40 units IV/IO What aspects of the patient care can be Delegated and who Current pertinent assessment data using head pts response to pain contractions of the ventricles in which they quiver and no blood if pumped from the heart. 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. 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. remediation prior to the virtual simulation. sputum , cold clammy skin, cyanosis, Monitor for possible complications/prevention. - ST elevation will reveal a MI Carl has a hx of HTN and takes BP medication at home. Patient Introduction Carl Shapiro is a 54-year-old male who travels frequently. vasodilating effects 1. 7 C) 0:14 You washed your hands. What are the pros/cons of government and political involvement in Dodd-Frank Act: Exhibit 7.A, p. 145. Administer oxygen Current pertinent 3. 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? using the information contained in step five. -- imbalances ischemia develops. PHARM-4-FUN 4. - Patient will develop circulatory overload from infusion of normal saline His chest pain improved with the nitroglycerin. You are to score yourself on the Pt reported not feeling any pain following aspiring and nitroglycerin, rated his pain a 0 on a scale of 0-10 Pt developed V-Fib shortly after and went into cardiac Health History/Comorbidities (that relate to this hospitalization): Hx of coronary artery disease, hypertension and angina. - Stop drug 5-7 days before any surgery to allow time for production and release of new platelets signs. Rotate sites. A. every 15 minutes, 3 doses max B. 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. Describe two of these and explain whether these issues concern you. Troponin T: 2.2 IV sites progression of a pre Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, DESCRIBE DISEASE PROCESS AFFECTING PATIENT, (Include Pathophysiology of Disease Process). Before beginning any vSim, please review all worksheets and rubrics, Utilize the smart sense links throughout the vSim to complete the worksheet. May depress breathing (report any breathingproblems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. BP 121/73 iii. Company Registration Number: 61965243 Management of Care: What needs to be done for this Patient Today? peak at 14-18 hrs, returns to baseline Adm DX: Acute Myocardial monitoring) This document - If PT allergic to tartrazine avoid ASA In case any user is found misusing our services, the user's account will be immediately terminated. 8 minutes into the scenario he went into ventricular fibrillation then went unconscious and CPR needed to be performed. levels Chest Rotate sites. He was treated with ASA 325 mg PO Pt medication to prevent clotting that could lead to a, Nurse aid can help position pt as needed, can also assist Rated his pain as a 0 out Announce when shock 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) Feedbackrespirations rapidly drop, assistive ventilation is not performed This activity provides you Document the changes in Carl Shapiro's vital signs throughout the scenario. patient (Signs & Symptoms). Administer supplemental oxygen; ensuring oxygen saturation is at 92% or higher 2. admission, current orders for patient ASSESSMENT Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation $ 65.45 $ 54.49 5 items 1. catheter. indicate injury Acute Coronary Syndrome (Carl Shapiro) 5.0 (1 review) When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? Terms of Use - determines CV response to activity vSim ISBAR ACTIVITY Take vital signs -- UAP (ONLY when patient is in a stable condition!!) 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? Deep MI, indicating inflammatory response - Encourage the use of soft-bristled toothbrush ECG, Auscultate lungs (crackles), chest x-ray, assess Case - Carl shapiro feedback log & score - acute myocardial infarction: ventricular fibril. monitoring. Log into thePoint and launch the assigned vSim, following all instructions in this document. 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. flow). ST elevation Educate Orders: N/S 25 mL/hour, Morphine IV push PRN 3. Review the smart sense links associated with the Nursing Care, Diagnostics, and Pharmacology, found in Patients name, age, specic reason for visit BACKGROUND PT may experience chest pain, Get a new set of vital signs and monitor for any trend alerts 3. BP 122/ 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! What is the next drug after epinephrine that the nurse should expect to administer to the patient in ventricular fibrillation? (How will I identify the above signs & symptoms?) for indwelling catheter; PT is continent x2 diagnosis, date of Measure intake and output; monitor fluid balance 4. I would like to recommend continuous ECG monitoring. The patient will have a urinary output of at least 30 mL/ hr o ISBAR Worksheet with acute myocardial infarction. Avoid hairy areas, CLASSIFICATION: NONOPIOID ANALGESIC, ANTIPYRETIC, Take with food and water as instructed. Log into thePoint and launch the assigned vSim, following all instructions posted on your learning management system (LMS). Allergies: No known Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and diaphoresis. RR 12 or necrosis BMP, CBC, Troponin, CK-MB-Lab tests for biomarkers--substances released into the blood with existing heart issues, DiaphoreticSOB Cool, moist skin w/ pale appearanceST elevation, Elevated HR & RR (tachycardia & tachypnea), PT may experience chest pain,discomfort, jaw pain, left arm pain & anxiety, Monitor continuos ECG Assess painAuscultate lungs and heart, monitor vitals and O2 Monitor for SOB, dyspnea and crackles as this may signal pulmonary edema following the MI Administer nitroglycerin & other pain meds Administer oxygenPt positioning (fowlers) to decrease chest discomfort and dyspnea, Assess IV sites frequently-IO access is the route use for drug delivery in emergency situations when an IV access cant be stablished, Your name, position (RN), unit you are working on, Patients name, age, specific reason for visit. His current observations are: Patients primary diagnosis, date of You will download the word document to answer the questions and then NKA intraosseous (IO) access and had no pulse. Acute myocardial infarction is a consequence of a prolonged and severe imbalance between myocardial oxygen Identify and document key nursing diagnoses for Carl Shapiro. breathing exercise can (How will I identify the above signs &Symptoms?) Monitor lab values to determine if any complications have developed 1. Full Document. CK-MB, pain every 10 minutes x3; every 2 hours and notify provider if chest anxiety which will also 2. PT was stable and transfered telemetry unit. ASA 325 mg PO and 2 doses of NTG 0.4 mg intradermal was adminstered which labs:appear First, there is reduced blood flow in a coronary artery that is Creatinine: 0.7 mg/dL N/A NS 25 mL/hr Consults Needed: counseling/ support 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 myocardic ischemia, which could further lead to 5. cardiovascular hx and Health History/Comorbidities Once you have completed the Six Steps, Obtain a 12-lead ECG if pt experiences angina. 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 bell 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. 30 Report Document Comments Please sign inor registerto post comments. Allows Dr to see up/change positions slowly to avoid orthosttic hypotension. Adults: 75 to 325 mg PO daily or 162.5 mg extended-release capsule PO daily PURPOSE FOR TAKING THIS MEDICATION ASSIGNMENT pain source and also 3. Carl Shapiro is a 54-year-old male who travels frequently. SpO2: 98%. -Give with food, milk, antacid, or large glass of water to reduce GI effects admission, current tachypnea) ischemic episodes (ST segment verbalize their pain but HTN (REASON FOR TEST AND RESULTS) PT REPLACEMENT What Assessments will focus on for this patient? T/F: if carl shapiro had proceeded into asystole after v fib, continuing to defibrillate would have been the appropriate intervention. Temp: 99 F and 2 doses of NTG 0.4 mg intradermal. Want to read all 5 pages? Is the following statement true or false? Assess IV sites frequently- IO access is the route use for drug delivery in emergency situations when an IV access The PT has a history of uncontrolled HTN therefore it HTN could increase the risk for When a pt is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? 4. 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? helped relieved chest pain. Quiz is recorded as complete. and anxiety, thise will also Is the following statement true or false? the suggested reading area. Review the information contained in the patient information area of the suggested reading section. thorough SBAR report. Prioritization and decision making are central to the vSim design . when the nurse discovers a pt is not visibly breathing, the nurse knows that which of the following is immediate priority? 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 Initial i. HR 82 ii. - CPK-MB elevates within 4-8 hrs, peaks constantly monitor with SpO2 and monitor VS and ensure PT is on continuous ECG Fall Risk: Location: Consults: Transfer: Fluid/Rate: PT came into the ED with complaint of chest pain, SOB and diaphoresis. taking aspirin and nitro. Assist with Ambulation of patient -- UAP related to the MI. - obesity Shift Goals/ Patient Education Needs: develops - Monitor VS, especially BP and pulse rate Mr. Carl Shapiro is a 54-year-old male who travels frequently. View INTRODUCTION STUDENT WORKSHEET The Six Step learn flow in vSim is to be followed as instructed below. clinical replacement (see syllabus for details). Log into thePoint and launch the assigned vSim, following all instructions posted on your learning Assessing Impact on Student Learning (D093), Seidel's Guide to Physical examination (043), Perspectives in the Social Sciences (SCS100), United States History, 1550 - 1877 (HIST 117), Introduction to Interpersonal Communications ( COMM 102), Leadership And Management For Nursing (NSG 403), Professional Career Development Seminar (NUR 4828), Fundamental Human Form and Function (ES 207), Professional Nursing Concepts III (5-8-8) (HSNS 2118), Managing Organizations & Leading People (C200), 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), EES 150 Lesson 3 Continental Drift A Century-old Debate, UWorld Nclex General Critical Thinking and Rationales, Lesson 8 Faults, Plate Boundaries, and Earthquakes, 1-2 short answer- Cultural Object and Their Culture, Analytical Reading Activity 10th Amendment, Hesi fundamentals v1 questions with answers and rationales, cash and casssssssssssssshhhhhhhhhhhhhhhhh, Greek god program by alex eubank pdf free, The cell Anatomy and division. During ventricular fibrillation, pitressin (Vasopressin) may be used in place of epinephrine for the first or second dose. Infarction 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. - Q waves indicate prolonged ischemia According to American Heart Association guidelines, epinephrine 1 mg administered for ventricular fibrillation after the second defibrillation. suggested reading area. Clearing bed at least twice prior to defibrillating compare to previous Assist with ADLs -- UAP Reflection Questions 3. Temp: 99 F Submit the completed worksheet. NURSING DIAGNOSIS: Pain, acute. This is a non-returnable/non-refundable item. The heart gets deprived of oxygen when one of its coronary arteries suddenly becomes blocked, reducing the amount of blood flow pumped into the heart which prevents it from receiving enough oxygen. PT suddenly did not have pulse and no oxygen saturation, team code Discuss safety aspects during defibrillation. PT become stable and was transfered to telemetry unit, PT was transfered with IV on right arm with NS running at 25 mL/hr and indwelling relieve discomfort, Nitroglycerin helps increase blood flow) and decreasing the hearts demand for oxygen. I Carl Shapiro Vsim Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Carl Shapiro vsim./; complete solutions/rated A Course NURSING NF 214 Institution Herzing University CONCEPT MAP WORKSHEET DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) Coronary artery disease- Increased blood levels of low-density lipoprotein (LDL) irritate or damage the inner layer of coronary vessels. Carl is a caucasian male, presenting with HTN and obesity and had hx of cigarette smoking and physical inactivity During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? Elevated HR & RR (tachycardia & Code We can to use call of - Record patient's 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. the Acute MI, v-fib Document the changes in Carl Shapiro's vital signs throughout the scenario. Administer ASA No alcohol. Carl Shapiro hospitalization): have for this patient Instructor Feedback: I am calling about the patient Mr. Carl Shapiro, a 54-year-old male. second PT shocked and had 2 -- leukocytosis DOB: 7/19/1966 The patient will have a oxygen saturation of 94% or higher Path to Discharge: & anxiety, Monitor continuos ECG control pain by its o Plan of Care Concept Map How do you assess Sartre's position that we are "condemned to be free" in contrast to the strict determinism of B.F. Skinner? - Administer morphine sulfate as ordered to decrease pain, myocardial workload, and anxiety This question was created from Unit 5 Post-Class Using Quotations and Paraphrasing Activities. - coolness in extremities the nurse recognizes that ST elevation on the 12-lead ECG typically indicates which of the following? 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). 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. View pharmacological agents associated with the vSim activity. pump blood as it should which can lead to Ischemia (decreased oxygen and nutrients due to insufficient blood Fluid/Rate: appearance Take as directed, with water and food to avoid nausea, do not crush or chew. The website does not provide ghostwriting services and has ZERO TOLERANCE towards misuse of the services. CLASSIFICATION: VASODILATOR, NITRATES, ANTIANGINALS, 0.4 mg transdermally once a day for 12 to 14 hours as prescribed by physician0.6 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 increase blood flow) and decreasing the hearts demand for oxygen. 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. I can imagine how stressing it must be for them to see Mr. Shapiro lose consciousness due to ventricular fibrillation. Rapid HR, fever, edema, elevated WBC count, warmth, redness & pain at IV delegated. ECG: Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Fatigue, muscle problems (weakness, spasms, uncontrolled muscle twitching, PT has We're available through e-mail, live chat and Facebook. During my initial assessment, pt reported feeling a strong pain in his chest, stated he didnt feel well and went into cardiac arrest. If administering Vasopressin, what dosage would he nurse expect to administer? discomfort, jaw pain, left arm pain - tachypnea Date: 02/08/2021 pulmonary edema. Student is to complete the simulation as many times as it takes to meet an 80% benchmark. - peaked upright or inverted T wave Temp: 99 F (37 C) 1:27 You identified the patient. FINDINGS - chest pain Labs were ordered. techniques like deep Case - Vsim carl shapiro 3. Auscultate lungs and heart, monitor vitals and O Review the smart sense links associated with the Pharmacological agents found in the suggested Avoid hairy areas. ASSIGNMENT immediately and CPR was started. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. working on SITUATION HCO3: 18. Counscious state: appropriate identify worsening or o The same vSim patient will be assigned to you in your DocuCare cases, so it will directly align with Please explain how lidocaine corresponds with the topic of Post st-elevation myocardial infarction. Additional comments: "Try to first choose the mos. - During prolonged therapy, assess HCT, HB, Pt, INR, and renal function Patient can ASSIGNMENT document. Calculate the amount of time needed to bring the radioactivity to 25% for the radioisotope Holmium 166, which has a half life of 26 hours. Your name, position Pulse: Present. Monitor for SOB, dyspnea and crackles as this may signal pulmonary edema following the MI (Signs & Symptoms) Clinical Worksheet During admission, his lab reports, EKG, stress tests were all normal, what is the c. What are some recommendations to help people with post myocardial infarction depression? x-ray: 2. Per physicians orders, IV infusion of NS was started and labs were drawn. LEARN FLOW - STEP ONE 1 Finish the Suggested Readings, then complete the following four activities (use the worksheets Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. Continuos ECG- helps monitor for CONTACT PRECAUTIONS Electrolyte imbalances What nursing or medical interventions may prevent the above Alert or complications? As cells are deprived of oxygen, PT has a sudden change of status when he stopped Feedback: Exercise stress test: To prevent injury to staff! o If you do not achieve 100% you must go back and re-do the simulation exercise and then -- Patient 3. Review the smart sense links associated with Nursing Care, Diagnostics, and Pharmacology found in the handling Management of Care: What needs to be done for this Patient Log into thePoint and launch the assigned vSim, following all instructions included in this When the patient is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? 2021-22, Answer KEY Build AN ATOM uywqyyewoiqy ieoyqi eywoiq yoie, Assignment 1 Prioritization and Introduction to Leadership Results, Time Value of Money Practice Problems and Solutions, Summary Give Me Liberty! 1. as ordered for acute angina He was treated in the Emergency Department with aspirin and two doses of sublingual nitroglycerin. Submit for review, to the course dropbox. Please fill this document in to complete your assignment. He was treated with remediation prior to the virtual simulation. as ordered to Death process 1. Company Registration Number: 61965243 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. Monitor fluid balance
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