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					Downloading NurseSquared to your computer
  Set your browser to: http://216.121.98.46/plattsburgh/
  Click “install” and follow all directions; a reboot will be required




    Troubleshooting GUIDE
 1. If for some reason buttons or controls that should be present on-screen do not
    appear, please be sure to set your Screen resolution to 1024 x 768 or higher.


 2. If for some reason an error containing “Int32” occurs when trying to interact
    with the software after successful log-in the following path will resolve this
    issue:

     a. Remove the N2 software via the Control Panel >> Add Remove Programs if
        using Windows XP or Control Panel >> Programs and Features if using Windows
        Vista


     b. Remove all .NET Frameworks except .NET 1.1 beginning with removing .NET
        3.5 and then removing .NET 2.0


     c.    Go to Microsoft’s website at the following URL:
          http://www.microsoft.com/downloads/details.aspx?familyid=333325FD-AE52-
          4E35-B531-508D977D32A6&displaylang=en
          and download .NET 3.5 only – DO NOT DOWNLOAD .NET 2.0

     d. Re-install N2 from download URL given by your faculty


 3. Please be mindful to report all issues through your faculty. If these issues
    cannot be resolved at the School level then your faculty will report them to
    NurseSquared for resolution.




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After you download NurseSquared it will bring you to a login screen.




You will login using your student ID (same as your Plattsburgh username) as the User
ID and Password1 as the Password (be sure to capitalize only the first letter).



Once you log in for the first time, you will be asked to change your password




You should change your password to something you will remember and then log into
the system.




                                                                                   2
Once you log in, choose the “My Clinicals” tab




After choosing the “My Clinicals” tab, click the “New Clinical” button




                                                                         3
At this point, double click to choose the appropriate class




                                                              4
Fill in information appropriate to the client




                                                5
After filling in the information, click “Save New Clinical”




                                                              6
At this point, double click the Clinical Patient to take them into the EHR to begin
documenting




                                                                                      7
The EHR will appear. Begin documenting your assessment




                                                         8
My Clinicals/Pre-Clinical Manager
Diagnosis
Diagnosis: Primary: TIA
Patho-Physiology: Transient Ischemic Attack (TIA) is also known as a “Mini-Stroke” and is a neurological event with the
signs and symptoms of a stroke but the s/s go away within a short period of time. A TIA is due to a temporary lack of
adequate blood and oxygen to the brain.

Therapeutic Regimen: 1) Drugs to prevent blood clots such as aspirin, warfarin, clopidogrel, dipyridamole.
2) Possible carotid endarterectomy (to reopen blocked/narrowed arteries). 3) Possible angioplasty with stenting. 4) Drugs
to lower cholesterol production. 5) Dietary changes. 6) Exercise regimen.

Current Health Problems/Related Functional Changes: Newly diagnosed Hyperlipidemia. Newly found: narrowing of
carotid arteries bilaterally.

Medications
Medication: Lipitor (Atorvastatin) (40mg by mouth daily)
Therapeutic Effect: Helps to lower “bad” cholesterol and fats (LDL, triglycerides) and raise “good” cholesterol (HDL) in
the blood. Lowering LDL and triglycerides and raising HDL decreases the risk of heart disease and helps prevent strokes
and heart attacks.

Medication Action: Reduces the amount of cholesterol made by the liver.

Medication Contraindications: This drug should not be used with telithromycin due to serious (possibly fatal) interactions
which may occur. Notify physician if also taking aliskiren, hormonal birth contol, clopidogrel, daptomycin, digoxin, azole
antifungals. Do not use during pregnancy or breast-feeding.

Medication Toxic Effects: Liver Toxicity; Muscle problems (pain/tenderness/weakness); rash, itching, swelling
(especially of the face/tongue/throat); dizziness; trouble breathing.

Medication Interventions: Avoid eating grapefruit or drinking grapefruit juice while taking this drug. Lab tests for
cholesterol and triglycerides along with liver function tests should be performed periodically to monitor progress and side
effects (Liver Toxicity). If taking other cholesterol-lowering drugs, take Atorvastin 1 hour before or 2 hours after taking
these medications.

Medication Safe Dosages (Include MSI/MSD for IVs): Take 10, 20, 40 or 80 mg daily.

Diagnostic Tests
Lab Test: LDL Cholesterol
Description/Definition of Test: This test is used to predict risk of heart disease. High levels of LDL increase the risk for
strokes and/or heart attacks due to buildup of plaque on the intima of the blood vessels.

Significance of Test for THIS patient: High levels of LDL increases the probability of Heart Disease, TIAs and/or
Strokes. A lower LDL target level can be achieved via exercise, diet, weight control and cholesterol-lowering
medications.

Test Result: 164 mg/dL High Result Significance: High LDL levels should be deceased to 100-129 mg/dL or lower.
Less than 100 mg/dL (2.59 mmol/L) — Optimal

100-129 mg/dL (2.59-3.34 mmol/L) — Near optimal, above optimal

130-159 mg/dL (3.37-4.12 mmol/L) — Borderline high

160-189 mg/dL (4.15-4.90 mmol/L) — High
Greater than 189 mg/dL (4.90 mmol/L) — Very high

Radiology Test: CT of brain and blood vessels of brain.
Test Description/Definition: CT (Computed Tomography) scans uses X-Rays to make detailed pictures of structures
inside the body. This was a scan of the brain and the blood vessels of the brain.


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Test Significance for THIS patient: Scanning the brain and blood vessels of the brain allows the physician to see
blockages within the blood vessels of the brain.

Significant Findings/Results: Narrowing of carotid artery bilaterally.

Admission History: (Go to Patient Charting tab and choose Admission Hx form) (fill out only the following areas)
Health History: Reported no previous health problems.
Allergies: Morphine: Severe Nausea/Vomiting                     SAVE YOUR WORK in ADM HX!




                                                                                                                    10
NurseSquared
My Scenarios List Screen
             Scenario Introduction
             Phase Information
             Electronic Documentation Simulation
             Completing a Phase
             Further Understanding Questions

Patient List Screen
             Course Practice Patients
             Mannequin Simulation Lab

Electronic Documentation Screen
             Patient Header

Patient Charting Tab
             Admission History
             Discharge Plan
             Discharge Summary
             Assessment
             Treatments
             Wounds, IVs, Ostomies, Drains and Tubes

Vital Signs Tab
             Vital Signs Area
             Intake / Output Area
             Height / Weight Area
             Glucose Monitoring

Order Entry Tab
             Pharmacy Order Entry
             Lab Order Entry
             Radiology Order Entry
      PT / OT / ST Order Entry
             Nursing Order Entry
             Dietary Order Entry

Order Review Tab
             Diagnostic Result Screen (Lab and Radiology)
             Pending vs Resulted

Patient Teaching Tab
             Teaching Documentation
             Teaching Review

Patient Card Tab
             Nursing Orders
             PT / OT / ST Orders
             Dietary Orders



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Patient Data Tab
            Allergies
            Home Meds
            Health History

      MAR Tab
                    All
                    Scheduled
                    PRN
                    Infusions

      Care Plans Tab
                    Choose by Nursing Diagnosis
                    Choose by Medical Diagnosis with Related Nursing Diagnoses

      Reports Tab
                    Admission History
                    Care Plans
\                   Discharge Plan
                    Discharge Summary and Instructions
                    MAR
                    Nurse’s Notes
                    Patient Card
                    Patient Teaching
                    Vitals / I&O




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posted:11/11/2011
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