If Carl's family has been present at bedside during the arrest, describe what you could have done to support them durin May View full document End of preview. existing heart issues IV of NS @ 25 mL/hr, continuous identify worsening or - Asses for presence of SOB, dyspnea, tachypnea, and crackles and symptoms In case any user is found misusing our services, the user's account will be immediately terminated. PT is now stable and on 4 L of oxygen via N/C and continuous ECG monitoring. including a focused assessment that reflects all areas of assessment performed in the vSim 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. Allows Dr to see Carl Shapiro is a 54-year-old male who travels frequently. IV sites pain returns . Please fill this document in to complete your assignment. Case - Vsim carl shapiro 3. Pitressin (Vasopressin) 40 unites IV/IO can be used to replace either the first or second dose of epinephrine. (Signs & Symptoms) Clinical Worksheet o The student documents the clinical events that occurred during the simulation using docuCare How do you assess Sartre's position that we are "condemned to be free" in contrast to the strict determinism of B.F. Skinner? myocardial infarction ANTICIPATED PHYSICAL PT came into ED with chest pain, diaphoretic, SOB. SpO2 97% NAME OF MEDICATION and CLASSIFICATION MEDICATION: Aspirin (acetylsalicylic acid) CLASSIFICATION: When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? Which of the following are cardiac markers assessed in the pt experiencing angina potential myocardial injury? or ensure it is within reach at all times . Compression and ventilations would be interrupted during defib. Height: 175 cm Educate released into the blood with vasodilating effects LEARN FLOW - STEP FOUR 4 Complete the Post-Quiz, you must achieve 100% Alternately, IO access may be established and can be inserted w/o interrupting CPR. only physically see if the lungs are being inflated, we cannot see if the chest compression are recirculating blood through the body. The patient will have a oxygen saturation of 94% or higher Path to Discharge: rather express it Patients primary diagnosis, date of diaphoresis. constantly monitor with SpO2 and monitor VS and ensure PT is on continuous ECG supplemental oxygen at 4 L/min to maintain SpO2 greater than 92%. Administer oxygen According to American Heart Association guidelines, epinephrine 1 mg administered for ventricular fibrillation after the second defibrillation. help towards We can May cause hypotension, change positions/get up slowly. Measure drain output -- UAP Adm DX: acute 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. catheter. Auscultate lungs (crackles), chest x-ray, assess respiration, pulse ox. respiration, pulse ox. Administer prescribed medications as ordered Complete blood count Perform perineal care and assess for patency and kinking in the foley catheter Temp: 99 F According to American Heart Association guidelines, epinephrine 1 mg is administered for ventricular fibrillation after the second defibrillation. - Patient will develop pressure injuries from immobilization Alerts: groups Why is your patient in the hospital (Answer in your own words and include the History of present Illness): increase due to the pain Assess vital signs & lab values 3. Help with Toileting schedule -- UAP - ST elevation will reveal a MI vSim ISBAR ACTIVITY - Encourage the use of soft-bristled toothbrush - Administer thromoblytics to dissolve thrombus in the coronary artery , allowing blood flow through the coronary or show Concepts like perfusion (Carl Shapiro) and fluid and electrolytes (Stan Checketts) are integrated into prioritization and decision making for next steps . bell This question was created from Unit 5 Post-Class Using Quotations and Paraphrasing Activities. embolus Please explain how lidocaine corresponds with the topic of Post st-elevation myocardial infarction. related to the MI. : 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. non-modifiable cardiac risk factors: family hx, increasing age, gender, and race. Temp: 99 F (37 C) 1:27 You identified the patient. This ISBAR activity assists you in building the skill of communicating pertinent information when caring for a alcohol. 4. which decreases Log into thePoint and launch the assigned vSim, following all instructions contained in this maintaining a stable BP, What are you on Alert for with this patient? o The same vSim patient will be assigned to you in your DocuCare cases, so it will directly align with LEARN FLOW - STEP SIX Reflection Questions and Lasater Evaluation problems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. can do it? is characterized by a ventricular rate > 300 bpm, an extremely irregular rhythm w/o specific pattern, and irregular, undulating waves w/o recognizable QRS complexes. Assessing carotid pulse BP 122/ Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. Is the following statement true or false? Blood pressure: 123/73 mm Hg. Take as directed, with water and food to avoid nausea, do not crush or chew. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. Feeding patient when necessary -- UAP List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above alert or complications? If administering Vasopressin, what dosage would he nurse expect to administer? nursing interventions, and other patient information associated with the patient situation. Terms of Use remediation prior to the virtual simulation. Students also viewed 5. He reports that he has mild pain and pressure in his lower abdomen. o Student may take several times using the answer key to provide immediate 5. immediately and CPR was started. when the nurse discovers a pt is not visibly breathing, the nurse knows that which of the following is immediate priority? (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) Initial i. HR 82 ii. monitoring) View 6. using aspetic technique capillary refill / oxygenation saturation Priorities for Managing the Patients Care Today GOAL: relief of chest pain and establish stable rhythmic heartbeat, OUTCOME CRITERIA NURSING ORDERS RATIONALE DOCUMENTATION/, Monitor non verbal helped relieved chest pain. HFand the nurse recognizes that ST elevation on the 12-lead ECG typically indicates which of the following? document. This activity provides you process or condition, the anticipated physical assessment ndings, vital signs, diagnostics, specic tests for biomarkers-- substances The prolonged ischemia causes cellular injury, leading to infarction or death of the cells. - Patient ambulates safely with a steady gait with no assistive devices and without feeling any dizziness, fatigue or nausea The aneurysm Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. Quiz is recorded as complete. 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. carl shapiro vsim documentation concept map worksheet describe disease process affecting patient (include pathophysiology of disease process) myocardial Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions Harvard University University of Georgia University of the People Hi, I'm a RN in the orthopedic floor. check for pulmonary edema 8 minutes into the scenario he went into ventricular fibrillation then went unconscious and CPR needed to be performed. process Pt howsuggestive PT was diagnosed with acute MI. What nursing or medical interventions may prevent the o Plan of Care Concept Map relaxation techniques Therapeutic class: NSAIDs - Patient will develop circulatory overload from infusion of normal saline This new feature enables different reading modes for our document viewer. 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. cant be stablished, Telemetry Unit Student is to complete the simulation as many times as it takes to meet an 80% benchmark. Review the smart sense links found within the Nursing Care, Diagnostics and Pharmacology areas of the Transdermal patch- apply once a day in the morning. He was diagnosed Electrolyte imbalances What nursing or medical interventions may prevent the above Alert or complications? - measures the hearts electrical activity LEARN FLOW - STEP THREE 3 Launch the virtual simulation Monitor cardiac This new feature enables different reading modes for our document viewer.By default we've enabled the "Distraction-Free" mode, but you can change it back to "Regular", using this dropdown. (Signs & Symptoms). usually Before beginning any vSim, please review all worksheets and rubrics, compare to previous working on SITUATION monitoring. of sodium The Six Step Weight: 110 kg Any orders or recommendations you may Creatinine: 0.7 mg/dL N/A NS 25 mL/hr Consults Needed: counseling/ support (thatteam 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. relieve discomfort, Nitroglycerin helps Pt medication to prevent clotting that could lead to a, Nurse aid can help position pt as needed, can also assist 2. - PCI also teach-back also help lessen pts 1. Discuss safety aspects during defibrillation. ECG: 1. If PT is hairy, you may have to shave the hair first. - Have PT chew non-enteric-coated tablet Assess pain Ventricular fibrillation- its a life-threatening cardiac emergency that causes rapid, irregular and ineffective 5. 7. If you need additional Pharm-4-fun sheets, add these with the which might help First, there is reduced blood flow in a coronary artery that is What aspects of the patient care can be Delegated and who can do it? 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) or necrosis No Initials: C.S Student Name: Terms of Use 2. retake the quiz modifiable cardiac risk factors can include hyperlipidemia, tobacco, HTN, diabetes, metabolic syndrome, obesity, and physical inactivity. or decrease pts HPlt]tM {sY'j. - Watch for small, round, red pinprick spots, bleeding gums, signs of GI bleeding Company Registration Number: 61965243 Dyspnea, productive cough w/ blood tinged frothy sputum , cold clammy skin, cyanosis, (How will I identify the above signs & symptoms? - Percutaneous Deep breathing exercise can also help lessen pts anxiety which will also help towards maintaining a stable BP. Weight: 110 kg 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 - elevates on second or third day after hospitalization): 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. PT has Oliguria, anuria, edema, altered skin color, altered LOC, hypotension 2. 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? the Administer supplemental oxygen; ensuring oxygen saturation is at 92% or higher 2. 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. His troponin levels are 2.2, CK-MB levels: 20, creatinine: 0.7 and REPLACEMENT - Monitor VS, especially BP and pulse rate This activity packet is intended to be used with your assigned virtual patient found in vSim. He was admitted to the ED today for complaints of chest pain, diaphoresis, and shortness of breath. for return of spontaneous circulation to prevent platelet aggregation List Complications may occur related to dx, procedure, Log into thePoint and launch the assigned vSim, following all instructions posted on your learning PT started to breath and had a pulse after defibrillator was shocked. 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. CK-MB, During ventricular fibrillation, pitressin (Vasopressin) may be used in place of epinephrine for the first or second dose. 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). A central line takes more time to place. NURSING DIAGNOSIS: Pain, acute. breathing Full Document, What is the purpose and mechanism of action of the following drugs prescribed for an acute myocardial infraction? May depress breathing (report any breathingproblems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. RR 12 iv. What got me more nervous was the background Describe two of these and explain whether these issues concern you. Low I can imagine how stressing it must be for them to see Mr. Shapiro lose consciousness due to ventricular fibrillation. I - Patient can teach-back the important information about all prescribed drugs such as: dosage, route, and adverse effects including those he must seek immediate Suggest student complete the vSim Tutorial prior to launching Step Three. LEARN FLOW - STEP FIVE 5 Document During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? Administer 2. 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? 0 mg transdermally once a day for 12 to 14 hours as prescribed by physician O\w 7}\?. Please include examples to bolster any statements made. What is the next drug after epinephrine that the nurse should expect to administer to the patient in ventricular fibrillation? 2. Review the information contained in the patient information. Assess for decreased urinary output 6. 6. DOB: 7/19/1966 supply and demand. in 12-20 hr, and returns to normal in PT was on supplemental oxygen via nasal canula at 4L/Min to maintain a SpO2 of greater than 92%. Review the smart sense links associated with the Pharmacological agents found in the suggested above alert or complications? during v fib, pitressin (vasopressin) may be used in place of epi for the first or second dose. ESR: NKA Clinical Worksheet Assigned vSim: Carl Shapiro Isolation: o If you do not achieve 100% you must go back and re-do the simulation exercise and then Patients name, age, specic reason for visit BACKGROUND NO PRECAUTIONS If administering Vasopressin, what dosage would the nurse expect to administer? The patient will not experience a pain level higher than 0/10 throughout day Instructor approach, pertinent Assess IV sites frequently- IO access is the route use for drug delivery in emergency situations when an IV access -WBC: with ambulation to the bathroom. List the pathophysiology associated with the pa, physical assessment findings, vital signs, diagnos. When viewing the past medical history, the nurse identifies which cardiac risk factors specific to Carl Shapiro? 1. o Student is to complete the simulation as many times as it takes to meet a 100% benchmark. T/F: if carl shapiro had proceeded into asystole after v fib, continuing to defibrillate would have been the appropriate intervention. additon to this Clinical Replacement Activity Packet, submit for grading as instructed in your syllabus. diagnosis, date of He was treated in the Emergency Department with aspirin and two doses of sublingual nitroglycerin. clinical replacement (see syllabus for details). MI, indicating inflammatory response ECG: sinus rhythm w/ anterior myocardial infarction. Administer ASA levels delegated. rounds of CPR before regaining consciousness. He was treated with -can Management of Care: What needs to be done for this Patient Today? 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! Pt medication to prevent clotting that could lead to a. myocardic ischemia, which could further lead to pulmonary edema. o Students are to complete the Lasater Evaluation on each vSim. Sublingual pills go under the tongue, dont chew or crush. 4. 48-72 hours. Transfer: Temp 99F v. SPo2 97% . Additional comments: "Try to first choose the mos. 2. Review the information contained in the patient information. Current pertinent - coolness in extremities IV in the R AC NS running at 25 ml/hr AOx 4 Pain is 0/10 after the second dose of nitro Cardiac focused assessment A. every 15 minutes, 3 doses max B. I would like to recommend continuous ECG monitoring. Cardiac enzymes and isoezymes: Current pertinent assessment data using head Utilize the smart sense links throughout the vSim to complete the worksheet. to toe approach, pertinent diagnostics, vital Fluid/Rate: or pulmonary He has no previous cardiac history and this is his first presentation to hospital with chest pain. ontroponin Ventricular fibrillation could have been caused by the elevated levels of troponin I and CK-MB. most common causes include vasospasm, decreased oxygen supply, and increased demand for oxygen. learn flow in vSim is to be followed as instructed below. Administer supplemental oxygen at 4 L/min via nasal canulla PT is receiving Carl Shapiro Virtual Simulation Virtual simulation through the Point online resource University National University (US) Course Medical-Surgical Nursing II (NSG 320) 23 Documents Academic year:2021/2022 Uploaded byChad Cronin Helpful? 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. progression of a pre in addition to the Clinical Replacement Activity Packet (worksheets included in this document), submit the 1. site,fatigue, chills 1. Dyspnea, productive cough w/ blood tinged frothy Allows Dr to see shape and size of heart and also check for pulmonary edema related to the MI. ischemic episodes (ST segment BP: 122/73 alleviate discomfort, assist pt in ASA 325 mg PO and two doses of NTG 0.4 mg. 2. c. - obesity Shift Goals/ Patient Education Needs: FINDINGS - chest pain Once you have completed the Six Steps, hearts o2 demand, Pt reported no pain after Log into thePoint and launch the assigned vSim, following all instructions included in this SpO2 97% Temp: 99 F Counscious state: appropriateECG: sinus rhythm w/ anterior myocardial infarction, Any orders or recommendations you may have for this patient, Dietary modification Follow medication therapySmoking cessation Cardiac reha-helps educate and assists pt with safe exercise, diet choices, stress management, NAME OF MEDICATION, CLASSIFICATION AND INCLUDE PROTOTYPE, 2 mg IV push PRN chest pain every 10 mins x3 as prescribed by physician, PATIENT EDUCATION WHILE TAKING THIS MEDICATION. handling Appropriate actions you should do to complete this activity include nding appropriate data to provide a PT shocked and had 2 Carl is a caucasian male, presenting with HTN and obesity and had hx of cigarette smoking and physical inactivity. through their behavior, Pain may cause RR to
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