vSim for Nursing | Gerontology
Millie Larsen Part 1
Instructor’s Overview:
Millie Larsen Part 1
Scenario Overview
Patient: Millie Larsen
Diagnosis: Urinary tract infection
This scenario is part of the Millie Larsen Unfolding Case. The scenario can be used as a standalone scenario or as part 1 of the case.
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The Unfolding Case
Millie Larsen is an 84-year-old Caucasian female who lives alone in a small home. Her husband Harold passed away a year ago and she has a cat, Snuggles, who is very important to her. Millie has one daughter, Dina Olsen, who is 50 years old, lives nearby, and is Millie’s major support system. Millie’s current medical problems include hypertension, glaucoma, osteoarthritis of the knee, stress incontinence, osteoporosis, and hypercholesterolemia.
The scenarios take place over 3 days when Millie is in the hospital with a diagnosis of urinary tract infection and dehydration. Her presentation is atypical, and she is confused. The scenarios depict varied situations Millie encounters during her brief hospital stay. The objectives focus on assessment; appropriate use of assessment tools such as the SPICES: An Overall Assessment Tool for Older Adults, a fall risk assessment tool, and Confusion Assessment Method (CAM); communication skills; conflict between Millie and her daughter on living arrangements; functional assessment; discharge teaching; and making appropriate referrals.
Brief Summary of Present Scenario
The scenario is set at 7 p.m., and Millie is in the emergency department. She was brought in with confusion by her daughter Dina three hours ago. As the scenario unfolds, it will become clear that due to her confusion, Millie has not been taking her medications properly in the days prior to admission and, as a result, her blood pressure is very elevated. Millie’s daughter Dina is at the bedside and is quite concerned about the confusion and elevated blood pressure. The students receive a report from the emergency room triage nurse and are expected to perform a general assessment as well as use the Confusion Assessment Method (CAM) and Morse Fall Scale tools. Objectives for this scenario include the identification and use of appropriate assessment tools for older adults, recognition of an elevated blood pressure, and notification of the physician, using SBAR format.