Nancy Gilbert Simulations
1. You are the nurse caring for a patient with a tracheostomy. What communication strategies can you
promote with your patient in order to effectively interact and communicate?
2. You are the nurse caring for a patient with methicillin-resistant staphylococcus aureus (MRSA).
a) What is MRSA?
b) Describe the precautions required when providing care to this patient.
c) List topics to include in the patient and family education.
3. Describe the assessment cues and nursing interventions for infiltration and extravasation of an
intravenous (IV) catheter
Sample Solution
Here are some communication strategies that nurses can promote with patients with tracheostomies in order to effectively interact and communicate:
- Assess the patient's communication needs. This includes determining the patient's level of consciousness, cognitive abilities, and physical limitations.
- Educate the patient and family about the different communication options available. This may include mouthing words, writing, using a communication board, or using an electrolarynx.
- Encourage the patient to use their preferred method of communication.
- Be patient and attentive. It may take the patient longer to communicate with a tracheostomy, so it is important to be patient and give them time to express themselves.
- Use nonverbal communication cues. This includes maintaining eye contact, nodding your head, and smiling.
- Avoid talking over the patient.
- Rephrase or repeat what you say if necessary.
- Use simple sentences and avoid using jargon.
- Break down complex tasks into smaller steps.
- Provide written instructions or visual cues.
- Encourage the patient to ask questions.
- MRSA
- a) What is MRSA?
- b) Precautions required when providing care to a patient with MRSA
- Wearing gloves and a gown when entering the patient's room.
- Washing hands thoroughly with soap and water before and after providing care.
- Cleaning and disinfecting all equipment and surfaces that come into contact with the patient.
- Avoiding contact with the patient's open wounds or lesions.
- c) Topics to include in patient and family education
- What is MRSA and how is it spread?
- The signs and symptoms of MRSA infection.
- The importance of hand hygiene.
- How to avoid the spread of MRSA in the home and community.
- Assessment cues and nursing interventions for infiltration and extravasation of an IV catheter
- Swelling and redness at the IV site
- Pain and tenderness at the IV site
- Coolness at the IV site
- Slowing of the IV infusion rate
- Swelling and redness at the IV site
- Pain and tenderness at the IV site
- Warmth at the IV site
- Blistering or necrosis at the IV site
- Stop the IV infusion.
- Remove the IV catheter.
- Elevate the affected limb.
- Apply a warm compress to the affected area.
- Notify the physician.
- Administration of an antidote
- Debridement of the affected tissue
- Surgery