Case 2: Introduction and Instructions

Care of an Older Adult with Infection and Impaired Cognition in an Acute Medical Setting

Scenario Introduction

The goal of this virtual case-based scenario is to promote participants’ clinical reasoning and decision-making when providing nursing care for an older adult with dementia and infection in an acute medical setting. Participants will use a virtual case-based scenario to assess a client, identify priority problems, formulate and implement a nursing plan, and evaluate the plan. The virtual scenario provides entry-level BSN students with an experience of working with a client in a community setting.


  • Chronic Disease Management
  • Clinical Judgement
  • Cognition
  • Communication
  • Gas Exchange
  • Infection
  • Pharmacology
  • Safety

Context: Acute medical unit of a hospital.

Level of Participant: Entry-level (year 1 or 2)

Completion Time: Varied up to 3.5 hours

  • Pre-Learning: Varied depending on the knowledge students have prior to engaging in the scenario. Completing all activities in their entirety may take up to 2.5 hours.
  • Scenario: Allow for about 30 minutes to complete the activity.
  • Reflection: Allow for about 30 minutes to complete the activity.

Learning Objectives

By the end of this scenario, participants will be able to do the following in a virtual case-based scenario:

  1. Identify and differentiate between the signs and symptoms of delirium, dementia, and depression to provide prioritized nursing care.
  2. Implement a client-specific nursing plan of care in an acute care setting to safely manage altered cognition and infection-related diagnoses.
  3. Communicate effectively with an older adult with dementia in an acute care setting to enhance a therapeutic relationship and provide culturally sensitive care.


  • Complete each section in the order it is presented.
  • After completing the pre-brief and pre-learning, you will find a short scenario to work through with decision-making questions. You can go through the scenario as many times as you would like.
  • After you complete the scenario, work through the post-scenario activities.
  • Your role is to assume all aspects of a practicing nurse’s professional behavior as if caring for a client in the clinical setting. However, work within your scope of practice as a student nurse.
  • Several aspects of the scenario may be limited in realism and when a gap occurs between simulated reality and actual reality, act according to the goals of the learning session.
  • These scenarios follow what is known as the Basic Assumption of simulation meaning that it is believed that you are intelligent, capable, and want to do your best to improve your skills. © Copyright 2004-2020 Center for Medical Simulation, Boston, Massachusetts, USA. All Rights Reserved – Used with permission.


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Nursing Virtual Case Studies Copyright © by Adrianna D'Ilio, RN, MSN and Amanda Egert, RN, MSN is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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