Clinical IV - Duncan

Spot it and Fix it

100

A patient is 30 minutes post-op, is difficult to arouse, with shallow respirations and an SpO₂ of 88%.

Airway/Respiratory Depression

200

A patient scheduled for surgery states, “I don’t remember signing consent,” and appears anxious.

Informed Consent, STOP THE PROCEDURE

300

A patient with an External Ventricular Drain (EVD) becomes increasingly restless, has unequal pupils, and a decreasing level of consciousness.

ICU - Increased ICP / possible herniation (emergency!)

400

A postpartum patient has a boggy uterus and heavy vaginal bleeding with clots.

OB — Postpartum hemorrhage (fundal massage needed!)

500

A patient being discharged suddenly states, “I don’t understand any of these medications,” and cannot repeat instructions.

 Unsafe discharge / failed patient education

Cool or Concerning?

100

A patient 12 hours post-op is restless, slightly confused, and has an SpO₂ of 93% on room air

Concering - early hypoxia. DO NOT TRUST YOUR NUMBERS ALONE

200

A patient receiving IV fluids has gained 2 lbs in 24 hours but has clear lung sounds and no edema.

Concerning - early fluid retention

300

A diabetic patient has a blood glucose of 72 mg/dL and reports feeling shaky and anxious

Concerning - symptomatic

400

A patient’s blood pressure drops from 160/90 to 110/70 after antihypertensive medication.

Cool- expected therapeutic response

500

A breastfeeding patient reports uterine cramping during feeds.

Cool - Oxytocin release.

You Can Only Pick One

100

• One ready for discharge

• One requesting pain medication

• One with an SpO₂ of 88% on room air

• One needing a scheduled dressing change

Spo2 of 88%

200

• A postpartum patient with a firm fundus and moderate bleeding

• A patient with a fever of 100.4°F

• A patient requesting help to the bathroom

• A patient due for routine medications

Post Partum Patient- highest risk

300

• A COPD patient with SpO₂ 90% resting comfortably

• A post-op patient who is restless and slightly confused

• A patient requesting pain medication rated 7/10

• A patient waiting for discharge instructions

Post- Op

400

• A patient receiving heparin with new bruising and a platelet drop

• A patient with diabetes and a blood glucose of 180 mg/dL

• A patient complaining of nausea after antibiotics

• A patient waiting for transport

Heparin Drip- possible HIT

500

• A post-op patient with a BP of 88/54 who is drowsy but arousable

• A patient requesting pain medication rated 9/10

• A patient with a potassium level of 3.4 mEq/L

• A patient waiting for discharge teaching

Post op patient

Who's got this?RN, LPN, UAP

100

Assist a patient to the bathroom after they press the call light.

UAP

200

Administer oral medications to a patient with routine scheduled meds.

LPN

300

Teach a patient how to use an incentive spirometer for the first time.

RN

400

A patient reports new chest pain and shortness of breath.

RN

500

Reinforce teaching about wound care.

LPN

Name that Unit

100

Patients arrive here immediately after surgery. They are often drowsy, airway is the priority, and stays are short.

PACU

200

You will see continuous cardiac monitoring, vasoactive drips, and a 1:1 or 1:2 nurse-to-patient ratio.

ICU

300

Patients may have multiple comorbidities. You manage meds, discharges, and 4–6 patients at once.

Med-Surg

400

This environment focuses on sterile technique, time-outs, and patient positioning before a procedure begins.

Peri-Op

500

You are monitoring fetal heart tones, assessing contraction patterns, and preparing for potential rapid changes in maternal or fetal status.

OB, Labor and Delivery