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• Michelle Pinkhasova

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NUR 377 Advanced Medical Surgical Nursing vSim Course Point Pharmacology: Juan Carlos Please complete the below activities to receive credit for the virtual simulation assignment. A rubric is available under the “assignments” tab in BlackBoard, so you can review the entire point breakdown.  Pre-simulation Quiz, vSim and post-simulation quiz for Juan Carlos in the Pharmacology vSims. o You do not need to complete the Documentation Assignment within vSim o The Guided Reflection Questions within vSim are included within this Simulation Worksheet o Must achieve an 80% on the vSim with a maximum of 3 attempts  The simulation worksheet (below)  Submit the following to Blackboard by Wednesday June 3, 2020 at 9:00am EST o Simulation Worksheet; information must be typed and submitted as a word doc o Screenshot of pre-quiz score, post-quiz score, and vSim feedback Simulation Worksheet Describe the disease process affecting patient (include Pathophysiology of Disease Process) Foot Ulcer in the presence of Diabetes Type II: Individuals with diabetes may have diminished nerve working due to peripheral diabetic neuropathy. This implies that the nerves that more often than not carry torment sensation to the brain from the feet don’t work as well and it is conceivable for harm to happen to your foot without feeling it. Treading on something, wearing tight shoes, cuts, rankles and bruises can all create into diabetes foot ulcers. Limited supply routes can too decrease blood stream to the feet among a few individuals with diabetes and this could impede the foot’s capacity to mend legitimately. When the foot can not mend, a foot ulcer can develop. Explain the following Treatment: Debridement: the removal of damaged and necrotic tissue or foreign objects from a wound to promote wound healing Different types of debridement: Autolytic debridement

Using body’s own enzymes and moisture with hydrocolloids, hydrogels and transp films

Enzymatic debridement

Using chemical enzymes: collagenase, papain-urea

Mechanical debridement

Hydrosurgery, ultrasonic debridement

Surgical debridement

Using sharp surgical debridement/Hydrosurgery • In the operating room • Bedside debridement

Biological debridement

Maggot debridement therapy

Why debride? Dead tissue acts as a medium for bacterial growth and increases the risk of infection. Bacterial colonies that are commonly present in necrotic tissue may develop proteases that bre ak down essential components of the extracellular matrix and have a negative impact on granul ation tissue formation. Explain the following lab values and what the listed result means for the patient (normal values are noted in the parentheses): Glucose (65-140mg/dl) 185mg/dL: Hyperglycemia. It means impaired regulation of Blood glucose level, which may be due to deficiency of insulin or resistance to action of insulin

GHb A1c (