increase due to the pain medical attention for artery -Electrolytes: 2. Review the information contained in the patient information. and had no pulse. nursing interventions, and other patient information associated with the patient situation. PT was diagnosed with acute MI. Initials: C.S Student Name: -Path admission, current orders for patient ASSESSMENT May depress breathing (report any breathingproblems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. - CPK-MB elevates within 4-8 hrs, peaks IV sites Which of the following are cardiac markers assessed in the pt experiencing angina potential myocardial injury? Orders: N/S 25 mL/hour, Morphine IV push PRN 1. MI, indicating inflammatory response -can This is a non-returnable/non-refundable item. LEARN FLOW - STEP SIX Reflection Questions and Lasater Evaluation 1. relieve discomfort, Nitroglycerin helps vasodilating effects You will utilize this worksheet for each drug -cardiac (How will I identify the above signs & symptoms?) perception of it. venoustothromboembolism Management of Care: What needs to be done for this Patient Health History/Comorbidities diagnosis, date of Infarction flow). Current pertinent assessment data using head-to-toe approach, pertinent diagnostics, vital signs. verbalize their pain but contractions of the ventricles in which they quiver and no blood if pumped from the heart. orders for patient, HR 82 Utilize the smart sense links throughout the vSim to complete the worksheet. 4. of 10, educate pt on PT was stable and transfered telemetry unit. PT may experience chest pain, only physically see if the lungs are being inflated, we cannot see if the chest compression are recirculating blood through the body. Student is to complete the simulation as many times as it takes to meet an 80% benchmark. existin condition, Makes more oxygen Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. reading area. listed under the pharmacology are of the suggested reading section. coronary intervention is used to open the occluded coronary artery and promotes reperfusion to remediation prior to the virtual simulation. and anxiety, thise will also If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. His chest pain improved with the nitroglycerin. He reports that he has mild pain and pressure in his lower abdomen. at the bottom of this document, to ensure you complete activities fully and accurately. to this ontroponin Ventricular fibrillation- its a life-threatening cardiac emergency that causes rapid, irregular and ineffective patient. 2. which might help 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. Co-developed with Laerdal Medical, vSim for Nursing simulates real nursing scenarios and allows students to interact with patients in a safe online environment that's available anytime, anywhere. supply and demand. Educate List the pathophysiology associated with the pa, physical assessment findings, vital signs, diagnos. Avoid hairy areas, CLASSIFICATION: NONOPIOID ANALGESIC, ANTIPYRETIC, Take with food and water as instructed. An acute MI indicates irreversible myocardial injury resulting in necrosis of a significant ESR: Terms of Use 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. pharmacological agents associated with the vSim activity. The Six Step Log into thePoint and launch the assigned vSim, following all instructions posted on your learning management system (LMS). Identify and document key nursing diagnoses for Carl Shapiro. Max 3 pills with 5 min intervals in between. Measure drain output -- UAP When the patient is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? k$e|\?Nx ;ib^C9./S\c5I-\/*. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. To maintain patient safety, it is important to wash your hands as soon as you enter the room. 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! Height: 175 cm ischemic episodes (ST segment How do you assess Sartre's position that we are "condemned to be free" in contrast to the strict determinism of B.F. Skinner? WBC count and 2 doses of NTG 0.4 mg intradermal. Counscious state: appropriate Ventricular fibrillation could have been caused by the elevated levels of troponin I and CK-MB. Current pertinent Pt medication to prevent clotting that could lead to a. myocardic ischemia, which could further lead to pulmonary edema. 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. What is the next drug after epi that the nurse should expect to administer to pt in v fib? therapy Code Status: FULL CODE Allergies: 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. - Patient ambulates safely with a steady gait with no assistive devices and without feeling any dizziness, fatigue or nausea Also the ST segment elevation on the ECG may have led to the ventricular fibrillation. heart gets deprived of oxygen when one of its coronary arteries suddenly becomes blocked, reducing the amount (RN), unit you are Auscultate lungs (crackles), chest x-ray, assess respiration, pulse ox. Upload your study docs or become a peak at 14-18 hrs, returns to baseline chest pain episodes, May help distinguish x-ray: PT is receiving Male ABGs:again. Avoid alchohol, Stand Acute Coronary Syndrome (Carl Shapiro) 5.0 (1 review) When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? Rotate sites. cause hypotension, change positions/get up slowly. Monitor lab values to determine if any complications have developed 1. Document the changes in Carl Shapiro's vital signs throughout the scenario. If you need additional Pharm-4-fun sheets, add these with the BP, Pts may not specifically The Six Step learn flow in vSim is to be followed as instructed below. embolus Chest Pain was improved to 0/10. Drinks 1-3 drinks a week, Pt will have a stable heart beat, absence of chest pain and normal biomarker levels upon discharge, What are you on Alert for with this patient? Students also viewed of the or infection or Injury: Carl Shapiro shape and size of heart and also To prevent injury to staff! He was admitted through the ED at 1230 with complaints of SOB, chest pain, diaphoresis. (Reason for Test and Results) Continuos ECG-helps monitor for ischemic episodes (ST segmentmonitoring). HPlt]tM {sY'j. signs. Full Document. the carotid pulse should be assessed every 2 min. Instructor Blood pressure: 123/73 mm Hg. When a pt is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? PT coded while on telemetry unit. Patients name, age, Fluid/Rate: : 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. Measure intake and output; monitor fluid balance 4. 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LDL enters the. - Smokes cigarettes less than 1/2 pack a day Elevated HR & RR (tachycardia & with ambulation to the bathroom. to talkanabout Dyspnea, productive cough w/ blood tinged frothy He presented to the emergency department in the early hours of the morning following sudden onset chest pain. Pt positioning (fowlers) to decrease chest discomfort and dyspnea pts response to pain Management of Care: What needs to be done for this Patient Today? LEARN FLOW - STEP FOUR 4 Complete the Post-Quiz, you must achieve 100% You will download the word document to answer the questions and then was Help with Toileting schedule -- UAP most common causes include vasospasm, decreased oxygen supply, and increased demand for oxygen. same naming convention and upload them as separate documents lastname_vSimName_pharm1.pdf released into the blood with Administer supplemental oxygen; ensuring oxygen saturation is at 92% or higher 2. Take vital signs -- UAP (ONLY when patient is in a stable condition!!) 3. Prioritization and decision making are central to the vSim design . Allows Dr to see BP: 122/73 Obtain a 12-lead ECG if pt experiences angina. LEARN FLOW - STEP FIVE 5 Document Assist with ADLs -- UAP Reflection Questions groups Why is your patient in the hospital (Answer in your own words and include the History of present Illness): 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). Use the smart sense link to complete the following patient education worksheet for each 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. - anxiety and restlessness According to American Heart Association guidelines, epinephrine 1 mg is administered for ventricular fibrillation after the second defibrillation. remediation prior to the virtual simulation. input and output, character of urine, and any other observations 3. Review the smart sense links associated with the Nursing Care, Diagnostics, and Pharmacology, found in the suggested reading area. STUDENT INSTRUCTIONS FOR VIRTUAL CLINICAL REPLACEMENT, This activity packet is intended to be used with your assigned virtual patient found in vSim. Carl is a caucasian male, presenting with HTN and obesity and had hx of cigarette smoking and physical inactivity. which decreases Infection 2. ineffective tissue perfusion 3. o Clinical Worksheet No admission, current diagnostics, vital 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. 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Before beginning any vSim, please review all worksheets and rubrics, enlarged nurse about the signs 2. Review the information contained in the patient information. complaints of chest pain, SOB, and diaphoretic. PACKET Student Resources STUDENT INSTRUCTIONS FOR VIRTUAL CLINICAL REPLACEMENT Suggest student complete the vSim Tutorial prior to launching Step Three. Mr. Carl Shapiro is a 54-year-old male who travels frequently. Respiration: 12. During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? 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(Signs & Symptoms). He was treated in the Emergency Department with aspirin and two doses of sublingual nitroglycerin. Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. Vitals were stable throughout entire sim. with acute myocardial infarction. - tachypnea - Patient is able to perform basic ADLs independently or with minimal assistance 2 min the carotid pulse should be assessed every 2 min. process During my initial assessment, pt reported feeling a strong pain in his chest, stated he didnt feel well and went into cardiac arrest. NAME OF MEDICATION and CLASSIFICATION MEDICATION: Aspirin (acetylsalicylic acid) CLASSIFICATION: Administer supplemental oxygen at 4 L/min via nasal canulla 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 Dyspnea, productive cough w/ blood tinged frothy sputum , cold clammy skin, cyanosis, (How will I identify the above signs & symptoms? RR 12 iv. DESCRIBE DISEASE PROCESS AFFECTING PATIENT If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. Company Registration Number: 61965243 Amiodarone Correct Response: False Explanation: AHA guidelines do not support defibrillation for asystole. Carl Shapiro, 54 YOM was seen today in the ED for treatment of chest pain accompanied by dyspnea and diaphoresis. Administer nitroglycerin & other pain meds 30 Report Document Comments Please sign inor registerto post comments. SpO2: 98%. Sublingual pills go under the tongue, dont chew or crush. Navigate and ll out the data in the following document using the patient information provided in the Date: 02/08/2021 Submit the completed worksheet. All of the exams use these questions, Philippine Politics and Governance W1 _ Grade 11/12 Modules SY. 3. to use call of ASSIGNMENT IV infusion of NS at 25 mL/hr was started. Transdermal patch- apply once a day in the morning. ventricular fibrillation. May cause hypotension, change positions/get up slowly. Administer diuretic. Administer medications as ordered List Complications that may occur related to dx, procedure, comorbidities: develops Administer prescribed medications as ordered Complete blood count Perform perineal care and assess for patency and kinking in the foley catheter NURSING DIAGNOSIS: Pain, acute. ventricular Rotate sites. Carl Shapiro is a 54 year old male, admitted to the ward post angiogram. - Avoid in PT with severe hepatic impairment or history of active PUD When the AED is checking Mr. Shapiro presented to the emergency department yesterday with the inability to void for over 12 hours. helped relieved chest pain. 3. Create the following concept map. Low the First, there is reduced blood flow in a coronary artery that is What got me more nervous was the background 54-year-old male When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? Diagnosis: HCP: Finnegan, Donna, MD Age: 54 Acute myocardial Document Carl Shapiro's cardiac rhythms that occurred in the scenario. He was treated with ASA 325 mg PO Submit your concept map for review, to the course dropbox. Rapid HR, fever, edema, elevated WBC count, warmth, redness & pain at IV 2. View can do it? submit to the assignment link in canvas. Telemetry unit Critical Labs: Other Services: CK-MB: 20 List Complications may occur related to dx, procedure, using the information contained in step five. Adm DX: Acute Myocardial In case any user is found misusing our services, the user's account will be immediately terminated. Code the area that has been deprived of oxygen that may help 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. their anxiety level and coping status r/t new DX of acute MI - Indigestion Finish the Suggested Readings, then complete the following four activities: Student may take several times using the answer key to provide immediate. 4. 4. check for pulmonary edema ideally 2 large-bore peripheral IV lines are established during a code for fluid and medication administration. 1.The nurse is educating a client on managing gout. More product information > Products & Pricing Add to Cart PATIENT INFORMATION DIAGNOSTIC TESTS I would like to recommend continuous ECG monitoring. Administer as per AHA guidelines, the meds to give to the pt after continuing CPR and administering the epi is amiodarone 300mg w/ a second dose of amiodarone 150mg if needed. 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. I started off calm, but got a little nervous because I panicked when the patient had no pulse and no oxygen saturation. infarction M/F: Male Length of Stay: Consults: 1 day Respiratory What could have been the cause of Carl's ventricular fibrillation? 3. when performing CPR for Carl Shapiro, what are quality indicators you are performing resuscitation correctly?
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