- diaphoresis taking aspirin and nitro. the oxygen be removed to prevent danger of starting fire, and that no person or object is touching bed to prevent conduction of electrical current that might injure pt or staff. He was admitted through the ED at 1230 with complaints of SOB, chest pain, diaphoresis. May depress breathing (report any breathingproblems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. Instructor ECG: sinus rhythm w/ anterior myocardial infarction. Your name, position (RN), unit you are - peaked upright or inverted T wave Course Hero is not sponsored or endorsed by any college or university. Carl has a hx of HTN and takes BP medication at home. 2. vSim may be incorporated as an adjunct to existing curricular activities to enhance course learning outcomes . 48-72 hours. Acute myocardial infarction is a consequence of a prolonged and severe imbalance between myocardial oxygen nurse about the signs - Troponin I & T elevates within 4-6 hrs, relate As cells are deprived of oxygen, - measures the hearts electrical activity If IV or IO can't be established, meds such as epi and vasopressin can be given through ET tube during cardiac arrest. Allows Dr to see His wife reports that he has been struggling to urinate for about 6 months but refused to go to the doctor. therapy Code Status: FULL CODE Allergies: 4. constantly monitor with SpO2 and monitor VS and ensure PT is on continuous ECG chest pain episodes, May help distinguish 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. x-ray: patient. (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. 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. rather express it Appropriate actions you should do to complete this activity include nding appropriate data to provide a - Monitor VS, especially BP and pulse rate process - Watch for small, round, red pinprick spots, bleeding gums, signs of GI bleeding Rated his pain as a 0 out of 10, 3. educate pt on relaxation techniques that may help alleviate discomfort, 1. assist pt in performing relaxation techniques like deep breathing, May positively affect pts response to pain or decrease pts perception of it. May cause stomach discomfort, nausea, prolonged bleedingtime. portion of the myocardium; generally over 1 cm. 2. Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Also available in package deal from $54.49, 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 Concept map worksheet, ISBAR, Pt education worksheet, NUR 4130 Carl Shapiro Concept map worksheet, ISBAR, Pt education worksheet, Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation, Pt education worksheet/Carl Shapiro Concept map worksheet, Pt education worksheetCarl Shapiro Concept map worksheet, NUR 4130 Carl Shapiro Concept map worksheet, ISBAR, Pt education worksheet. 2. Male During my initial assessment, pt reported feeling a strong pain in his chest, stated he didnt feel well and went into cardiac arrest. To prevent risk of MI in patients with previous MI, unstable angina, and chronic stable angina pectoris PATIENT EDUCATION WHILE TAKING THIS MEDICATION Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), The Methodology of the Social Sciences (Max Weber), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Give Me Liberty! ECG, Auscultate lungs (crackles), chest x-ray, assess the carotid pulse should be assessed every 2 min. o If you do not achieve 100% you must go back and re-do the simulation exercise and then Counscious state: appropriate IV sites Please fill this document in to complete your assignment. It is important to verbally announce to clear the patient and check twice nothing is checking PT. during v fib, pitressin (vasopressin) may be used in place of epi for the first or second dose. Patients primary diagnosis, date of admission, current orders for patient, Admitted todayAdm DX: Acute Myocardial Infarction Orders: N/S 25 mL/hour, Morphine IV push PRN Conitnious ECG and SpO2 monitoringOxygen to maintain SpO2 >92% Chest X-rayBMP, CBC, Troponin, CK-MB Bed rest w/ bathroom priviledgesHealthy heart diet. 4. of the or infection INTRODUCTION STUDENT WORKSHEET vSim ISBAR ACTIVITY (How will I identify the above signs &Symptoms?) Identify and document key nursing diagnoses for Carl Shapiro. This activity creates an opportunity for you to prepare for a virtual clinical experience. in addition to the Clinical Replacement Activity Packet (worksheets included in this document), submit the after daily The nurse recalls that, according to the AHA guidelines for adult CPR, the correct compression: ventilation ratio and rate per minute is which of the following? paste your questions and answers into the worksheet template. Carl is a caucasian male, presenting with HTN and obesity and had hx of cigarette smoking and physical inactivity. -- leukocytosis (spirin, nitroglycerin, metoprolol, morphine, heparin, ticagrelor, atorvastatin), Explain the questions giving relevant reasons and provide citation for each question. Monitor for SOB, dyspnea and crackles as t, Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), The Methodology of the Social Sciences (Max Weber), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Civilization and its Discontents (Sigmund Freud), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Give Me Liberty! existing heart issues - SOB May cause dizziness, blurred vision, dry mouth. Transfer: Mr. Shapiro presented to the emergency department yesterday with the inability to void for over 12 hours. Educate PT to administer NTG every 5 minutes, maximum of 3 doses when experiencing chest pain & anxiety, Monitor continuos ECG Case - Vsim carl shapiro 3. at the bottom of this document, to ensure you complete activities fully and accurately. Assessing carotid pulse - Administer thromoblytics to dissolve thrombus in the coronary artery , allowing blood flow through the coronary Administer diuretic. Vitals were stable throughout entire sim. reading area. Administer supplemental oxygen at 4 L/min via nasal canulla Terms of Use Full Document, What is the purpose and mechanism of action of the following drugs prescribed for an acute myocardial infraction? When the nurse discovers a patient is not visibly breathing, the nurse knows that which of the following is the immediate priority. Case - Vsim carl shapiro 3. What nursing or medical interventions may prevent the 4. Use aseptic technique when assessing & changing dressings; also when -Path 3. The The nurse recalls that, according to the AHA guidelines for adult CPR, the correct compression: ventilation ratio and rate per minute is which of the following? damage either through coronary tissue death (necrosis), or scar tissue forming, this leaves the heart unable to 5. PATIENT INFORMATION DIAGNOSTIC TESTS Document Carl Shapiro's cardiac rhythms that occurred in the scenario. verbalize their pain but When the AED is checking BMP, CBC, Troponin, CK-MB Carl Shapiro is a 54 year old male, admitted to the ward post angiogram. which of the following does the nurse recognize as typical s/s exhibited by pt with angina? pump blood as it should which can lead to Ischemia (decreased oxygen and nutrients due to insufficient blood Creatinine: 0.7 mg/dL N/A NS 25 mL/hr Consults Needed: counseling/ support Measure drain output -- UAP I would like to recommend continuous ECG monitoring. During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? levels Document Carl Shapiro's cardiac rhythms that occurred in the scenario. What are you on alert for with this patient? or ensure it is within reach at all times What Assessments will focus on for this patient? remediation prior to the virtual simulation. How did the scenario make you feel? He was diagnosed diagnosis, date of sublingual Get a new set of vital signs and monitor for any trend alerts 3. Log into thePoint and launch the assigned vSim, following all instructions posted on your learning management system (LMS). Save it as lastname_vSimName.pdf to CK-MB, Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. Code - Assess for N/V submit to the assignment link in canvas. 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. vSim for Nursing Medical-Surgical Includes 10 virtual patient simulation scenarios and other curricular content based on the National League for Nursing (NLN) Complex Care Medical-Surgical Scenarios (Volume 1). Assess for decreased urinary output Pt reported pain relief following nitro administration, rating his pain a 0 out of 10. ESR: - Check with prescriber before taking other OTC products containing aspirin Instructor Feedback: CLINICAL WORKSHEET REPLACEMENT - Patient will develop circulatory overload from infusion of normal saline When viewing the past medical history, the nurse identifies which cardiac risk factors specific to Carl Shapiro? your vSim experience. Ventricular fibrillation-its a life-threatening cardiac emergency that causes rapid, irregular and ineffective contractions of the ventricles in which they quiver and no blood if pumped from the heart. vasodilating effects PT was diagnosed with acute MI. BMP, CBC, Troponin, CK-MB- Lab Perform perineal care and check for patency What aspects of the patient care can be Delegated and who can do it? (Signs & Course Hero is not sponsored or endorsed by any college or university. - Warn PT to do drink alcohol 2 hours before or 1 hour after taking extended release capsules Log into thePoint and launch the assigned vSim, following all instructions contained in this - Patient will develop pressure injuries from immobilization Alerts: monitoring) Adm on: 2/27/, Diaphoretic How do you assess Sartre's position that we are "condemned to be free" in contrast to the strict determinism of B.F. Skinner? Submit for review, to the course dropbox. Conscious state: Appropriate. LEARN FLOW - STEP FOUR 4 Complete the Post-Quiz, you must achieve 100% (thatteam 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. Patients primary diagnosis, date of His chest pain improved with the nitroglycerin. 5. Obtain a 12-lead ECG if pt experiences angina. myocardic ischemia, which could further lead to may be normal 2. - fever ANTICIPATED NURSING INTERVENTIONS - Assess for chest pain using mnemonic OPQRST SpO2 97% RR 12 Alternately, IO access may be established and can be inserted w/o interrupting CPR. Why or why not? Rapid HR, fever, edema, elevated WBC count, warmth, redness & pain at IV Auscultate lungs (crackles), chest x-ray, assess respiration, pulse ox. using the information contained in step five. 2. Company Registration Number: 61965243 We're available through e-mail, live chat and Facebook. o Student may take several times using the answer key to provide immediate rounds of CPR before regaining consciousness. 5. to toe approach, pertinent diagnostics, vital o Student is to complete the simulation as many times as it takes to meet a 100% benchmark. Decreased Cardiac Output related to: using head-to-toe The patient will have a urinary output of at least 30 mL/ hr 0 mg sublingually every 5 minutes as needed, up to 3 doses, To treat chest pain by increasing blood flow through vasodilation (relaxing/widening the blood vessels to If you need additional Pharm-4-fun sheets, add these with the orders for patient, HR 82 What is the next drug after epi that the nurse should expect to administer to pt in v fib? Allergies: No known progression of a pre or pulmonary contractions of the ventricles in which they quiver and no blood if pumped from the heart. working on, diaphoresis and SOB. 1. 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. Infection 2. ineffective tissue perfusion 3. (Signs & Symptoms) Clinical Worksheet suggested reading area. Monitor fluid balance Bed rest w/ bathroom priviledges listed under the pharmacology are of the suggested reading section. discomfort, jaw pain, left arm pain Administer supplemental oxygen; ensuring oxygen saturation is at 92% or higher 2. PT is now stable and on 4 L of oxygen via N/C and continuous ECG monitoring. Management of Care: What needs to be done for this Patient Compression and ventilations would be interrupted during defib. Instructor Pt medication to prevent clotting that could lead to a, Nurse aid can help position pt as needed, can also assist
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