Paw Paw's Holiday Plate

What it is

Paw Paw's Holiday Plate is a simulated Thanksgiving dinner with twelve grandparents to choose from, six Paw Paws and six Mamaws, each with their own chart. Conditions include heart failure, diabetes, warfarin, gout, post-stroke dysphagia, hemodialysis, a nut allergy, an MAOI, gastric bypass, kidney disease, and celiac disease.

Pick a level, then serve one course at a time. Beginner platters are single foods, Intermediate are classic holiday dishes, and Hard are combo plates. Serve the wrong one and their smartwatch alarms, they react, and the screen cuts to an EHR with an NCLEX-style question, including select all that apply, and a rationale for every option.

What you'll learn

• Why sodium triggers heart failure, BP spikes, and fluid overload
• Why ACE inhibitors, spironolactone, kidney failure, and salt substitutes cause hyperkalemia
• Why warfarin needs consistent vitamin K, not zero vitamin K
• How purines and alcohol trigger gout flares
• Which foods and liquids put a client with dysphagia at risk for aspiration
• Fluid and phosphorus limits for clients on hemodialysis
• First actions for heart failure, hyperkalemia, stroke, bleeding, glucose, gout, aspiration, and dialysis emergencies
• Why tree nuts and peanuts cause anaphylaxis and why epinephrine comes first
• Why MAOIs and high-tyramine foods cause a hypertensive crisis
• Which foods trigger dumping syndrome after gastric bypass
• Where gluten hides for clients with celiac disease

How it helps you

NCLEX tests clinical judgment, using NCSBN's Clinical Judgment Measurement Model. Every NURSYN game is built on the nursing process. Paw Paw's Holiday Plate works these ADPIE steps: Assessment, Diagnosis, Implementation, Evaluation.

• Diet teaching questions on the NCLEX test the why behind each restriction. Seeing the reaction makes the why stick.
• Every emergency ends with a prioritization question, the same skill the NCLEX tests.

How to play

1. Slide through the grandparents, pick one, and read their chart and meds.
2. Pick Beginner, Intermediate, or Hard.
3. Choose a dish for each course, then serve it or pass.
4. If their watch alarms, answer the EHR question, then fix the plate.

Clinical topics covered

Sources

The clinical content and the teaching approach behind this game line up with these references.

1. Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Hinkle, Cheever, and Overbaugh)Wolters Kluwer. Heart failure, kidney disease, dialysis, diabetes, hyperkalemia, anticoagulation, gout, stroke, dysphagia, anaphylaxis, and MAOI nursing care.
2. Celiac Disease; Dumping SyndromeNational Institute of Diabetes and Digestive and Kidney Diseases. Celiac disease and dumping syndrome after gastric surgery.
3. High Blood Pressure; Heart Failure; Atrial FibrillationAmerican Heart Association. Sodium, blood pressure, heart failure, and atrial fibrillation.
4. National Diabetes Statistics Report; GoutCenters for Disease Control and Prevention. Diabetes and gout facts and population rates.
5. Potassium, Phosphorus, and Fluid in Kidney DiseaseNational Kidney Foundation. Diet and fluid limits for kidney disease and hemodialysis.
6. Gout GuidelineAmerican College of Rheumatology. Acute gout flare treatment and urate-lowering therapy.
7. Adult DysphagiaAmerican Speech-Language-Hearing Association. Swallow evaluation, diet textures, and thickened liquids.
8. FoodData CentralU.S. Department of Agriculture. Food composition used to decide which dishes are risky.