Activity 6 · Part 1 — Recognizing & Verifying the Data
PAWS — Patient Assessment & Workflow System · RCC Nursing Simulation Lab
M.C. · SIM-02142026
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Patient Snapshot
PatientM.C. (male)
Age63
MRNSIM-02142026
Admitted02/14/2026 — 1347
Code StatusFull Code
AllergiesPenicillin · Codeine
Noticing / Assessment / Recognizing Cues
Admitting Diagnosis
Pneumonia — Community-Acquired (CAP), right lower lobe consolidation
History of Present Problem
M.C. is a 63-year-old male with T2DM, HTN, and obesity (BMI 31.4) who presented to the ED with a 4-day history of productive cough (yellow-green sputum), subjective fever at home (39.2°C), progressive dyspnea on exertion, and pleuritic right-sided chest pain. Decreased appetite and PO intake ×2 days. CXR confirmed RLL consolidation. SpO₂ 88% on room air on arrival, improved to 95% on 3L NC.
Significant PMH
Type 2 Diabetes Mellitus, Hypertension, Obesity (BMI 31.4), OSA (CPAP not at bedside), GERD, Hyperlipidemia
Personal & Social History
High school PE teacher. Lives with spouse and two adult children. Non-smoker. Occasional alcohol use (1–2 drinks/week). No illicit drug use.
Vital Signs
| Time | Temp | HR | Resp | BP / MAP | O₂ Sat | Pain | By |
|---|---|---|---|---|---|---|---|
| 02/14 1347 (Admit) | 38.6°C Oral | 104 | 22 | 148/92 — MAP 111 | 92% / 3L NC | 4/10 | JR |
| 02/14 1700 | 36.9°C | 108 | 20 | 152/94 — MAP 113 | 94% | 5/10 | JR |
| 02/14 2100 | 39.4°C Oral | 116 | 24 | 158/98 — MAP 118 | 93% / 3L NC | 6 | JR |
| 02/15 0300 | 39.8°C Oral | 122 | 26 | 162/102 — MAP 122 | 91% / 3L NC | 7/10 | TN |
| 02/15 0700 | 39.6°C Oral | 118 | 24 | 160/100 — MAP 120 | 91% / 3L NC | 6/10 | TN |
This is the actual documented flowsheet, unedited. Read it closely before you answer the questions below.
Labs — Collected 02/14/2026 1410
| Test | Reference Range | Result | Flag | Follow-Up (02/15) |
|---|---|---|---|---|
| Hematology — CBC with Differential | ||||
| WBC | 4.5–10.7 ×10³/uL | 14.2 | H | — |
| RBC | 4.50–5.90 ×MIL/uL | 4.80 | WNL | — |
| Hemoglobin | 13.5–17.5 g/dL | 13.8 | WNL | — |
| Hematocrit | 41–53% | 42 | WNL | — |
| MCV | 81–99 fL | 89 | WNL | — |
| Platelets | 130–400 ×10³/uL | 298 | WNL | — |
| Neutrophils % | 54.0–70.0% | 84.3 | H | — |
| Bands | 0–5% | 9 | H | — |
| Lymphocytes % | 30.0–45.0% | 9.8 | L | — |
| Chemistry — BMP | ||||
| Sodium (Na¹) | 136–144 mmol/L | 138 | WNL | — |
| Potassium (K¹) | 3.6–5.1 mmol/L | 3.4 | L | Pending |
| Chloride (Cl−) | 101–111 mmol/L | 103 | WNL | — |
| CO₂ (Bicarb) | 22–32 mmol/L | 23 | WNL | — |
| BUN | 8–26 mg/dL | 24 | WNL | Pending |
| Creatinine | 0.7–1.2 mg/dL | 1.1 | WNL | Pending |
| eGFR (MDRD) | >60 | 74 | WNL | Pending |
| Glucose (admit) | 70–110 mg/dL | 187 | H | 214 H (0600) |
| Inflammatory Markers | ||||
| C-Reactive Protein (CRP) | <1.0 mg/dL | 18.4 | HH | — |
| Procalcitonin (PCT) | <0.5 ng/mL | 2.8 | H | — |
| ESR | 0–20 mm/hr (M) | 68 | H | — |
| Microbiology | ||||
| Blood Culture ×2 | No growth | Pending | — | — |
| Sputum Gram Stain | Normal flora | Gram (+) cocci in pairs | H | — |
| MRSA Nasal Swab | Negative | Negative | WNL | — |
Dashes mean no repeat draw was ordered. "Pending" means a repeat draw was ordered and is expected, but hasn't resulted yet — that's a different kind of gap.
Diagnostic Tests
CXR
Right lower lobe consolidation.
Sputum Gram Stain
Gram-positive cocci in pairs. Culture & sensitivity pending; speciation not yet resulted.
Your Reflections
PAWS — Patient Assessment & Workflow System · RCC Nursing Simulation Lab
For educational simulation use only — no real patient data. All names, dates, MRNs, clinical findings, and case details are entirely fictitious; any resemblance to real persons or actual clinical events is purely coincidental and unintentional.
PAWS is a Pixelated Learning Activity.
For educational simulation use only — no real patient data. All names, dates, MRNs, clinical findings, and case details are entirely fictitious; any resemblance to real persons or actual clinical events is purely coincidental and unintentional.
PAWS is a Pixelated Learning Activity.