1. Skills Practicum

2. You – Are working in the Poly- Clinic

3. Your patient: Is a 45 year old male

4. Patient History: Chief complaint of Right sided weakness and blurred vision Pt states he is feeling over-tired Reports he was having trouble talking for a few minutes Says he couldn’t lift his Right arm earlier

5. What do you do?

6. Blood Pressure 154/97 Heart Rate 95 Respiration Rate 18 Pulse Oximetry 92% on Room Air Temperature 36.5 Celsius Check pupils Check neuro status ◦Face ◦Arms ◦Speech

7. Checking pupils - normal? Yes or No?

8. Doctor assesses the patient Orders ECG What is this ECG rhythm?

9. Doctor assess the patient Orders CT Scan

10. You come back to check on the patient and find. Patient is laying on table - lethargic and you cannot understand him. ◦What do you do?

11. What do you do? Blood Pressure 184/100 Heart Rate 95 Respiration Rate 26 and shallow Pulse Oximetry 89% on Room Air Temperature 36.5 Celsius Check pupils Check neuro status Call for assistance Continue to watch the patient and Protect the Airway

12. What is going on with the patient?

13. Headache, Right sided weakness

14. Blood pressure 154/97 Is this okay? Why or why not? What would you do? 154 97

15. Heart in Arial Fibrillation – why is this a problem?

16. When you went back to check on the patient – was he better or worse? What makes you think he was better or worse?

17. Lethargic, speech is slurred Blood pressure 184/100 Is this okay? Why or why not? 184 100

18. Since your patient was worse when you went back to check on him, what would you do?