1
INSTRUCTOR GUIDE – CVA SCENARIO
Case overview: A 45 year old male comes to the Poly Clinic for an
appointment. He was on patrol when an IED went off. No loss of
consciousness. Accident was 60 minutes ago.
Scenario purpose: To assess the learner’s ability to safely perform an
assessment and interventions on a patient who is seen in the Poly Clinic
with signs of a stroke.
During this case, students will have the opportunity to perform an
assessment and complete or assist with interventions for this male
patient with Right sided weakness, blurred vision and problems talking.
Learning objectives:
The student will:
1. Obtain and document VS and an admission history and
assessment.
2. Complete a neurological assessment to include pupil check, smile
(facial drooping), arm lifting and speech.
3. Identify and complete appropriate nursing care based on their
assessment of the patient
4. Complete reassessments of V/S and neurological status.
5. Describe changes in patient condition and complete interventions
based on changes in condition
6. Describe potential complications for this patient.
Admission type/unit: Poly Clinic
Patient name:
Age: 45
Gender: M
Reason for admission/chief complaint: Right sided weakness,
problems talking
Primary diagnosis: Possible CVA
LEARNERS MUST COMPLETE A NEUROLOGICAL ASSESSMENT
AND MONITOR VITAL SIGNS.
Recommended scenario time limit: Estimated time for scenario 15 20 minutes
Recommended debriefing time: Estimated 20 – 30 minutes
Simulation Lab Preparation:
Equipment/supplies:
•
•
•
•
•
•
Equipment for completing V/S (T, P, R, B/P. O2 Saturation)
Stethoscope
IV insertion and blood draw equipment – IV catheters, solution, blood tubes
Penlight
Appropriate documentation forms
O2 therapy equipment choices (cannula, masks, airways, ambu bag)
\
2
Exceeds
Expectations
Evaluation Rating
Meets
Does Not Meet
Expectations
Expectations
STUDENT PERFORMANCE GUIDELINES
CVA SCENARIO
Comments
Hand hygiene
Introduced self
Informed patient about what they were going to do
Checked all V/S (T, P, RR, B/P, O2 saturation,
Pain rating)
Obtain and document patient history
Apply oxygen
Obtain 12 lead EKG
Attach to monitor, monitor EKG and VS
Assess neurological status
Start IV and implement other MD orders
Reassess VS and neurological status
Obtain orders for X-Ray, lab
Implemented Emergency procedures if needed
YES
NO
NONE REQUIRED
Reassessment completed after interventions
Interventions modified based on reassessment
Positioned patient to protect airway after change in
level of consciousness and VS
Instructor Debriefing Guide
1. Ask the nurses:
a. How do you think the scenario went?
b. How do you think you did?
c. If you could do anything differently if you were to do this over again, what would it be?
d. What have you learned that will help you care for patients?
2. Ask the observers to comment.
3. Provide constructive critique and feedback.
4. IF students didn’t complete neurological assessment and position patient to protect airway after change in level of consciousness and VS, this key
assessment should be reviewed with students then completing a demonstration of these checks on each other.