Focused Exam: Type 1 Diabetes
Patient: Chelsea Warren
Digital Clinical Experience Score
100%
Subjective Data Collection: 25 of 25 (100.0% Category
Patient Status
Finding:
Assessed patient status
Finding:
Reports feeling “way better”
(Found)
Pro Tip: Assessing a pediatric patient’s status involves asking about their current comfort,
needs, and chief complaint. It’s important to check in with a patient’s status, because it
may reveal insight into their current condition.
Example Question:
How do you feel?
Finding:
Reports eagerness to go home
(Found)
Pro Tip: Assessing a pediatric patient’s status involves asking about their current comfort,
needs, and chief complaint. It’s important to check in with a patient’s status, because it
may reveal insight into their current condition.
Example Question:
How do you feel?
Finding:
Asked about patient’s comfort
Finding:
Reports feeling comfortable
(Found)
Pro Tip: Assessing a pediatric patient’s status involves asking about their current comfort,
needs, and chief complaint. It’s important to check in with a patient’s status, because it
may reveal insight into their current condition.
Example Question:
Are you having pain right now?
Finding:
Asked about patient’s needs
Finding:
Denies needing anything
(Found)
Pro Tip: Assessing a pediatric patient’s status involves asking about their current comfort,
needs, and chief complaint. It’s important to check in with a patient’s status, because it
may reveal insight into their current condition.
Example Question:
Do you need anything?
History of Present Illness Patient
Finding:
Asked patient about symptoms of DKA
Finding:
Denies remembering incident very well
(Found)
Pro Tip: Asking a pediatric patient about the duration and onset of their current health
issues solicits information relevant to the history of their present illness. Details of their
current complaint will help you follow-up on any present conditions or symptoms, such
as the location of their pain or the amount of pain they may be experiencing.
Example Question:
Why were you admitted?
Finding:
Reports feeling nauseated at a horseback riding lesson
(Found)
Pro Tip: Asking a pediatric patient about the duration and onset of their current health
issues solicits information relevant to the history of their present illness. Details of their
current complaint will help you follow-up on any present conditions or symptoms, such
as the location of their pain or the amount of pain they may be experiencing.
Example Question:
Why were you admitted?
Finding:
Reports vomiting
(Found)
Pro Tip: Asking a pediatric patient about the duration and onset of their current health
issues solicits information relevant to the history of their present illness. Details of their
current complaint will help you follow-up on any present conditions or symptoms, such
as the location of their pain or the amount of pain they may be experiencing.
Example Question:
Why were you admitted?
Finding:
Asked about patient’s other symptoms prior to DKA
Finding:
Reports frequent urination prior to DKA
(Found)
Pro Tip: Asking a pediatric patient about the duration and onset of their current health
issues solicits information relevant to the history of their present illness. Details of their
current complaint will help you follow-up on any present conditions or symptoms, such
as the location of their pain or the amount of pain they may be experiencing.
Example Question:
Have you been urinating more often than usual?
Finding:
Reports excessive thirst prior to DKA
(Found)
Pro Tip: Asking a pediatric patient about the duration and onset of their current health
issues solicits information relevant to the history of their present illness. Details of their
current complaint will help you follow-up on any present conditions or symptoms, such
as the location of their pain or the amount of pain they may be experiencing.
Example Question:
Have you been feeling more thirsty lately?
Finding:
Reports fatigue prior to DKA
(Found)
Pro Tip: Asking a pediatric patient about the duration and onset of their current health
issues solicits information relevant to the history of their present illness. Details of their
current complaint will help you follow-up on any present conditions or symptoms, such
as the location of their pain or the amount of pain they may be experiencing.
Example Question:
Are you always fatigued?
Finding:
Reports lack of appetite prior to DKA
(Available)
Pro Tip: Asking a pediatric patient about the duration and onset of their current health
issues solicits information relevant to the history of their present illness. Details of their
current complaint will help you follow-up on any present conditions or symptoms, such
as the location of their pain or the amount of pain they may be experiencing.
Example Question:
How is your appetite?
Finding:
Asked about onset of prior symptoms
Finding:
Reports other symptoms began around 10 days prior
(Found)
Pro Tip: Asking a pediatric patient about the duration and onset of their current health
issues solicits information relevant to the history of their present illness. Details of their
current complaint will help you follow-up on any present conditions or symptoms, such
as the location of their pain or the amount of pain they may be experiencing.
Example Question:
When did you start feeling sick?
Assess Patient Knowledge
Finding:
Assessed patient’s knowledge of type 1 diabetes
Finding:
Reports knowledge of type 1 diabetes
(Found)
Pro Tip: Assessing a pediatric patient’s knowledge of their preexisting conditions helps
you determine how to educate both guardian and patient.
Example Question:
What type of diabetes do you have?
Assess Patient Diet
Finding:
Asked about diet at mother’s house
Finding:
Reports mother is a “health nut”
(Found)
Pro Tip: Assessing a pediatric patient’s diet solicits information relevant to their current
diagnosis that informs you of potential aggravating and relieving factors of their chief
complaint. Details of their current diet will help you to educate the patient on a diet that
will help in the treatment and management of their condition.
Example Question:
What is your diet like?
Finding:
Reports typical breakfast at mother’s home is yogurt and fruit
(Available)
Pro Tip: Assessing a pediatric patient’s diet solicits information relevant to their current
diagnosis that informs you of potential aggravating and relieving factors of their chief
complaint. Details of their current diet will help you to educate the patient on a diet that
will help in the treatment and management of their condition.
Example Question:
What’s your usual breakfast?
Finding:
Reports typical lunch is a salad with chicken
(Available)
Pro Tip: Assessing a pediatric patient’s diet solicits information relevant to their current
diagnosis that informs you of potential aggravating and relieving factors of their chief
complaint. Details of their current diet will help you to educate the patient on a diet that
will help in the treatment and management of their condition.
Example Question:
What do you usually eat for lunch?
Finding:
Reports typical dinner is grilled meat and vegetables
(Available)
Pro Tip: Assessing a pediatric patient’s diet solicits information relevant to their current
diagnosis that informs you of potential aggravating and relieving factors of their chief
complaint. Details of their current diet will help you to educate the patient on a diet that
will help in the treatment and management of their condition.
Example Question:
What’s a typical dinner?
Social History Patient
Finding:
Asked about social activities
Finding:
Reports riding horses 2-3 times a week after school
(Found)
Pro Tip: A pediatric patient’s social history encompasses their family and support system,
living situation, and daily behaviors such as diet and exercise. Even though you are
working with pediatric patients, it is important to ask about sexual activity and substance
use. These factors can influence their current health and wellness. Asking about a
pediatric patient’s social history can also unveil the influence of their present illnesses in
their social lives.
Example Question:
How often do you ride horses?
Finding:
Asked about substance use
Finding:
Denies tobacco use
(Available)
Pro Tip: A pediatric patient’s social history encompasses their family and support system,
living situation, and daily behaviors such as diet and exercise. Even though you are
working with pediatric patients, it is important to ask about sexual activity and substance
use. These factors can influence their current health and wellness. Asking about a
pediatric patient’s social history can also unveil the influence of their present illnesses in
their social lives.
Example Question:
Have you ever experimented with smoking?
Finding:
Denies vaping
(Available)
Pro Tip: A pediatric patient’s social history encompasses their family and support system,
living situation, and daily behaviors such as diet and exercise. Even though you are
working with pediatric patients, it is important to ask about sexual activity and substance
use. These factors can influence their current health and wellness. Asking about a
pediatric patient’s social history can also unveil the influence of their present illnesses in
their social lives.
Example Question:
Have you ever vaped or used an ecigarette?
Finding:
Denies alcohol use
(Available)
Pro Tip: A pediatric patient’s social history encompasses their family and support system,
living situation, and daily behaviors such as diet and exercise. Even though you are
working with pediatric patients, it is important to ask about sexual activity and substance
use. These factors can influence their current health and wellness. Asking about a
pediatric patient’s social history can also unveil the influence of their present illnesses in
their social lives.
Example Question:
Do you drink alcohol?
Review of Relevant Systems Patient
Finding:
Asked about general symptoms
Finding:
Denies current excessive thirst
(Found)
Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of
their physiological systems. This is necessary to understand what symptoms may indicate
larger issues, and what treatments the patient may require.
Example Question:
Have you been feeling more thirsty lately?
Finding:
Asked about gastrointestinal symptoms
Finding:
Denies current nausea
(Found)
Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of
their physiological systems. This is necessary to understand what symptoms may indicate
larger issues, and what treatments the patient may require.
Example Question:
Did your nausea improve?
Finding:
Denies current vomiting
(Found)
Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of
their physiological systems. This is necessary to understand what symptoms may indicate
larger issues, and what treatments the patient may require.
Example Question:
Are you going to be sick?
Finding:
Reports normal bowel movements
(Available)
Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of
their physiological systems. This is necessary to understand what symptoms may indicate
larger issues, and what treatments the patient may require.
Example Question:
Are you feeling constipated?
Finding:
Asked about urinary symptoms
Finding:
Denies current frequent urination
(Found)
Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of
their physiological systems. This is necessary to understand what symptoms may indicate
larger issues, and what treatments the patient may require.
Example Question:
How long have you been urinating more frequently?
Finding:
Denies high volume of urine
(Found)
Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of
their physiological systems. This is necessary to understand what symptoms may indicate
larger issues, and what treatments the patient may require.
Example Question:
Do you urinate a lot?
Finding:
Asked about neurological system
Finding:
Denies neurological symptoms
(Found)
Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of
their physiological systems. This is necessary to understand what symptoms may indicate
larger issues, and what treatments the patient may require.
Example Question:
Do you feel tingling anywhere?
Confirmed Guardian’s Relationship
Finding:
Confirmed guardian’s relationship to patient
Finding:
Reports he is patient’s father
(Found)
Pro Tip: Determining the guardian’s relationship to a pediatric patient confirms the
appropriate family members are present. Knowing who is with the pediatric patient will
help you to develop the best approach to gathering information on the patient’s condition.
Example Question:
what is your relationship to the patient
History of Present Illness Guardian
Finding:
Asked about patient’s diagnosi
Finding:
Reports patient is diagnosed with type 1 diabetes
(Found)
Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s
current health issues solicits information relevant to the history of their present illness.
Details of their current complaint will help you follow-up on any present conditions or
symptoms, such as the location of their pain or the amount of pain they may be
experiencing.
Example Question:
What is your daughter’s diagnosis
Finding:
Followed up on history of present illness leading to diagnosis
Finding:
Reports patient was admitted to hospital two days prior
(Found)
Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s
current health issues solicits information relevant to the history of their present illness.
Details of their current complaint will help you follow-up on any present conditions or
symptoms, such as the location of their pain or the amount of pain they may be
experiencing.
Example Question:
When was your daughter hospitalized
Finding:
Reports patient had diabetic ketoacidosis when admitted
(Found)
Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s
current health issues solicits information relevant to the history of their present illness.
Details of their current complaint will help you follow-up on any present conditions or
symptoms, such as the location of their pain or the amount of pain they may be
experiencing.
Example Question:
Did your daughter have complications with her diabetes?
Finding:
Asked guardian about symptoms of DKA
Finding:
Reports thinking she had a “stomach bug” at first
(Found)
Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s
current health issues solicits information relevant to the history of their present illness.
Details of their current complaint will help you follow-up on any present conditions or
symptoms, such as the location of their pain or the amount of pain they may be
experiencing.
Example Question:
How was your daughter feeling?
Finding:
Reports taking daughter to ED when he realized she was “out of it”
(Found)
Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s
current health issues solicits information relevant to the history of their present illness.
Details of their current complaint will help you follow-up on any present conditions or
symptoms, such as the location of their pain or the amount of pain they may be
experiencing.
Example Question:
How was your daughter feeling?
Finding:
Asked about patient’s symptoms prior to DKA
Finding:
Reports weight loss
(Found)
Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s
current health issues solicits information relevant to the history of their present illness.
Details of their current complaint will help you follow-up on any present conditions or
symptoms, such as the location of their pain or the amount of pain they may be
experiencing.
Example Question:
Has your daughter’s weight changed lately?
Finding:
Followed up on weight loss
Finding:
Reports patient lost 5 pounds
(Found)
Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s
current health issues solicits information relevant to the history of their present illness.
Details of their current complaint will help you follow-up on any present conditions or
symptoms, such as the location of their pain or the amount of pain they may be
experiencing.
Example Question:
How much weight has your daughter lost?
Finding:
Reports weight loss happened in the two weeks since he last saw the patient
(Found)
Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s
current health issues solicits information relevant to the history of their present illness.
Details of their current complaint will help you follow-up on any present conditions or
symptoms, such as the location of their pain or the amount of pain they may be
experiencing.
Example Question:
How much weight has your daughter lost?
Assess Guardian Knowledge
Finding:
Assessed knowledge of type 1 diabetes
Finding:
Reports knowledge of type 1 diabetes
(Found)
Pro Tip: Assessing a pediatric guardian’s knowledge of the patient’s preexisting condition
helps you determine how to educate both guardian and patient.
Example Question:
Do you know anything about type 1 diabetes?
Assess Patient Diet Guardian
Finding:
Asked about guardian’s knowledge of patient’s diet
Finding:
Reports patient’s favorite breakfast is pancakes and fruit
(Available)
Pro Tip: Asking a pediatric patient’s guardian about their diet solicits information relevant
to their current diagnosis that informs you of potential aggravating and relieving factors
of their current chief complaint. Details of their current diet will help you to educated the
guardian on a diet that will help in the treatment and management of their condition.
Example Question:
What does your daughter usually eat for breakfast?
Finding:
Reports typical lunch is a sandwich and chips
(Available)
Pro Tip: Asking a pediatric patient’s guardian about their diet solicits information relevant
to their current diagnosis that informs you of potential aggravating and relieving factors
of their current chief complaint. Details of their current diet will help you to educated the
guardian on a diet that will help in the treatment and management of their condition.
Example Question:
What does your daughter usually eat for lunch?
Finding:
Reports going out to dinner often
(Available)
Pro Tip: Asking a pediatric patient’s guardian about their diet solicits information relevant
to their current diagnosis that informs you of potential aggravating and relieving factors
of their current chief complaint. Details of their current diet will help you to educated the
guardian on a diet that will help in the treatment and management of their condition.
Example Question:
What does your daughter usually eat for dinner?
Finding:
Denies knowledge of high carb intake
(Available)
Pro Tip: Asking a pediatric patient’s guardian about their diet solicits information relevant
to their current diagnosis that informs you of potential aggravating and relieving factors
of their current chief complaint. Details of their current diet will help you to educated the
guardian on a diet that will help in the treatment and management of their condition.
Example Question:
How many carbohydrates does your daughter eat a day
Finding:
Reports belief in a low sugar intake
(Found)
Pro Tip: Asking a pediatric patient’s guardian about their diet solicits information relevant
to their current diagnosis that informs you of potential aggravating and relieving factors
of their current chief complaint. Details of their current diet will help you to educated the
guardian on a diet that will help in the treatment and management of their condition.
Example Question:
How many carbohydrates does your daughter eat a day
Social History Guardian
Finding:
Asked guardian about social history
Finding:
Reports being divorced from patient’s mom
(Found)
Pro Tip: A patient’s and their guardian’s social history encompasses their family and
support system, living situation, and daily behaviors such as diet, exercise, and substance
use. These factors can influence their current health and wellness. Asking a guardian
about a pediatric patient’s social history can also unveil the influence of their present
illnesses on their social lives.
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Example Question:
Are you married?
Finding:
Reports patient splits time evenly between homes
(Found)
Pro Tip: A patient’s and their guardian’s social history encompasses their family and
support system, living situation, and daily behaviors such as diet, exercise, and substance
use. These factors can influence their current health and wellness. Asking a guardian
about a pediatric patient’s social history can also unveil the influence of their present
illnesses on their social lives.
Example Question:
Are you married?
Finding:
Reports patient alternates between homes every 2 weeks
(Found)
Pro Tip: A patient’s and their guardian’s social history encompasses their family and
support system, living situation, and daily behaviors such as diet, exercise, and substance
use. These factors can influence their current health and wellness. Asking a guardian
about a pediatric patient’s social history can also unveil the influence of their present
illnesses on their social lives.
Example Question:
Have you been divorced?
Finding:
Reports a stable home life
(Found)
Pro Tip: A patient’s and their guardian’s social history encompasses their family and
support system, living situation, and daily behaviors such as diet, exercise, and substance
use. These factors can influence their current health and wellness. Asking a guardian
about a pediatric patient’s social history can also unveil the influence of their present
illnesses on their social lives.
Example Question:
How is your daughter’s relationship with her mother?
Past Medical History Guardian
Finding:
Asked about past hospitalizations
Finding:
Denies past hospitalizations
(Found)
Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can
reveal past diagnoses and previous conditions or concerns. Information about the patient’s
existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate
where you should follow-up for further care and treatment.
Example Question:
Has your daughter been hospitalized before?
Finding:
Denies past surgeries
(Found)
Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can
reveal past diagnoses and previous conditions or concerns. Information about the patient’s
existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate
where you should follow-up for further care and treatment.
Example Question:
Has your daughter been hospitalized before?
Family Medical History Guardian
Finding:
Asked about relevant family medical history
Finding:
Reports patient’s paternal grandmother has type 2 diabetes
Objective Data Collection: 2 of 2 (100%)
Correct
Partially correct
Incorrect
Missed
Assessed Vitals
1 of 1 point
Temperature (1/5 point)
Normothermic
Hyperthermic
Hypothermic
Blood Pressure (1/5 point)
Normotensive
Hypertensive
Hypotensive
Heart Rate (1/5 point)
No abnormal findings
Tachycardia
Bradycardia
Respiratory Rate (1/5 point)
No abnormal findings
Tachypnea
Bradypnea
Oxygen Saturation (1/5 point)
No abnormal findings
Hypoxemia
Assessed Growth
1 of 1 point
Bmi For Age (1/2 point)
Underweight
Normal Weight
Overweight
Obese
Question 1: You Scored a 1 out of 1
Educate Chelsea in the most therapeutic manner on what supplies she will need to
administer insulin.
Student Response
1st Try – Correct
Chelsea, before you administer insulin, you will need a new, packaged syringe, a vial of
insulin, alcohol wipes, and access to a special container for storing your used syringe. Do
you have any questions?
Feedback: Okay, got it.
Question 2: You Scored a 1 out of 1
Educate in the most therapeutic manner on how to prepare a syringe for injection.
Student Response
1st Try – Correct
Chelsea, take the syringe out of its packaging, and pull the cap off of the needle on the
syringe. Pull the plunger of syringe back until it is level with the correct dose. The
numbers are printed on the side of the syringe.
Feedback: Take the syringe out of the package, get the cap off the needle, pull the
plunger back to my correct dose. Roger, dodger.
Question 3: You Scored a 1 out of 1
Educate Chelsea on the first steps in filling the syringe with insulin.
Student Response
1st Try – Correct
Put the bottle of insulin on a flat surface, and hold it steady with one hand. With your
other hand, push the needle straight into the insulin bottle and slowly push the plunger
down. This will inject the air in the syringe into the bottle. Don’t pull the syringe out yet.
Any questions?
Feedback: No questions. So far, so good.
Question 4: You Scored a 1 out of 1
Educate Chelsea on completing the process of filling the syringe with insulin.
Student Response
1st Try – Correct
With the needle still in the insulin vial, turn both upside down, so that the bottom of the
vial is pointing at the ceiling. Slowly draw the plunger down so that insulin fills the
syringe. Keep the tip of the needle in the insulin, and make sure you don’t bend the
needle. Do you have any questions?
Feedback: I still get it.
Question 5: You Scored a 1 out of 1
Educate Chelsea on how to evacuate air bubbles from the syringe.
Student Response
1st Try – Correct
The needle is still in the bottle at this point. Tap the side of the syringe with your finger to
make any bubbles rise to the top. Then, you can push the plunger just enough to force the
air out through the needle.
Feedback: Makes sense to me.
Question 6: You Scored a 1 out of 1
Educate Chelsea on prepping the insulin injection site.
Student Response
1st Try – Correct
After removing the needle from the vial, use an alcohol pad to clean the injection site. Let
the site dry, otherwise it might sting a little. Pinch approximately 1 inch of skin, not too
hard. Insert the needle into the pinched skin at the proper angle and slowly push the
plunger in until it is empty. Leave the needle in your skin for five seconds. Any
questions?
Feedback: Huh, okay.
Question 7: You Scored a 1 out of 1
Educate Chelsea on how to complete the injection process.
Student Response
1st Try – Correct
Once you take the needle out, keep an eye on the area you injected. If you see any
bleeding, use a tissue to clean it up. If you see any insulin leak out, check back with your
provider to go over the injection process again.
Feedback: Watch out for leaks, and clean up the blood. I got it.
Documentation / Electronic Health Record
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Model Documentation
Chelsea’s current condition is stable. She is feeling better than she has been lately. No current
nausea or vomiting. Chelsea is alert and curious, and expressed an eagerness to go home. She said
that she has not administered her own insulin yet, or done her own glucose monitoring.
Chelsea had diabetic ketoacidosis two days prior. She was at a horseback riding lesson and started
feeling nauseated; when her dad picked her up she threw up in his car. That evening, Ned said that
his daughter seemed really out of it and was not acting like herself. He brought her to the ED, and
she was diagnosed with DKA and type 1 diabetes. Chelsea’s blood glucose is more stable now.
Prior to the DKA, Chelsea said she felt sick for about 10 days. Her dad, Ned, said that she lost
five pounds in the two weeks since he’s seen her. She experienced increased thirst and increased
urination / a higher volume of urine during the 10 days leading up to her DKA. Chelsea said her
mother thought she was “going through a growth spurt” or coming down with a cold.
Chelsea expressed some confusion about the pathophysiology of type 1 diabetes. She said she had
not done her own insulin administration or glucose monitoring. Her father also expressed some
misunderstandings over carbohydrates.
Chelsea’s diet is currently high in carbohydrates. Her father, Ned, expressed some confusion
about what foods are higher in carbohydrates, as well as carb counting and hidden carbohydrates.
Since Chelsea splits her time between two houses, both parents will need to be educated about a
diet that is appropriate for a diabetic child. Chelsea says her mom is more of a “health nut,” but
her dad may need more guidance.
Model Documentation
Chelsea is very socially active and engaged. She horseback rides several times a week, attends
Sunday school, and has a healthy group of friends. She denies alcohol or tobacco use. She divides
her time 50/50 between her father and mother’s homes, but she seems to be well-adjusted to the
arrangement.
GENERAL: Afebrile, denies polydipsia GASTROINTESTINAL: Denies nausea, recent vomiting
URINARY: Denies polyuria, denies high volume of urine NEUROLOGICAL: Denies dizziness,
denies confusion
Chelsea’s paternal grandmother has type 2 diabetes.
Care Plan : 11.5 of 11.5 (100.0%)
Nursing Diagnosis
3.5 out of 3.5
Nursing Diagnoses: Definitions & Classifications 2018-2020 © NANDA-International, 2017
used by arrangement with Thieme Medical Publishers, Inc., a division of the Thieme Group. All
rights reserved. Authorized translation from the English language edition published by Thieme
Medican Publishers Inc. No part of this material may be reproduced in any form without the
written permission of the agent of the copyright holder, NANDA-International. Direct inquires to
nanda-i@thieme.com. Link for more information: http://www.nanda.org/.
Status
Student
Response
Model
Answer
Explanation Points
Earned
exhibits exhibits The correct status for the nursing diagnosis is
“exhibits,” because Chelsea’s current behavior shows
readiness to learn more about managing her health.
This is not a risk but is present.
0.5 out of
0.5
Diagnosis
Student Response Model Answer Explanation Points
Earned
readiness for
enhanced health
management
readiness for
enhanced health
management
Chelsea’s behavior indicates she is
ready to learn more about
managing her newly diagnosed
chronic illness.
0.5 out of 0.5
Etiologies
Student
Response
Model
Answer
Explanation Points Earned
new onset
chronic
disease
new onset
chronic
disease
Chelsea is ready for enhanced health
management as it relates to her newly
onset chronic disease.
0.5 out of 0.5
Signs & Symptoms
Student
Response
Model Answer Explanation Points
Earned
expresses
interest in
learning
expresses
interest in
learning
Chelsea expresses a desire to better
manage her chronic illness by
expressing a desire to enhance
management of her illness, expressing a
desire to enhance management of
prescribed regimens, expressing a desire
to enhance management of risk factors,
and expressing an interest in learning.
0.5 out of
0.5
expresses desire
to enhance
management of
expresses desire
to enhance
management of
Chelsea expresses a desire to better
manage her chronic illness by
expressing a desire to enhance
0.5 out of
0.5
illness illness management of her illness, expressing a
desire to enhance management of
prescribed regimens, expressing a desire
to enhance management of risk factors,
and expressing an interest in learning.
expresses desire
to enhance
management of
risk factors
expresses desire
to enhance
management of
risk factors
Chelsea expresses a desire to better
manage her chronic illness by
expressing a desire to enhance
management of her illness, expressing a
desire to enhance management of
prescribed regimens, expressing a desire
to enhance management of risk factors,
and expressing an interest in learning.
0.5 out of
0.5
expresses desire
to enhance
management of
prescribed
regimens
expresses desire
to enhance
management of
prescribed
regimens
Chelsea expresses a desire to better
manage her chronic illness by
expressing a desire to enhance
management of her illness, expressing a
desire to enhance management of
prescribed regimens, expressing a desire
to enhance management of risk factors,
and expressing an interest in learning.
0.5 out of
0.5
Self Assessment
Your answer is not automatically evaluated by the simulation, but may be reviewed by your
instructor.
Prompt Model Answer Explanation
Why would a
nursing diagnosis
of impaired
comfort be
incorrect,
compared to
While it can be
uncomfortable for a newly
diagnosed type 1 diabetic
to learn how to use a
glucometer or inject
insulin, the most effective
Your nursing diagnosis should always take
into account what condition is most serious,
receiving the greatest benefit from your
help. This diagnosis may not be the most
obvious physical symptom to you or your
patient, so always consider what is
readiness for
enhanced health
management?
nursing care you can
provide for Chelsea is a
comprehensive approach
to her health management.
This is supported by her
desire to learn more about
managing her chronic
illness.
jeopardizing a patient’s health the most.
Planning
5.5 out of 5.5
Short-Term Goal
Student Response Model Answer Explanation Points
Earned
To have the patient and her
guardian verbalize and
agree to their instructions
on how to manage type 1
diabetes until care is
established with an
endocrinologist, by end of
the hospital stay
To have the patient and her
guardian verbalize and
agree to their instructions
on how to manage type 1
diabetes until care is
established with an
endocrinologist, by end of
the hospital stay
Enhancing Chelsea
and her family’s
knowledge of
managing her type 1
diabetes will have the
highest impact on the
patient’s chronic
illness.
0.5 out
of 0.5
Interventions
Student Response Model Answer Explanation Points
Earned
Instruct family and
patient on
carbohydrate counting
and a diabetic diet
Instruct family and
patient on
carbohydrate counting
and a diabetic diet
Many of these instructions work
toward enhancing the patient’s
and family’s knowledge of
health management, which can
0.5 out
of 0.5
lead to better care for the
patient’s chronic illness.
Instruct family and
patient on how to
create an “action plan”
at school
Instruct family and
patient on how to
create an “action plan”
at school
Many of these instructions work
toward enhancing the patient’s
and family’s knowledge of
health management, which can
lead to better care for the
patient’s chronic illness.
0.5 out
of 0.5
Instruct family and
patient on the causes
of type 1 diabetes
Instruct family and
patient on the causes
of type 1 diabetes
Many of these instructions work
toward enhancing the patient’s
and family’s knowledge of
health management, which can
lead to better care for the
patient’s chronic illness.
0.5 out
of 0.5
Instruct family and
patient on the
differences between
type 1 and type 2
diabetes
Instruct family and
patient on the
differences between
type 1 and type 2
diabetes
Many of these instructions work
toward enhancing the patient’s
and family’s knowledge of
health management, which can
lead to better care for the
patient’s chronic illness.
0.5 out
of 0.5
Instruct family and
patient on the signs
and symptoms of
hyperglycemia
Instruct family and
patient on the signs
and symptoms of
hyperglycemia
Many of these instructions work
toward enhancing the patient’s
and family’s knowledge of
health management, which can
lead to better care for the
patient’s chronic illness.
0.5 out
of 0.5
Instruct family and
patient on the signs
and symptoms of
hypoglycemia
Instruct family and
patient on the signs
and symptoms of
hypoglycemia
Many of these instructions work
toward enhancing the patient’s
and family’s knowledge of
health management, which can
lead to better care for the
patient’s chronic illness.
0.5 out
of 0.5
Instruct family and Instruct family and Many of these instructions work 0.5 out
patient on what to do
during sick days
patient on what to do
during sick days
toward enhancing the patient’s
and family’s knowledge of
health management, which can
lead to better care for the
patient’s chronic illness.
of 0.5
Instruct patient on
how and when to
administer insulin
Instruct patient on
how and when to
administer insulin
Many of these instructions work
toward enhancing the patient’s
and family’s knowledge of
health management, which can
lead to better care for the
patient’s chronic illness.
0.5 out
of 0.5
Instruct patient on
how frequently to use
the glucometer
Instruct patient on
how frequently to use
the glucometer
Many of these instructions work
toward enhancing the patient’s
and family’s knowledge of
health management, which can
lead to better care for the
patient’s chronic illness.
0.5 out
of 0.5
Intervention Rationale
Your answer is not automatically evaluated by the simulation, but may be reviewed by your
instructor.
Prompt Model Answer Explanation
In 1 or 2
sentences,
explain how
your selected
interventions
work to
accomplish your
goal.
These interventions
will teach Chelsea and
her guardian how to
manage her type 1
diabetes in a variety
of ways, so that
Chelsea can enhance
her knowledge of her
own health
management.
Managing type 1 diabetes requires a multi-faceted
approach, so it’s important that your patient and
family teaching covers a thorough and specific
array of health management habits.
Data Collections
Student Response Model Answer Explanation Points
Earned
Ask patient and
family members to
state back and
agree to a plan for
type 1 diabetes
management
Ask patient and
family members to
state back and
agree to a plan for
type 1 diabetes
management
It is important that your patient and
her family agree to their
instructions, as changing lifestyle
habits can be intimidating but
necessary for the patient’s health.
Having Chelsea and her father
verbalize back their instructions
also assures they remember and
understand the details.
0.5 out of
0.5
Discussion Of Care
Your answer is not automatically evaluated by the simulation, but may be reviewed by your
instructor.
Prompt Model Answer Explanation
Explain the
rationale
behind your
nursing
diagnosis.
Ned, Chelsea’s
diagnosis is readiness
for enhanced health
management related to
her new onset chronic
illness. This diagnosis
is evidenced by her
desire to learn more
about managing her
illness, managing her
prescribed regimens,
managing risk factors,
and an interest in
learning. When
Chelsea gets
established with her
endocrinologist, you
A guardian should understand the patient’s nursing
diagnosis and the rationale behind it in order to
increase their sense of involvement and to identify
areas for future improvement.
and your family can
continue to learn about
managing Chelsea’s
type 1 diabetes. Our
goal today is to get
you and your daughter
prepared for managing
her diabetes over the
next few days.
Explain to Ned
your goal and
the
interventions
and data
collections
through which
you will
achieve it.
Ned, I’m going to have
a conversation with
you and Chelsea about
ways that everyone in
Chelsea’s family can
help her manage her
diabetes. We’ll work
together in this
discussion, and then
you will both agree to
your goals. Then I’m
going to have you and
Chelsea repeat back
what you’ve learned,
so we can make sure
you understand.
You should communicate the Care Plan to the
patient’s guardian, allowing them to exercise
involvement and agency in their own healthcare.
Explicitly ask
for Ned’s
consent to the
Care Plan.
Does this plan I just
talked about sound
good to you?
A guardian must consent to all interventions in
their Care Plan. Disagreements are opportunities to
provide further patient education and to consider
alternative options.
Inform Ned
you will now
begin
educating
them.
It’s time to begin your
education
interventions, so let
your patient’s guardian
know.
Ned, if you don’t have any other questions, I’m
going to speak with Chelsea now.
Explain the
rationale
behind your
Chelsea, I think you’re
ready to learn more
about type 1 diabetes,
A patient should understand their nursing diagnosis
and the rationale behind it to increase their sense of
involvement and to identify areas for future
nursing
diagnosis.
and I’d like to give
you some valuable
skills and knowledge
before you leave the
hospital, so that you
can learn how to
manage your diabetes
over the next few
days. When you get
established with your
endocrinologist they
can help you more, but
I’m going to go over
some basic
information so that
you can leave here
feeling comfortable
about managing your
diabetes. I know that a
new diagnosis can be
overwhelming, but
you’ve expressed an
interest in learning
more, and I think you
can handle it.
improvement.
Explain your
goal for
Chelsea and
the
interventions
and data
collections
through which
you will
achieve it.
Ok, Chelsea, here’s
the plan! I am going to
have a conversation
with you and your
father about the things
you can do to manage
your diabetes. All of
us will work together
in this discussion, and
then you have to agree
to your goals. Then
I’m going to have you
and your father repeat
what you’ve learned,
so we can make sure
you’ve got it down.
You should communicate the Care Plan to the
patient, allowing them to exercise involvement and
agency in their own healthcare.
Explicitly ask
for Chelsea’s
consent to the
Care Plan.
Does this plan I just
talked about sound
good to you?
A patient must consent to all interventions in their
Care Plan. Disagreements are opportunities to
provide further patient education and to consider
alternative options.
Inform
Chelsea you
will now begin
educating her
and her
guardian.
Chelsea, if you don’t
have any other
questions, we can start
our discussion now!
It’s time to begin your education interventions, so
let your patient know!
Intervention & Evaluation
2.5 out of 2.5
Student
Response
Model
Answer
Explanation Points
Earned
Partially Partially While Chelsea and Ned correctly state back most of the
instructions related to diabetes management, Chelsea still
expresses apprehension about managing her insulin
administration by herself. Ned agrees to help her
administer the insulin. Chelsea is old enough to learn
how to administer her own insulin and should take an
active role in managing her diabetes. Your goal has been
partially achieved.
2.5 out
of 2.5
Intervention & Evaluation Rationale
Your answer is not automatically evaluated by the simulation, but may be reviewed by your
instructor.
Prompt Model Answer Explanation
Did you achieve
your goal for
your patient and
her guardian by
the end of the
visit, getting each
of them to agree
to and verbalize
your instructions
for enhancing
their knowledge
of how to manage
Chelsea’s newly
onset chronic
illness?
While Chelsea and
Ned correctly state
back most of the
instructions related to
diabetes management,
Chelsea still expresses
apprehension about
managing her insulin
administration by
herself. Ned agrees to
help her administer the
insulin. Chelsea is old
enough to learn how to
administer her own
insulin, and should
take an active role in
managing her diabetes.
Your goal has been
partially achieved.
Even with progress being made in almost all
aspects of your patient teaching, you must
adhere to your goal and consider your work
incomplete if certain agreements have not been
reached.