaryCardsNotShown":"Cards in pool not shown:","summaryOverallScore":"Overall Score","summaryCardsCompleted":"Cards you have completed learning:","summaryCompletedRounds":"Completed rounds:","summaryAllDone":"Well done! You got all @cards cards correct @max times in a row!","progressText":"Card @card of @total","cardFrontLabel":"Card front","cardBackLabel":"Card back","tipButtonLabel":"Show tip","audioNotSupported":"Your browser does not support this audio","confirmStartingOver":{"header":"Start over?","body":"All progress will be lost. Are you sure you want to start over?","cancelLabel":"Cancel","confirmLabel":"Start over"},"title":""},"subContentId":"5ac84274-51e2-4df4-8d1b-8bcaeef7c58c","metadata":{"contentType":"Dialog Cards","license":"U","title":"Adult Patient Vital Signs"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"keywords":[{"main":"Test your knowledge"}],"slideBackgroundSelector":{}},{"elements":[{"x":30.010893246187365,"y":29.955947136563875,"width":40,"height":40,"action":{"library":"H5P.MultiChoice 1.16","params":{"media":{"disableImageZooming":false},"answers":[{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Hi, this is Amina Hamza, the nurse on duty at Happy Times Nursing home. I am calling about Mr. X, 72-year-old male resident who has had vomitting and diarrhea that has been ongoing for 3 days.<\/p>\n"},{"correct":false,"tipsAndFeedback":{"chosenFeedback":"
Remember that the MD or NP you are calling will have many patients, so your communication with this colleague should begin with telling the MD or NP who you are and who you are calling about.<\/p>\n","tip":"","notChosenFeedback":""},"text":"
Hi, I am calling about Mr. X, a 72-year-old male resident who has had vomitting and diarrhea that has been ongoing for 3 days.<\/p>\n"},{"correct":false,"tipsAndFeedback":{"chosenFeedback":"
Remember that the MD or NP you are calling will have many patients, so your communication with this colleague should begin with telling the MD or NP who you are and who you are calling about.<\/p>\n","tip":"","notChosenFeedback":""},"text":"
I'm really worried about a resident who has had nausea and vomitting for the last three days.<\/p>\n"},{"correct":false,"tipsAndFeedback":{"chosenFeedback":"
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I'm calling about a 72-year old resident who has had nausea and vomitting for the last three days. He has had nausea and dizziness, and can only tolerate small sips of clear fluid. He is developing orthostatic hypotension, because his supine BP was 122\/78 and his standing BP was 98\/68. His standing radial pulse is 120 bpm. He has poor skin turgor and his urine output has only been 982 cc in the last 24 hours. I would like you to come and take a look at this resident and determine if he needs an IV and an order for Gravol.<\/p>\n"}],"overallFeedback":[{"from":0,"to":100}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again.","submitAnswerButton":"Submit"},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
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