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<<set $times = ["Admission","0800","1000","1200","1400","1600","1800"]>> <<set $patients = ["Robert","","Eleanor"]>> /* Which labs each patient shows (row order) */ <<set $labList = { "Robert": ["Hgb","WBC","Platelets","Na","K","Mg","Creatinine"], /* +Mg so the Mg→K logic is visible */ "": ["WBC","CRP","Hgb","Na","K","Creatinine"], /* Only WBC abnormal for */ "Eleanor":["WBC","Lactate","Hgb","Creatinine","Na","K"] /* Bleed trend AM→1400 */ }>> /* ===== Updated LABS ===== */ <<set $labs = { "Robert": { /* N/V + dehydration; low Mg keeps K low unless corrected (resolver updates 1400+) */ "Hgb": {"Admission":14.8,"0800":14.6,"1000":14.5,"1200":14.4,"1400":14.3,"1600":14.2,"1800":14.1}, "WBC": {"Admission":8.6, "0800":8.4, "1000":8.3, "1200":8.4, "1400":8.3, "1600":8.2, "1800":8.2}, "Platelets": {"Admission":230, "0800":228, "1000":226, "1200":225, "1400":224, "1600":224, "1800":223}, "Na": {"Admission":135, "0800":135, "1000":135, "1200":136, "1400":136, "1600":136, "1800":136}, "K": {"Admission":3.6, "0800":3.0, "1000":3.0, "1200":3.0, "1400":3.0, "1600":3.1, "1800":3.2}, /* default = no improvement */ "Mg": {"Admission":1.6, "0800":1.2, "1000":1.2, "1200":1.2, "1400":1.2, "1600":1.3, "1800":1.4}, /* default = no improvement */ "Creatinine": {"Admission":1.3, "0800":1.2, "1000":1.2, "1200":1.1, "1400":1.0, "1600":1.0, "1800":1.0} }, "": { /* COPD exac; only WBC abnormal; others normal; improving trend across day */ "WBC": {"Admission":12.8,"0800":14.8,"1000":15.2,"1200":15.0,"1400":14.6,"1600":14.0,"1800":13.8}, "CRP": {"Admission":8, "0800":8, "1000":7, "1200":7, "1400":6, "1600":6, "1800":6}, /* normal range */ "Hgb": {"Admission":12.8,"0800":12.7,"1000":12.6,"1200":12.6,"1400":12.5,"1600":12.5,"1800":12.4}, "Na": {"Admission":137, "0800":137, "1000":137, "1200":137, "1400":137, "1600":137, "1800":137}, "K": {"Admission":4.0, "0800":3.9, "1000":3.9, "1200":4.0, "1400":4.0, "1600":4.0, "1800":4.0}, "Creatinine": {"Admission":0.8, "0800":0.8, "1000":0.8, "1200":0.8, "1400":0.8, "1600":0.8, "1800":0.8} }, "Eleanor": { /* Post‑op bleed concern; AM labs then 1400 Hgb drop; mild WBC/lactate bump */ "WBC": {"Admission":10.2,"0800":10.4,"1000":10.8,"1200":11.0,"1400":11.2,"1600":10.9,"1800":10.6}, "Lactate": {"Admission":1.3, "0800":1.4, "1000":1.5, "1200":1.6, "1400":1.8, "1600":1.7, "1800":1.6}, "Hgb": {"Admission":11.4,"0800":11.1,"1000":10.9,"1200":10.4,"1400":9.8, "1600":9.7, "1800":9.6}, "Creatinine": {"Admission":1.1, "0800":1.1, "1000":1.2, "1200":1.2, "1400":1.1, "1600":1.1, "1800":1.1}, "Na": {"Admission":138, "0800":138, "1000":137, "1200":137, "1400":138, "1600":138, "1800":138}, "K": {"Admission":3.9, "0800":3.9, "1000":3.8, "1200":3.8, "1400":3.8, "1600":3.9, "1800":3.9} } }>> /* ===== Updated VITALS ( needs ↑O2 early → wean; Robert on RA) ===== */ <<set $currentPatient = "Robert">> <<set $labMode = "trend">>> <<set $currentTime = "0800">> <<set $vitals = { "Robert": { "Admission": { BP:"132/76", HR:88, RR:20, Temp:"98.4°F", O2:"97% (RA)" }, "0800": { BP:"132/76", HR:88, RR:20, Temp:"98.4°F", O2:"97% (RA)" }, "1000": { BP:"130/74", HR:94, RR:22, Temp:"98.5°F", O2:"97% (RA)" }, "1200": { BP:"130/74", HR:90, RR:20, Temp:"98.6°F", O2:"98% (RA)" }, "1400": { BP:"126/74", HR:88, RR:20, Temp:"98.6°F", O2:"98% (RA)" }, "1600": { BP:"126/74", HR:88, RR:20, Temp:"98.6°F", O2:"98% (RA)" }, "1800": { BP:"124/74", HR:86, RR:20, Temp:"98.6°F", O2:"98% (RA)" } }, "": { "Admission": { BP:"115/72", HR:92, RR:20, Temp:"101.5°F", O2:"92% (2 L NC)" }, "0800": { BP:"110/70", HR:95, RR:22, Temp:"101.2°F", O2:"90% (3 L NC)" }, "1000": { BP:"108/69", HR:96, RR:22, Temp:"", O2:"91% (3 L NC)" }, "1200": { BP:"108/70", HR:92, RR:22, Temp:"100.8°F",O2:"92% (2.5 L NC)" }, "1400": { BP:"108/68", HR:90, RR:20, Temp:"", O2:"93% (2 L NC)" }, "1600": { BP:"102/72", HR:88, RR:18, Temp:"99.2°F", O2:"94% (2 L NC)" }, "1800": { BP:"110/68", HR:86, RR:20, Temp:"", O2:"94–95% (2 L NC)" } }, "Eleanor": { "Admission": { BP:"112/70", HR:84, RR:18, Temp:"99.2°F", O2:"96% (RA)" }, "0800": { BP:"105/68", HR:98, RR:18, Temp:"99.0°F", O2:"96% (RA)" }, "1000": { BP:"100/64", HR:90, RR:20, Temp:"-", O2:"96% (RA)" }, "1200": { BP:"100/65", HR:90, RR:20, Temp:"99.5°F", O2:"96% (RA)" }, "1400": { BP:"102/65", HR:88, RR:20, Temp:"-", O2:"96% (RA)" }, "1600": { BP:"102/72", HR:82, RR:18, Temp:"99.2°F", O2:"95% (RA)" }, "1800": { BP:"104/66", HR:86, RR:18, Temp:"-", O2:"96% (RA)" } } }>> /* ===== Robert’s Mg→K correction logic (set flags in your decision passages) ===== Example when learner orders correctly: <<set $robertMgReplacedEarly = true>> <<set $robertKReplacedAfterMg = true>> Then, when 1400 labs “post”: <<run setup.resolve1400()>> */ <<set $robertMgReplacedEarly to false>> <<set $robertKReplacedAfterMg to false>> <<set $checkbladder to false>> <<run window.setup = window.setup || {}; setup.resolve1400 = function () { const v = State.variables, L = v.labs; /* If Mg was replaced early AND K was replaced after Mg, show improvement by 1400 */ if (v.robertMgReplacedEarly && v.robertKReplacedAfterMg) { L["Robert"]["Mg"]["1400"] = 1.8; L["Robert"]["Mg"]["1600"] = 1.9; L["Robert"]["Mg"]["1800"] = 2.0; L["Robert"]["K"]["1400"] = 3.6; L["Robert"]["K"]["1600"] = 3.8; L["Robert"]["K"]["1800"] = 4.0; } }; >> <<widget "vitalsViewer">> /* Usage: <<vitalsViewer "Robert">> */ <<set _patient = _args[0]>> <<if !_patient>> <p><strong>Error:</strong> You must call <code><<vitalsViewer "PatientName">></code>.</p> <</if>> <<if !$vitals or !$vitals[_patient]>> <p><strong>No vitals recorded for <<= _patient ? _patient : "that patient" >>.</strong></p> <</if>> <<if _patient and $vitals and $vitals[_patient]>> <div class="labviewer"> <h2><<= _patient >> — Vitals Trends</h2> <table class="vitals-table"> <thead> <tr> <th>Time</th> <th>BP</th> <th>HR</th> <th>RR</th> <th>Temp</th> <th>O₂</th> </tr> </thead> <tbody> <<for _ti = 0; _ti < $times.length; _ti++>> <<set _t = $times[_ti]>> <<set _vt = ($vitals[_patient] && $vitals[_patient][_t]) ? $vitals[_patient][_t] : null>> <tr> <td><<= _t >></td> <td><<= _vt ? _vt.BP : "-" >></td> <td><<= _vt ? _vt.HR : "-" >></td> <td><<= _vt ? _vt.RR : "-" >></td> <td><<= _vt ? _vt.Temp : "-" >></td> <td><<= _vt ? _vt.O2 : "-" >></td> </tr> <</for>> </tbody> </table> </div> <</if>> <</widget>> <<widget "labsTrend">> /* Usage: <<labsViewer "Robert">> */ <<set _patient = _args[0]>> :: vitalsLine[widget] /* Usage: <<vitalsLine "Robert">> -> uses $currentTime <<vitalsLine "Robert" "1200">> -> explicit time */ <<set _p = _args[0]>> <<set _t = _args.length > 1 ? _args[1] : ($currentTime ? $currentTime : "0800")>> <<set _v = ($vitals and $vitals[_p] and $vitals[_p][_t]) ? $vitals[_p][_t] : null>> <<if !_v>> <span class="subtle">No vitals recorded for <<= _p >> at <<= _t >>.</span> <<else>> BP <<= _v.BP ? _v.BP : "-" >> | HR <<= _v.HR is not undefined ? _v.HR : "-" >> | RR <<= _v.RR is not undefined ? _v.RR : "-" >> | Temp <<= _v.Temp ? _v.Temp : "-" >> | O₂ <<= _v.O2 ? _v.O2 : "-" >> <</if>> <<if !_patient>> <p><strong>Error:</strong> You must call <code><<labsViewer "PatientName">></code>.</p> <</if>> <<if !$labs or !$labs[_patient]>> <p><strong>No labs recorded for <<= _patient ? _patient : "that patient" >>.</strong></p> <</if>> <<if _patient and $labs and $labs[_patient]>> <div class="labviewer"> <h2><<= _patient >> — Lab Trends</h2> <table class="lab-table"> <thead> <tr> <th>Lab</th> <<for _ti = 0; _ti < $times.length; _ti++>> <th><<= $times[_ti] >></th> <</for>> </tr> </thead> <tbody> <<for _i = 0; _i < $labList[_patient].length; _i++>> <<set _lab = $labList[_patient][_i]>> <tr> <td class="lab-name"><<= _lab >></td> <<for _ti = 0; _ti < $times.length; _ti++>> <<set _t = $times[_ti]>> <td><<= ($labs[_patient][_lab] && $labs[_patient][_lab][_t] !== undefined) ? $labs[_patient][_lab][_t] : "-" >></td> <</for>> </tr> <</for>> </tbody> </table> </div> <</if>> <</widget>> /* Safe inits if not already present (won’t overwrite) */ <<if $robertMgReplacedEarly is undefined>><<set $robertMgReplacedEarly = false>><</if>> <<if $robertKReplacedAfterMg is undefined>><<set $robertKReplacedAfterMg = false>><</if>> <<if $robertBolusGiven is undefined>><<set $robertBolusGiven = false>><</if>> d <<if $eleanorOrthoAssessed is undefined>><<set $eleanorOrthoAssessed = false>><</if>> <<if $eleanorBleedMonitored is undefined>><<set $eleanorBleedMonitored = false>><</if>> <<if $eleanorTypeScreen is undefined>><<set $eleanorTypeScreen = false>><</if>> <<if $eleanorProviderNotified is undefined>><<set $eleanorProviderNotified = false>><</if>> <<if $AnxietyCoached is undefined>><<set $AnxietyCoached = false>><</if>> <<if $Wean1200 is undefined>><<set $Wean1200 = false>><</if>> <<if $Wean1400 is undefined>><<set $Wean1400 = false>><</if>> <<if $Wean1600 is undefined>><<set $Wean1600 = false>><</if>>
Report is as follows: <b>Robert: </b> 49-year-old admitted for nausea, vomiting, and dehydration. This morning he’s complaining of leg cramps and fatigue. No significant PMH. He’s on Normal Saline at 75 an hour. He recieved 1x potassium 40mEq replacement at 9pm last night. Labs were rechecked this morning and results are pending. Vitals stable, Last vitals: 118/74, HR 88, RR 18, O2 98% <br> <b>Eleanor:</b> 62-year-old, post-op day 1 from a laproscopic cholecystectomy for acute cholecystitis. Surgery was uncomplicated. Past medical history of hypertension, hyperlipidemia, GERD. No allergies. Overnight she had low urine output and reports some mild dizziness when standing. She’s stable otherwise. She has a JP drain in the RUQ with about 40 mL serosanguinous output since last night. She’s on LR at 75 an hour. Vitals at 0700: 115/82, HR 82, RR 22, sats 96% on room air. Abdomen is mildly distended but soft, pain is well-controlled. <br> [[Start my day->0700_Start]]
<<nobr>> <<if !$visitedRobert && !$visitedEleanor>> You receive report on your 2 patients for the day. Based on the current information you have: Select who do see first?<br> [[See Robert->0700-Robert]] <br> [[See Eleanor->0700-Eleanor]] <<elseif $visitedRobert && !$visitedEleanor>> <<set $visitedRobertfirst = true>> You've completed Roberts assessment<br> [[Go to Eleanor->0700-Eleanor]] <<elseif $visitedEleanor && !$visitedRobert>> <<set $visitedEleanorfirst = true>> You've completed Elenors assesment<br> [[Go to Robert->0700-Robert]] <<else>> You have assessed all patients.<br> [[Proceed to 1000->1000_start]] <</if>> <</nobr>>
Robert chart reviewed: 0600 Lab resulted:: <table border="1" style="border-collapse: collapse; width: 100%;"> <thead> <tr> <th>Lab</th> <th>2000</th> <th>0600</th> <th>Normal Range</th> </tr> </thead> <tbody> <tr><td colspan="4"><b>CBC</b></td></tr> <tr><td>WBC</td><td style="color:#28a745;">8.8</td><td style="color:#28a745;">9.0</td><td>4.0–11.0 ×10³/µL</td></tr> <tr><td>RBC</td><td style="color:#28a745;">4.9</td><td style="color:#28a745;">4.8</td><td>4.7–6.1 ×10⁶/µL</td></tr> <tr><td>Hgb</td><td style="color:#28a745;">14.8</td><td style="color:#28a745;">14.5</td><td>14–18 g/dL</td></tr> <tr><td>Hct</td><td style="color:#28a745;">44.4</td><td style="color:#28a745;">43.0</td><td>41–53 %</td></tr> <tr><td>MCV</td><td style="color:#28a745;">88</td><td style="color:#28a745;">88</td><td>80–96 fL</td></tr> <tr><td>Plt</td><td style="color:#28a745;">255</td><td style="color:#28a745;">260</td><td>150–400 ×10³/µL</td></tr> <tr><td colspan="4"><b>BMP</b></td></tr> <tr><td>Na</td><td style="color:#28a745;">137</td><td style="color:#28a745;">135</td><td>135–145 mEq/L</td></tr> <tr><td>K</td><td style="color:#28a745;">3.4</td><td style="color:#dc3545;">3.3</td><td>3.5–5.0 mEq/L</td></tr> <tr><td>Cl</td><td style="color:#28a745;">101</td><td style="color:#28a745;">100</td><td>98–106 mEq/L</td></tr> <tr><td>HCO₃</td><td style="color:#28a745;">25</td><td style="color:#28a745;">24</td><td>22–28 mEq/L</td></tr> <tr><td>BUN</td><td style="color:#28a745;">15</td><td style="color:#28a745;">16</td><td>7–20 mg/dL</td></tr> <tr><td>Cr</td><td style="color:#28a745;">1.0</td><td style="color:#28a745;">1.0</td><td>0.6–1.2 mg/dL</td></tr> <tr><td>Mg</td><td style="color:#28a745;">1.5</td><td style="color:#dc3545;">1.4</td><td>1.7–2.4 mg/dL</td></tr> <tr><td>Glucose</td><td style="color:#28a745;">102</td><td style="color:#28a745;">110</td><td>70–110 mg/dL (random)</td></tr> </tbody> </table> <p><b>Status:</b> Leg cramps; mild fatigue; skin turgor slightly decreased.<br> <b>Current Orders:</b> Monitor electrolyte panel q6h, encourage oral intake, NS @ 75 ml/hr</p> What is your priority action? * [[Notify physician->0700-Decision-Robert-Correct]] * [[Complete assessment and continue to monitor->0700-Decision-Robert-Incorrect]]
Eleanor <table border="1" style="border-collapse: collapse; width: 100%;"> <thead> <tr> <th>Lab</th> <th>0200</th> <th>0600</th> <th>Normal Range</th> </tr> </thead> <tbody> <tr><td colspan="4"><b>CBC</b></td></tr> <tr><td>WBC</td><td>6</td><td style="color:#28a745;">8.0</td><td>4.0–11.0 ×10³/µL</td></tr> <tr><td>RBC</td><td>5</td><td style="color:#28a745;">4.5</td><td>4.2–5.4 ×10⁶/µL</td></tr> <tr><td>Hgb</td><td>13</td><td style="color:#dc3545;">11.9</td><td>12–16 g/dL</td></tr> <tr><td>Hct</td><td>37.2</td><td style="color:#dc3545;">34.0</td><td>36–46 %</td></tr> <tr><td>MCV</td><td>90</td><td style="color:#28a745;">90</td><td>80–96 fL</td></tr> <tr><td>Plt</td><td>265</td><td style="color:#28a745;">250</td><td>150–400 ×10³/µL</td></tr> <tr><td colspan="3"><b>BMP</b></td></tr> <tr><td>Na</td><td>140</td><td style="color:#28a745;">140</td><td>135–145 mEq/L</td></tr> <tr><td>K</td><td>4.2</td><td style="color:#28a745;">4.0</td><td>3.5–5.0 mEq/L</td></tr> <tr><td>Cl</td><td>104</td><td style="color:#28a745;">103</td><td>98–106 mEq/L</td></tr> <tr><td>HCO₃</td><td>25</td><td style="color:#28a745;">24</td><td>22–28 mEq/L</td></tr> <tr><td>BUN</td><td>12</td><td style="color:#28a745;">14</td><td>7–20 mg/dL</td></tr> <tr><td>Cr</td><td>.6</td><td style="color:#28a745;">0.9</td><td>0.6–1.2 mg/dL</td></tr> <tr><td>Mg</td><td>2.5</td><td style="color:#28a745;">2.4</td><td>1.7–2.4 mg/dL</td></tr> <tr><td>Glucose</td><td>98</td><td style="color:#28a745;">100</td><td>70–101 mg/dL </td></tr> </tbody> </table> Status: Abdomen soft, mildly distended; pain controlled; dizziness persists when upright. She would like her pain medication before getting up this morning. Orders: Continue LR 75 mL/hr, 8am meds: prn oxycodone 5mg q 2hr, maintain type and screen <<set $visitedEleanor = true>> What is your next action? * [[Notify Physician ->0700-Decision-Eleanor-Correct]] * [[Bladder Scan->0700-Eleanor-Bladder]] * [[Look at incision and drainage->Look at incision]] * [[Complete Eleanor assessment->0700_Start]]
You page the provider awaiting orders <<set $visitedRobert = true>> [[Return to patient list->0700_Start]]
You continue routine monitoring until 1000 <<set $visitedRobert = true>> <<set $physicannotnotified = true>> [[Return to patient list->0700_Start]]
Robert (1000): BP 130/74, HR 94, RR 22, O₂ 97%<br> <<nobr>><<if $physicannotnotified >> No new orders for robert <<else>> New orders for Robert: 40 mEq IV potassium give over 4 hours, 1 g IV magnesium <</if>> <</nobr>> Eleanor (1000): BP 100/64, HR 90, RR 20, O₂ 96% New orders for Eleanor: 1L IV fluid bolus, type & screen, CBC<br> <hr> ''Robert'' * <<nobr>><<linkreplace "Start Mg replacement now per order">><<set $robertMgOrder = true>><<set $robertMgReplacedEarly = true>>✅ Start Mg replacement now per order<</linkreplace>><</nobr>> * <<nobr>><<linkreplace "Hold K until a second IV is started (plan to give)">><<set $robertKOrderPlanned = true>>✅ Hold K until a second IV is started (plan to give)<</linkreplace>><</nobr>> * <<nobr>><<linkreplace "Give K⁺ now and hold Mg until K is completed">><<set $robertKGiven = true>><<set $robertMgHeld = true>>✅ K⁺ is running (Mg held)<</linkreplace>><</nobr>> * <<nobr>><<linkreplace "Run K and Mg together in the same IV">><<set $robertMgReplacedEarly = true>>✅ Run K and Mg together in the same IV<</linkreplace>><</nobr>> * <<nobr>><<linkreplace "Call for a central line">><<set $calledforcentralline = true>> ✅ Called for a central line — MD response: “Please run peripherally; no central line needed.”<</linkreplace>><</nobr>> <<nobr>><<if $robertKGiven or $robertMgOrder or $robertKOrderPlanned or $robertUnsafeComboTried or $calledforcentralline>> ''Selected for Robert:'' <<if $robertMgOrder>> • Mg started early<</if>> <<if $robertKOrderPlanned>> • K planned after 2nd IV<</if>> <<if $robertKGiven>> • K given now<</if>> <<if $robertMgHeld>> • Mg held<</if>> <<if $robertUnsafeComboTried>> • ⚠ Tried to run K + Mg together<</if>> <<if $calledforcentralline>> • ⚠ Called for central line (not required)<</if>> <</if>> <</nobr>> <<nobr>><</nobr>> <hr> ''Eleanor'' * <<nobr>><<linkreplace "Reassess: JP output/character, incision; quantify & trend">><<set $eleanorBleedMonitored = true>>✅ Reassess: JP output/character, incision; quantify & trend<</linkreplace>><</nobr>> * <<nobr>><<linkreplace "Collect labs (CBC, type & screen)">><<set $eleanorLabsCollected = true>>✅ Collect labs (CBC, type & screen)<</linkreplace>><</nobr>> * <<nobr>><<linkreplace "Start Fluid Bolus">><<set $gavefluidtoeleanor = true>>✅ Gave fluid bolus<</linkreplace>><</nobr>> * <<nobr>><<linkreplace "Give oxycodone">><<set $gaveoxytoeleanor = true>>✅ Gave oxycodone<</linkreplace>><</nobr>> <<if $eleanorBleedMonitored or $eleanorLabsCollected or $gaveoxytoeleanor>> ''Selected for Eleanor:'' <<if $eleanorBleedMonitored>> • Reassessed drain & incision<</if>> <<if $eleanorLabsCollected>> • Labs collected<</if>> <<if $gaveoxytoeleanor>> • ⚠ Oxycodone given<</if>> <</if>> <hr> <<set $currentTime = "1000">> [[Proceed to 1200->1200-Start]]
You notify the physician, awaiting futher orders <<set $visitedEleanor = true>> [[Return to patient list->1000_start]]
:: 1200-Start <<nobr>><<set $currentTime = "1200">><</nobr>> <b>Vitals @ 1200</b><br> Robert (1200): BP 130/74, HR 90, RR 20, Temp 98.6°F, O₂ 98%<br> Eleanor (1200): BP 100/65, HR 90, RR 20, Temp 99.5°F, O₂ 96% <<if $eleanorLabsCollected>> <table border="1" style="border-collapse: collapse; width: 100%; margin-bottom: 0.5rem;"> <thead> <tr><th colspan="4">Eleanor — CBC Trends</th></tr> <tr> <th>Lab</th> <th>0600</th> <th>1000</th> <th>Normal Range (Female)</th> </tr> </thead> <tbody> <tr><td>WBC</td><td style="color:#28a745;">8.0</td><td style="color:#28a745;">10.8</td><td>4.0–11.0 ×10³/µL</td></tr> <tr><td>RBC</td><td style="color:#28a745;">4.5</td><td style="color:#dc3545;">3.2</td><td>4.2–5.4 ×10⁶/µL</td></tr> <tr><td>Hgb</td><td style="color:#dc3545;">11.9</td><td style="color:#dc3545;">9.4</td><td>12–16 g/dL</td></tr> <tr><td>Hct</td><td style="color:#dc3545;">34.0</td><td style="color:#dc3545;">28.0</td><td>36–46 %</td></tr> <tr><td>MCV</td><td style="color:#28a745;">90</td><td style="color:#28a745;">90</td><td>80–96 fL</td></tr> <tr><td>Plt</td><td style="color:#28a745;">250</td><td style="color:#28a745;">280</td><td>150–400 ×10³/µL</td></tr> </tbody> </table> <</if>> ''Robert'' <<nobr>><<linkreplace "K⁺ and Mg²⁺ already replaced; anticipate lab recheck in 2 hours">><<set $robert1200Recheck2h = true>>✅ K⁺ is running and Mg²⁺ already replaced; recheck labs in 2 hours<</linkreplace>><</nobr>> <<nobr>><<linkreplace "K⁺ and Mg²⁺ replaced, anticipate rechecking labs in the morning">><<set $robert1200RecheckAm = true>>✅ Recheck deferred to morning<</linkreplace>><</nobr>> <<if $robert1200Recheck2h or $robert1200RecheckAm>> ''Selected for Robert:'' <<if $robert1200Recheck2h>> • Recheck labs in 2 hours<</if>> <<if $robert1200RecheckAm>> • ⚠ Recheck deferred to morning<</if>> <</if>> ''Eleanor'' <<nobr>><<linkreplace "Re-check vitals/UOP">><<set $eleanor1200VitalsUOP = true>>✅ Re-checked vitals/UOP<</linkreplace>><</nobr>> <<nobr>><<if $eleanorLabsCollected>> <<linkreplace "CBC resulted — notify physician">><<set $eleanor1200Notified = true>>✅ Physican notified, stat CT ordered<</linkreplace>> <<else>> <<linkreplace "Notify Physician">><<set $eleanor1200Notified = true>>✅ physician notified, please collect CBC<</linkreplace>> <</if>> <</nobr>> <<nobr>><<linkreplace "Continue to monitor — no interventions">><<set $eleanor1200Monitor = true>>Continued to monitor<</linkreplace>><</nobr>> <<if $eleanor1200VitalsUOP or $eleanor1200Notified or $eleanor1200Monitor>> ''Selected for Eleanor:'' <<if $eleanor1200VitalsUOP>> • Re-checked vitals/UOP<</if>> <<if $eleanor1200Notified>> • Notified physician of CBC<</if>> <<if $eleanor1200Monitor>> • No interventions<</if>> <</if>> <<set $robertDid1200 = ($robert1200Recheck2h or $robert1200RecheckAm)>> <<set $eleanorDid1200 = ($eleanor1200VitalsUOP or $eleanor1200Notified or $eleanor1200Monitor)>> [[Proceed to 1400->1400-Start]]
<b>You’ve made it to the end of the shift!</b><br> Let’s review. <b>Robert</b> <<if $robertMgReplacedEarly>> <b>Action:</b> Mg replaced before or with K.<br> <<else>> <b>Action:</b> Mg <b>not</b> replaced early.<br> <</if>> <<if $robert1200Recheck2h>> Great job! Lab values are often check two hours after replacement if very low or an ongoing problem. <<else>> Waiting until morning to check labs is not appropriate in this patient. Check orders or notify physican if a recheck is indicated since patient has required multiple replacements and remains low. <</if>> <b>Why it matters:</b> Correcting Mg first improves cellular K uptake and helps K normalize, if able to give at the same time it is allowed, however K+ and Mag can be irritating. Replacing together is also an option if access and patient comfort allows. <b>Eleanor</b> <<if $checkincision>> • <b>Action:</b>Bladder Scan, JP assessed and trended<br> <<else>> Current assessment data should be gathered prior to notifying physican. Having all the component of your SBAR prior to notification will allow you to be prepared. <</if>> <b>Why it matters:</b> Post-op bleeding can present with dizziness/low UOP and falling H/H, even if still in normal range, early notification enables timely intervention. Trend vitals, drain output/character, and H/H and notify the provider. <silently> <hr></silently> Q: What are the top complications to watch for after surgical procedures? Q: How do you distinguish “expected post-op changes” from early warning signs? Q: What information do you need before calling the provider? Please complete the post assessment here: <img src="SV_54R5uaj52oJ1cTY-qrcode.png" alt="QR Code" style="max-width: 100%; height: auto; display: block;">
Eleanor is waiting for CT Robert's cramps are improvings. It's <strong>1400</strong> and you find out you are getting floated at 1500, finalize your needs for the next nurse taking over for your assignment. Robert (1400): BP 124/74, HR 86, RR 20, O₂ 98% Eleanor (1400): BP 98/60, HR 102, RR 18, O₂ 96% [[Debrief->Shift-Handoff]]
<50 ml in bladder upon scan <<set $checkbladder = true>> [[0700-Eleanor]]
Welcome: Please join below: <img src="Screenshot 2025-08-18 194955.png" alt="QR Code" style="max-width: 100%; height: auto; display: block;"> [[Report]]
Incision is clean dry and intact <<set $checkincision = true>> [[0700-Eleanor]]