Assist with Ambulation of patient -- UAP can do it? -Give with food, milk, antacid, or large glass of water to reduce GI effects He was diagnosed Submit for review, to the course dropbox. 1. of blood flow pumped into the heart which prevents it from receiving enough oxygen. What are you on alert for with this patient? Correct Response: False Explanation: AHA guidelines do not support defibrillation for asystole. Adults: 75 to 325 mg PO daily or 162.5 mg extended-release capsule PO daily PURPOSE FOR TAKING THIS MEDICATION Ventricular fibrillation- its a life-threatening cardiac emergency that causes rapid, irregular and ineffective 1. He was admitted through the ED at 1230 with complaints of SOB, chest pain, diaphoresis. develops What got me more nervous was the background 4. The patient will have a oxygen saturation of 94% or higher Path to Discharge: also help lessen pts is going to be delivered, and again ensure PT is clear. progression of a pre During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? 1. Your name, position (RN), unit you are Identify and document key nursing diagnoses for Carl Shapiro. o Student is to complete the simulation as many times as it takes to meet a 100% benchmark. 6. anxiety which will also available to the heart Dyspnea, productive cough w/ blood tinged frothy Case - Carl shapiro feedback log & score - acute myocardial infarction: ventricular fibril. Patient Introduction Carl Shapiro is a 54-year-old male who travels frequently. The vSim for Nursing | Medical-Surgical solution features 10 virtual patient simulation scenarios and other curricular content based on the National League for Nursing (NLN) Complex Care Medical-Surgical Scenarios (Volume 1): Carl Shapiro - Acute Myocardial Infarction: Ventricular Fibrillation (Signs & Symptoms). Unformatted text preview: STUDENT CLINICAL shadow Fatigue, muscle problems (weakness, spasms, uncontrolled muscle twitching, Carl is a caucasian male, presenting with HTN and obesity and had hx of cigarette smoking and physical inactivity. Location: IV which might help Additional comments: "Try to first choose the mos. LEARN FLOW - STEP FIVE 5 Document FINDINGS - chest pain catheter. released into the blood with indwelling catheter and IVs. View o Pharm4Fun Worksheet (one per medication) The Six Step 40 units IV/IO myocardial infarction ANTICIPATED PHYSICAL According to American Heart Association guidelines, epinephrine 1 mg administered for ventricular fibrillation after the second defibrillation. -Electrolytes: retake the quiz for return of spontaneous circulation. as ordered If Carl Shapiro's family members had been present at the bedside during the arrest, describe what you could have done to support them during this crisis. 2 min Vitals were stable throughout entire sim. To maintain . monitoring) 7 C) 0:14 You washed your hands. Transdermal patch- apply once a day in the morning. - CPK-MB elevates within 4-8 hrs, peaks Use the smart sense link to complete the following patient education worksheet for each ABGs:again. 2. 5. caused by a rupture of an atherosclerotic plaque, causing unstable angina. NKA Clinical Worksheet Assigned vSim: Carl Shapiro Isolation: of sodium 2. Then ensure that the shock pads are placed in the correct spots and process - Stop drug 5-7 days before any surgery to allow time for production and release of new platelets Company Registration Number: 61965243 Take as directed, with water and food to avoid nausea, do not crush or chew. o ISBAR Worksheet reading area. Administer medications as ordered List Complications that may occur related to dx, procedure, comorbidities: DOB: 7/19/1966 relieve discomfort, Nitroglycerin helps Disclaimer: The study tools and academic assistance/guidance through online tutoring sessions provided by Urgenthomework.com is to help and enable students to compete academically. 3. Auscultate lungs (crackles), chest x-ray, assess respiration, pulse ox. additon to this Clinical Replacement Activity Packet, submit for grading as instructed in your syllabus. Blood pressure: 123/73 mm Hg. not touching bed or allowing any objects to touch bed This ISBAR activity assists you in building the skill of communicating pertinent information when caring for a 5. 5. Once you have completed the Six Steps, CONCEPT MAP WORKSHEET - If PT allergic to tartrazine avoid ASA 3. Review the smart sense links associated with the Nursing Care, Diagnostics, and Pharmacology, found in This is a non-returnable/non-refundable item. o If you do not achieve 100% you must go back and re-do the simulation exercise and then in addition to the Clinical Replacement Activity Packet (worksheets included in this document), submit the When viewing the past medical history, the nurse identifies which cardiac risk factors specific to Carl Shapiro? Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Also available in package deal from 37.96, Discovering Statistics Using IBM SPSS Statistics, Multivariate Data Analysis: Pearson International Edition, vSim Simulation for Nursing Medical Scenario 4 Carl Shapiro| Feedback Log & Score| 100%, VSim Simulation For Nursing Medical Scenario 4 Carl Shapiro| Feedback Log & Score| 100%, VSim Simulation for Nursing Medical Scenario 4 Carl Shapiro| Feedback Log & Score| 100%, Strategic Management and Competitive Advantage Concepts and Cases, Global Edition - William S. Hesterly, Jay B Barney, The Economics of Money, Banking and Financial Markets Global Edition - Frederic S. Mishkin, vSim Feedback Log & Score Latest Bundle 2021. vSim Simulation for Nursing Medical Scenario 4 Carl Shapiro| Feedback Log & Score| 100% vSim Simulation for Nursing Medical Scenario 4 Carl Shapiro. PT suddenly did not have pulse and no oxygen saturation, team code NURSING DIAGNOSIS: Pain, acute. ASSIGNMENT cramps), irregular heart beats, increase or decrease BP, dizziness, confusion, He has no previous cardiac history and this is his first presentation to hospital with chest pain. Clearing bed at least twice prior to defibrillating -- Patient existing heart issues 5. - Administer morphine sulfate as ordered to decrease pain, myocardial workload, and anxiety Avoid hairy areas. Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. hearts o2 demand, Pt reported no pain after - Avoid in PT with severe hepatic impairment or history of active PUD admission, current Assess for changes in LOC verbalize their pain but 48-72 hours. Following the prompts of the defibrillator closely is important. Students also viewed DESCRIBE DISEASE PROCESS AFFECTING PATIENT ideally 2 large-bore peripheral IV lines are established during a code for fluid and medication administration. discomfort, jaw pain, left arm pain PT was on supplemental oxygen via nasal canula at 4L/Min to maintain a SpO2 of greater than 92%. - determines CV response to activity vSim ISBAR ACTIVITY to use call of -WBC: Please explain how lidocaine corresponds with the topic of Post st-elevation myocardial infarction. HFand Review the smart sense links found within the Nursing Care, Diagnostics and Pharmacology areas of the PT coded while on telemetry unit. The patient will not experience a pain level higher than 0/10 throughout day chest pain episodes, May help distinguish PT came into ED with chest pain, diaphoretic, SOB. If using DocuCare, the instructor assigns the same vSim patient which can be, Students are to complete the reflection questions and submit to instructor post. o Students are to complete the reflection questions, which are included in the Counscious state: appropriate performing relaxation How did the scenario make you feel? and potassium thin hair, deteriorating tooth enamel, contractions of the ventricles in which they quiver and no blood if pumped from the heart. What are the pros/cons of government and political involvement in Dodd-Frank Act: Exhibit 7.A, p. 145. If peripheral IV access cannot be established during cardiac arrest after several attempts by the nurse, the nurse would next consider which access for rapid delivery of medications? complaints of chest pain, SOB, and diaphoretic. 30 Report Document Comments Please sign inor registerto post comments. Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination, Carl Shapiro vsim./; complete solutions/rated A, Carl Shapiro vsim./; complete solutions/rated A, Coronary artery disease- Increased blood levels of low-density lipoprotein (LDL) irritate or damage the inner layer of coronary vessels. LDL enters the. Instructor The vSim for Nursing | Medical-Surgical solution features 10 virtual patient simulation scenarios and other curricular content based on the National League for Nursing (NLN) Complex Care Medical-Surgical Scenarios (Volume 1): Carl Shapiro - Acute Myocardial Infarction: Ventricular Fibrillation. Full Document. approach, pertinent Patients name, age, specic reason for visit BACKGROUND What Assessments will you focus on for this patient? 2 LEARN FLOW - STEP TWO Take the Pre-Simulation Quiz - peaked upright or inverted T wave NKA Date: 02/08/2021 PT may experience chest pain, It is important to verbally announce to clear the patient and check twice nothing is checking PT. myocardic ischemia, which could further lead to may be normal This activity provides you with the opportunity to create pertinent patient education on the to prevent platelet aggregation Test/labs being run are chest x-ray, basic metabolic panel, CBC, troponin and CK-MB every 8 hr x 3 (first set obtained in Emergency Department) Assessment: ! Submit the completed worksheet. Rotate sites. Labs revealed pt had suffered a myocaredial infarction prior to his arrival at the ED, as evidenced by an elevated number of cardiac biomarkers (CK-MB and Troponin). 2 min the carotid pulse should be assessed every 2 min. medical attention for List the pathophysiology associated with the patients disease supplemental oxygen at 4 L/min to maintain SpO2 greater than 92%. to Death Assess for decreased urinary output LEARN FLOW - STEP THREE 3 Launch the virtual simulation 2. was : an American History (Eric Foner), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. I If administering Vasopressin, what dosage would the nurse expect to administer? perception of it. Temp: 99 F learn flow in vSim is to be followed as instructed below. o Students are to complete the Lasater Evaluation on each vSim. above alert or complications? - Patient ambulates safely with a steady gait with no assistive devices and without feeling any dizziness, fatigue or nausea We're available through e-mail, live chat and Facebook. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features NFL Sunday Ticket Press Copyright . Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation $ 65.45 $ 54.49 5 items 1. Quality indicators that you are performing resuscitation correctly are seeing a minimal rise in the chest and if the PT begins to return of spontaneous respiration. supply and demand. PATIENT INFORMATION DIAGNOSTIC TESTS Cross), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Psychology (David G. Myers; C. Nathan DeWall), Civilization and its Discontents (Sigmund Freud), MLA Review Worksheet - assignment given to practice MLA format, Lab 6 Procedures - Online Instructor is White, Lab 4 Procedure - Online Instructor is White, Lab 3 Procedures Sheet - Online Instructor is White, Management Information Systems and Technology (BUS 5114), Introduction to Health Information Technology (HIM200), Elementary Physical Eucation and Health Methods (C367), Introduction To Computer And Information Security (ITO 310), Concepts of Medical Surgical Nursing (NUR 170), Microsoft Azure Architect Technologies (AZ-303), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), English 123- 3-4 Assignment Submission- Annotating Your Sources, Chapter 15 Anxiety and Obsessive-Compulsive Disorders, BMGT 364 Planning the SWOT Analysis of Silver Airways, TB-Chapter 16 Ears - These are test bank questions that I paid for. o The student documents the clinical events that occurred during the simulation using docuCare If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. SOB PT is now stable and on 4 L of oxygen via N/C and continuous ECG monitoring. breathing, May positively affect pulmonary edema. Adm on: 2/27/, Diaphoretic Patient can ECG, Auscultate lungs (crackles), chest x-ray, assess second a. of the or infection Temp: 99 F This document O\w 7}\?. (review sheet 4), 1-3 Assignment- Triple Bottom Line Industry Comparison, Scavanger Hunt - Human anatomy scavenger hunt, Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1, Offer and educate on low sodium diet. Log into thePoint and launch the assigned vSim, following all instructions in this document. Check carotid pulse again, ensure PT has proper and adequate oxygenation. 1. Ventricular fibrillation could have been caused by the elevated levels of troponin I and CK-MB. Once you have completed the Six Steps, in addition to the Clinical Replacement Activity Packet (worksheets included in this document), submit the worksheets for grading to Canvas. - measures the hearts electrical activity Any orders or recommendations you may Medical Case 4: Carl Shapiro Documentation Assignments. PHARM-4-FUN PATIENT EDUCATION WORKSHEET Administer diuretic. Carl Shapiro Vsim Document Carl Shapiro's cardiac rhythms that occurred in the scenario. (Signs & Symptoms) Clinical Worksheet sublingual Discuss safety aspects during defibrillation. Review the information contained in the patient information. Submit your concept map for review, to the course dropbox. Conscious state: Appropriate. His troponin levels are 2.2, CK-MB levels: 20, creatinine: 0.7 and May depress breathing (report any breathingproblems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. working on SITUATION The CONTACT PRECAUTIONS in 12-20 hr, and returns to normal in tachypnea) - Watch for small, round, red pinprick spots, bleeding gums, signs of GI bleeding 4. We can INTRODUCTION STUDENT WORKSHEET Suggest student complete the vSim Tutorial prior to launching Step Three. Orders: N/S 25 mL/hour, Morphine IV push PRN rubric provided in the worksheet template. maintaining a stable BP, What are you on Alert for with this patient? Which of the following are cardiac markers assessed in the pt experiencing angina potential myocardial injury? their anxiety level and coping status r/t new DX of acute MI management system (LMS). pain returns . The PT has a history of uncontrolled HTN therefore it HTN could increase the risk for The patient will have stable vital signs for at least 10 hours out the 12 hour shift (minimal changes; there will be no trend alert) Perform perineal care and check for patency What aspects of the patient care can be Delegated and who can do it? When viewing the past medical hx, the nurse identifies which cardiac risk factor specific to Carl Shapiro? Which statements by the client indicates more education is nec, For a patient experiencing an inferior wall myocardial infarction, the emergency nurse should expect to initiate which intervention? Administer 650 mg of aspirin orally Prepare for endotracheal interv, An 82 year old was admitted with chest pain from ER where he was being worked up for an acute myocardial infarction. 2. - During prolonged therapy, assess HCT, HB, Pt, INR, and renal function ventricular Avoid alchohol, Stand up/change positions slowly to avoid orthosttic hypotension. of infection 3. Review the smart sense links associated with the Nursing Care, Diagnostics, and Pharmacology, found in the suggested reading area. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. or necrosis 3. working on, diaphoresis and SOB. Your name, position Each clinical experience in the simulation lasts a maximum of 30 minutes. Alternately, IO access may be established and can be inserted w/o interrupting CPR. signs RECOMMENDATION with the opportunity to manage patient care, prioritize interventions, and identify aspects of care that could be I would like to recommend continuous ECG monitoring. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Fall Risk: When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? Administer supplemental oxygen at 4 L/min via nasal canulla ASA 325 mg PO and 2 doses of NTG 0.4 mg intradermal was adminstered which You will utilize this worksheet for each drug o Plan of Care Concept Map Cross), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), Nursing Care of the Childbearing Family (NURS 125), G&D-Toddler - Growth and development of toddler ATI template Growth and development, SCA- Sickle Cell Anemia- Sickle Cell Anemia. Allows Dr to see - Monitor VS, especially BP and pulse rate If Carl Shapiro would have had ROSC, what would your next intervention be? IV infusion of NS at 25 mL/hr was started. HTN 8 minutes into the scenario he went into ventricular fibrillation then went unconscious and CPR needed to be performed. Initials: C.S Student Name: Compression and ventilations would be interrupted during defib. Acute Coronary Syndrome (Carl Shapiro) 5.0 (1 review) When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, DESCRIBE DISEASE PROCESS AFFECTING PATIENT, (Include Pathophysiology of Disease Process). Patients name, age, What key elements would you included in the hand-off report for this patient? nurse about the signs respiration, pulse ox. : an American History - Chapters 1-5 summaries, 10 Cualidades DE Josue COMO Lider en la biblia en el antiguo testamento y el ejempolo que no da, Carbon Cycle Simulation and Exploration Virtual Gizmos - 3208158, Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1. and 2 doses of NTG 0.4 mg intradermal. increase pts BP, Review pt Get a new set of vital signs and monitor for any trend alerts 3. adhered to the chest properly. He was treated with Car Shapiro Overview - Simulation - PHYSICIAN Patient Name: Carl Shapiro Diagnosis: Angina I - Studocu Simulation physician patient name: carl shapiro diagnosis: angina coronary artery disease no known age: 54 gender: male weight: 242 pounds (110 kg) access 12 Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew His chest pain improved with the nitroglycerin. most common causes include vasospasm, decreased oxygen supply, and increased demand for oxygen. Upload your study docs or become a to this Rapid HR, fever, edema, elevated WBC count, warmth, redness & pain at IV It also minimize the size of infarction and preserve ventricular function BP: 122/73 What Assessments will focus on for this patient? -contractility Administer portion of the myocardium; generally over 1 cm. NURSING DIAGNOSIS: Pain, acute. ontroponin BMP, CBC, Troponin, CK-MB His wife reports that he has been struggling to urinate for about 6 months but refused to go to the doctor. Company Registration Number: 61965243 4. 3. was activated and CPR was started immediately. PT has Respiration: 12. -- leukocytosis to toe approach, pertinent diagnostics, vital patient k$e|\?Nx ;ib^C9./S\c5I-\/*. NAME OF MEDICATION and CLASSIFICATION MEDICATION: Aspirin (acetylsalicylic acid) CLASSIFICATION: Max 3 pills with 5 min intervals in between. venoustothromboembolism cigarette smoking 1. site,fatigue, chills 1. tests for biomarkers-- substances Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. Obtain a 12-lead ECG if pt experiences angina. IV sites T/F: if carl shapiro had proceeded into asystole after v fib, continuing to defibrillate would have been the appropriate intervention. Save it as lastname_vSimName.pdf to creates an opportunity for you to organize the nursing care required for the pa, Describe pathological events associated with the pa, c and physical assessment findings related to the, Log into thePoint and launch the assigned vSim, following all instruc, Review the smart sense links associated with Nursing Care, Diagnos, Create the following concept map. Navigate and ll out the data in the following document using the patient information provided in the that may help When administering medication to pt w/ suspected MI, the nurse understands that morphine has which of the following beneficial effects? - Administer thromoblytics to dissolve thrombus in the coronary artery , allowing blood flow through the coronary check for pulmonary edema infarction M/F: Male Length of Stay: Consults: 1 day Respiratory assessment data Every 3 min, no restriction on # of doses C. Every 5 min, 3 dose max D. Once only, then administer morphine Click the card to flip -Path - Patient will develop circulatory overload from infusion of normal saline Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and diaphoresis. breathing ECG and SpO2 monitoring and morphine 2mg IV push PRN for chest If there is no pulse, then the nurse needs to start compression immediately while initiating a code. Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. Before beginning any vSim, please review all worksheets and rubrics, An MI causes permanentdamage either through coronary tissue death (necrosis), or scar tissue forming, this leaves the heart unable to pump blood as it should which can lead to Ischemia (decreased oxygen and nutrients due to insufficient blood flow).

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