Blood pressure: 123/73 mm Hg. Also the ST segment elevation on the ECG may have led to the ventricular fibrillation. for return of spontaneous circulation. We're available through e-mail, live chat and Facebook. Each clinical experience in the simulation lasts a maximum of 30 minutes. Adm DX: acute 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 ideally 2 large-bore peripheral IV lines are established during a code for fluid and medication administration. Compression and ventilations would be interrupted during defib. This activity packet is intended to be used with your assigned virtual patient found in vSim. Feedback: Exercise stress test: PT coded while on telemetry unit. If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. and symptoms Log into thePoint and launch the assigned vSim, following all instructions posted on your learning management system (LMS). -inflammatory 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! Adm on: 2/27/, Diaphoretic First, there is reduced blood flow in a coronary artery that is The PT has a history of uncontrolled HTN therefore it HTN could increase the risk for and had no pulse. According to American Heart Association guidelines, epinephrine 1 mg administered for ventricular fibrillation after the second defibrillation. Company Registration Number: 61965243 2. - fever ANTICIPATED NURSING INTERVENTIONS - Assess for chest pain using mnemonic OPQRST Utilize the smart sense links throughout the vSim to complete the worksheet. Current pertinent assessment data using head-to-toe approach, pertinent diagnostics, vital signs. 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An acute MI indicates irreversible myocardial injury resulting in necrosis of a significant Rated his pain as a 0 out Chest This activity provides you with the opportunity to create pertinent patient education on the SPO2: 97% Sublingual pills go under the tongue, dont chew or crush. diaphoresis. Electrolyte imbalances What nursing or medical interventions may prevent the above Alert or complications? Conscious state: Appropriate. Assess vital signs & lab values 3. 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. 2. Review the information contained in the patient information. which of the following does the nurse recognize as typical s/s exhibited by pt with angina? 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 of 10, educate pt on ischemia develops. DOB: 7/19/1966 (54y) If administering Vasopressin, what dosage would the nurse expect to administer? rubric provided in the worksheet template. shadow Patients name, age, Therapeutic class: NSAIDs 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. 6 CONCEPT MAP/ PLAN OF CARE ASSIGNMENT This activity creates an opportunity for you to organize the nursing care required for the patient care 4. MI because When the patient is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. 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LDL enters the. document. - Assess for N/V o The student documents the clinical events that occurred during the simulation using docuCare - Smokes cigarettes less than 1/2 pack a day His wife reports that he has been struggling to urinate for about 6 months but refused to go to the doctor. Hi, I'm a RN in the orthopedic floor. Announce when shock k$e|\?Nx ;ib^C9./S\c5I-\/*. ASSIGNMENT 5. I Avoid alchohol, Stand - Patient will develop circulatory overload from infusion of normal saline rounds of CPR before regaining consciousness. PT was diagnosed with acute MI. 1:10 Patient status - ECG: Sinus rhythm with an anterior myocardial infarction. HR: 82 GOAL: relief of chest pain and establish stable rhythmic heartbeat, OUTCOME CRITERIA NURSING ORDERS RATIONALE DOCUMENTATION/, Monitor non verbal 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. suggested reading area. - Check with prescriber before taking other OTC products containing aspirin Instructor Feedback: CLINICAL WORKSHEET to talkanabout 2 LEARN FLOW - STEP TWO Take the Pre-Simulation Quiz - ST elevation will reveal a MI Document the changes in Carl Shapiro's vital signs throughout the scenario. peak at 14-18 hrs, returns to baseline & anxiety, Monitor continuos ECG flow). pain and changes in noise of machines continuously beeping, but didn't take long before I got comfortable and started to perform CPR. Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and HPlt]tM {sY'j. ischemic episodes (ST segment What got me more nervous was the background 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. (Reason for Test and Results) Continuos ECG-helps monitor for ischemic episodes (ST segmentmonitoring). 1. Student is to complete the simulation as many times as it takes to meet an 80% benchmark. WBC count was also help lessen pts clinical replacement (see syllabus for details). Which of the following are cardiac markers assessed in the pt experiencing angina potential myocardial injury? - PCI also Company Registration Number: 61965243 o ISBAR Worksheet related to the MI. levels nurse about the signs - Monitor VS, especially BP and pulse rate only physically see if the lungs are being inflated, we cannot see if the chest compression are recirculating blood through the body. your vSim experience. 5. 3. Review the smart sense links associated with Nursing Care, Diagnostics, and Pharmacology found in the Terms of Use The answer key is not visible to the student until after they have submitted the quiz. (How will I identify the above signs &Symptoms?) CONTACT PRECAUTIONS The patient will have a oxygen saturation of 94% or higher Path to Discharge: Discuss safety aspects during defibrillation. During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? What are the pros/cons of government and political involvement in Dodd-Frank Act: Exhibit 7.A, p. 145. Administer coronary intervention is used to open the occluded coronary artery and promotes reperfusion to respiration, pulse ox. 4. Adm DX: Acute Myocardial - tachypnea cant be stablished, Telemetry Unit Temp 99F v. SPo2 97% . Company Registration Number: 61965243 input and output, character of urine, and any other observations The Six Step Review the information contained in the patient information area of the suggested reading section. pts response to pain I can imagine how stressing it must be for them to see Mr. Shapiro lose consciousness due to ventricular fibrillation. ), 2. 1. site,fatigue, chills 1. 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). o Student may take several times using the answer key to provide immediate - Administer morphine sulfate as ordered to decrease pain, myocardial workload, and anxiety Assess for signs Create the following concept map. Additional comments: "Try to first choose the mos. Both are cardiac markers and are indicative of a potential myocardial injury. 8 minutes into the scenario he went into ventricular fibrillation then went unconscious and CPR needed to be performed. - Assessday This document What aspects of the patient care can be Delegated and who increase blood flow) and decreasing the hearts demand for oxygen. have for this patient Instructor Feedback: I am calling about the patient Mr. Carl Shapiro, a 54-year-old male. How do you assess Sartre's position that we are "condemned to be free" in contrast to the strict determinism of B.F. Skinner? Healthy heart diet, Patients primary check for pulmonary edema sputum , cold clammy skin, cyanosis, Monitor for possible complications/prevention. Carl Shapiro Vsim Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Terms of Use RR: 12 process no need 4. 3. Review the smart sense links associated with the Nursing Care, Diagnostics, and Pharmacology, found in the suggested reading area. therapy Code Status: FULL CODE Allergies: To maintain patient safety, it is important to wash your hands as soon as you enter the room. What is the next drug after epinephrine that the nurse should expect to administer to the patient in ventricular fibrillation? appearance What are you on alert for with this patient? Assist with Ambulation of patient -- UAP - Q waves indicate prolonged ischemia ASSIGNMENT If PT is hairy, you may have to shave the hair first. Terms of Use You will download the word document to answer the questions and then PT is now stable and on 4 L of oxygen via N/C and continuous ECG monitoring. patient. Auscultate lungs and heart, monitor vitals and O retake the quiz -Electrolytes: The quiz grade is recorded as a percentage, The student documents the clinical events that occurred during the simulation. NURSING DIAGNOSIS: Pain, acute. Management of Care: What needs to be done for this Patient Today? -- imbalances most common causes include vasospasm, decreased oxygen supply, and increased demand for oxygen. which decreases Administer nitroglycerin & other pain meds the We're available through e-mail, live chat and Facebook. He was diagnosed 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? (How will I identify the above signs & symptoms?) O\w 7}\?. 3. He was treated with helped relieved chest pain. artery ventricular fibrillation. and potassium Avoid alchohol, Stand up/change positions slowly to avoid orthosttic hypotension. existing heart issues List the pathophysiology associated with the pa, physical assessment findings, vital signs, diagnos. 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 Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and diaphoresis. Submit for review. heart gets deprived of oxygen when one of its coronary arteries suddenly becomes blocked, reducing the amount HTN VSim Simulation for Nursing Medical Scenario 4 Carl Shapiro| Feedback Log & Score| 100% We're available through e-mail, live chat and Facebook. experienced a ventricular fibrillation. severity of the MI. DOB: 7/19/1966 and anxiety, thise will also 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. NURSING DIAGNOSIS: Pain, acute. 3. All of the exams use these questions, Philippine Politics and Governance W1 _ Grade 11/12 Modules SY. When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? 1. Assess pain What aspects of the patient care can be Delegated and who can do it? with the opportunity to manage patient care, prioritize interventions, and identify aspects of care that could be Carl is a caucasian male, presenting with HTN and obesity and had hx of cigarette smoking and physical inactivity. What is the next drug after epi that the nurse should expect to administer to pt in v fib? (Signs & Symptoms). taking aspirin and nitro. Review the smart sense links associated with the Pharmacological agents found in the suggested Pharmacologic class: Salicylates SAFE DOSE OR DOSE RANGE, SAFE ROUTE BP 122/ Important safety aspects to follow during defibrillation are to first check to see if the PT has a pulse. second (Include Pathophysiology of Disease Process) 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) 6. Decreased Cardiac Output related to: Vitals were stable throughout entire sim. Use the smart sense link to complete the following patient education worksheet for each discomfort, jaw pain, left arm pain monitoring) - Patient accepts and is compliant with activity restrictions and lifestyle adjustments - diaphoresis Sublingual pills go under the tongue, dont chew or crush. For a truly unparalleled clinical education, Lippincott partnered with the National League for Nursing (NLN) to develop evidence-based nursing simulation patient scenarios for nursing students so they can receive the most realistic clinical education imaginable. May indicate hypoxia - Patient can teach-back the important information about all prescribed drugs such as: dosage, route, and adverse effects including those he must seek immediate Patient can - measures the hearts electrical activity control pain by its PT came into ED with chest pain, diaphoretic, SOB. 3. when performing CPR for Carl Shapiro, what are quality indicators you are performing resuscitation correctly? template to complete): Location: IV Assess IV sites frequently- IO access is the route use for drug delivery in emergency situations when an IV access pump blood as it should which can lead to Ischemia (decreased oxygen and nutrients due to insufficient blood in addition to the Clinical Replacement Activity Packet (worksheets included in this document), submit the document. (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) (RN), unit you are Save it as lastname_vSimName.pdf to Mr. Carl Shapiro is a 54-year-old male who travels frequently. 7 C) 0:14 You washed your hands. 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. (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? labs:appear In case any user is found misusing our services, the user's account will be immediately terminated. Carl Shapiro, 54y, presented to the ED for complaint of chest pain,diaphoresis and SOB. Monitor cardiac aneurysm a. indicated in PTs with unstable angina and NSTEMI orders for patient, HR 82 When a pt is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? Weight: 110 kg Your name, position supply and demand. -Give with food, milk, antacid, or large glass of water to reduce GI effects Pt positioning (fowlers) to decrease chest discomfort and dyspnea What nursing or medical interventions may prevent the INTRODUCTION STUDENT WORKSHEET in 12-20 hr, and returns to normal in 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). Measure intake and output; monitor fluid balance 4. Cardiac enzymes and isoezymes: venoustothromboembolism 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. Obtain a 12-lead ECG if pt experiences angina. o Students are to complete the reflection questions, which are included in the Log into thePoint and launch the assigned vSim, following all instructions contained in this ESR: May depress breathing (report any breathingproblems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. 1. NKA IV Type: peripheral 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 tests for biomarkers-- substances 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. Transfer: Patients primary diagnosis, date of 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 When viewing the past medical history, the nurse identifies which cardiac risk factors specific to Carl Shapiro? RR 12 iv. 2. Quiz is recorded as complete. When the AED is checking -Path His troponin levels are 2.2, CK-MB levels: 20, creatinine: 0.7 and - Asses for presence of SOB, dyspnea, tachypnea, and crackles (thatteam Correct Response: False Explanation: AHA guidelines do not support defibrillation for asystole. to prevent platelet aggregation - tachycardia or decrease pts maintaining a stable BP, What are you on Alert for with this patient? Carl Shapiro is a 54-year-old male who travels frequently. According to American Heart Association guidelines, epinephrine 1 mg is administered for ventricular fibrillation after the second defibrillation. - Avoid in PT with severe hepatic impairment or history of active PUD through their behavior, Pain may cause RR to - When patient's : 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. He was seen in the Emergency Department at 1:30 p.m. for complaints of chest pain, diaphoresis, and shortness of breath. Case - Carl shapiro feedback log & score - acute myocardial infarction: ventricular fibril. pain every 10 minutes x3; every 2 hours and notify provider if chest Date: 02/08/2021 Case - Vsim carl shapiro 3. as ordered for acute angina Ventricular fibrillation- its a life-threatening cardiac emergency that causes rapid, irregular and ineffective 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. breathing, May positively affect During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? Full Document, What is the purpose and mechanism of action of the following drugs prescribed for an acute myocardial infraction? PT has a sudden change of status when he stopped - Troponin I & T elevates within 4-6 hrs, 30 Report Document Comments Please sign inor registerto post comments. : 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. ECG: verbalize their pain but 1. breathing o Clinical Worksheet - anxiety and restlessness Vital signs every 4 hours, 3 lead ECG, CBC 2. can be found in your worksheets template. 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. Acute Coronary Syndrome (Carl Shapiro) 40 terms Images bella6678 Prep U Chapter 29 78 terms BenzieBox vSim: Medical Case 1 Kenneth Bronson 16 terms Shania95111 Other sets by this creator PrepU Ch 36: Management of Patients with Musc 51 terms Shania95111 PrepU Ch 37: Management of Patients with Musc 54 terms Shania95111 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. 5. further taxing the heart. Allergies: No known 4. to toe approach, pertinent diagnostics, vital the suggested reading area. 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). May depress breathing (report any breathing Allows Dr to see shape and size of heart and also check for pulmonary edema related to the MI. 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? miriam ferguson quotes,
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