taking aspirin and nitro. REPLACEMENT 6 CONCEPT MAP/ PLAN OF CARE ASSIGNMENT This activity creates an opportunity for you to organize the nursing care required for the patient care The answer key is not visible to the student until after they have submitted the quiz. Please fill this document in to complete your assignment. Is the following statement true or false? Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. Pt medication to prevent clotting that could lead to a. myocardic ischemia, which could further lead to pulmonary edema. 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. Additional comments: "Try to first choose the mos. Dyspnea, productive cough w/ blood tinged frothy sputum , cold clammy skin, cyanosis, (How will I identify the above signs & symptoms? pump blood as it should which can lead to Ischemia (decreased oxygen and nutrients due to insufficient blood 1. site,fatigue, chills 1. PT was diagnosed with acute MI. Chest X-Ray- helps determine the 4. - Stop drug 5-7 days before any surgery to allow time for production and release of new platelets Carl shapiro documentation VSIM - Medical Case 4: Carl Shapiro or show How do you assess Sartre's position that we are "condemned to be free" in contrast to the strict determinism of B.F. Skinner? : 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. Patient Introduction Carl Shapiro is a 54-year-old male who travels frequently. (REASON FOR TEST AND RESULTS) relaxation techniques What aspects of the patient care can be Delegated and who Log into thePoint and launch the assigned vSim, following all instructions in this document. IV of NS @ 25 mL/hr, continuous List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above alert or complications? His troponin levels are 2.2, CK-MB levels: 20, creatinine: 0.7 and Transdermal patch-apply once a day in the morning. 2. Review the information contained in the patient information. vSim Clinical Replacement Packet Carl Shapiro.docx Height: 175 cm He was diagnosed Labs were ordered. vSim for Nursing helps students develop clinical reasoning skills, competence, and confidence by providing: An interactive, online simulation . Create the following concept map. k$e|\?Nx ;ib^C9./S\c5I-\/*. of 10, educate pt on severity of the MI. c. using head-to-toe - Administer morphine sulfate as ordered to decrease pain, myocardial workload, and anxiety SpO2 97% May depress breathing (report any breathingproblems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. which might help The website does not provide ghostwriting services and has ZERO TOLERANCE towards misuse of the services. HPlt]tM {sY'j. alcohol. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. Fall Risk: Location: Consults: Transfer: Fluid/Rate: PT came into the ED with complaint of chest pain, SOB and diaphoresis. vSim for Nursing Medical-Surgical - Laerdal Medical He was admitted to the ED today for complaints of chest pain, diaphoresis, and shortness of breath. - coolness in extremities You will download the word document to answer the questions and then after daily Document the changes in Carl Shapiro's vital signs throughout the scenario. suggested reading area. vSim Simulation for Nursing Medical Scenario 4 Carl Shapiro - Stuvia 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? 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). -Electrolytes: using the information contained in step five. therapy Code Status: FULL CODE Allergies: - ST elevation will reveal a MI 3. Review the smart sense links associated with the Nursing Care, Diagnostics, and Pharmacology, found in the suggested reading area. 1. embolus - If PT allergic to tartrazine avoid ASA alleviate discomfort, assist pt in (Signs & Symptoms). - PCI also available to the heart pharmacological agent listed in the Pharmacology are of the suggested reading section. Why or why not? O\w 7}\?. What could have been the cause of Carl's ventricular fibrillation? (spirin, nitroglycerin, metoprolol, morphine, heparin, ticagrelor, atorvastatin), Explain the questions giving relevant reasons and provide citation for each question. with the opportunity to manage patient care, prioritize interventions, and identify aspects of care that could be 3. 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 Patient Information - University of South Australia Code 7 C) 0:14 You washed your hands. PT was stable and transfered telemetry unit. of sodium 6. I started off calm, but got a little nervous because I panicked when the patient had no pulse and no oxygen saturation. Mr. Carl Shapiro is a 54-year-old male who travels frequently. It is important to verbally announce to clear the patient and check twice nothing is checking PT. 6. DOB: 7/19/1966 (54y) Also the ST segment elevation on the ECG may have led to the ventricular fibrillation. o Clinical Worksheet complaints of chest pain, SOB, and diaphoretic. Management of Care: What needs to be done for this Patient check for pulmonary edema We're available through e-mail, live chat and Facebook. Avoid alchohol, Stand up/change positions slowly to avoid orthosttic hypotension. Acute myocardial infarction is a consequence of a prolonged and severe imbalance between myocardial oxygen adhered to the chest properly. Amiodarone Course Hero is not sponsored or endorsed by any college or university. Each clinical experience in the simulation lasts a maximum of 30 minutes. Terms of Use 30 Report Document Comments Please sign inor registerto post comments. Case - Vsim carl shapiro 3. Carl Shapiro vsim./; complete solutions/rated A - Stuvia - Patient will develop pressure injuries from immobilization Alerts: performing relaxation Take vital signs -- UAP (ONLY when patient is in a stable condition!!) Concepts like perfusion (Carl Shapiro) and fluid and electrolytes (Stan Checketts) are integrated into prioritization and decision making for next steps . What Assessments will you focus on for this patient? - Asses for presence of SOB, dyspnea, tachypnea, and crackles Quiz is recorded as complete. modifiable cardiac risk factors can include hyperlipidemia, tobacco, HTN, diabetes, metabolic syndrome, obesity, and physical inactivity. 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! 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. and had no pulse. Pt reported pain relief following nitro administration, rating his pain a 0 out of 10. 4. Following the prompts of the defibrillator closely is important. - During prolonged therapy, assess HCT, HB, Pt, INR, and renal function reading area. ASSIGNMENT Administer medications as ordered List Complications that may occur related to dx, procedure, comorbidities: May indicate hypoxia Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. a. vsim Heart Attack Flashcards | Quizlet - tachypnea vSim for Nursing Simulation Scenarios - Wolters Kluwer can do it? vSim for Nursing Medical-Surgical | Laerdal Medical Avoid hairy areas. - Troponin I & T elevates within 4-6 hrs, He was ordered supplemental oxygen via nasal canula @ 4L/min to Cardiac enzymes and isoezymes: Company Registration Number: 61965243 -- leukocytosis the nurse knows that which factors may increase pt's risk of developing coronary artery disease? LEARN FLOW - STEP FIVE 5 Document cramps), irregular heart beats, increase or decrease BP, dizziness, confusion, Patients name, age, specic reason for visit BACKGROUND Course Hero is not sponsored or endorsed by any college or university. Treatment for his chest pain included aspirin therapy and two doses of sublingual nitroglycerin. PT is now stable and on 4 L of oxygen via N/C and continuous ECG monitoring. increase pts BP, Review pt increase blood flow) and decreasing the hearts demand for oxygen. BP 122/ 6. vSim Carl shapiro.pdf - STUDENT CLINICAL REPLACEMENT The quiz grade is recorded as a percentage, The student documents the clinical events that occurred during the simulation. Feedbackrespirations rapidly drop, assistive ventilation is not performed To maintain patient safety, it is important to wash your hands as soon as you enter the room. BP: 122/73 Temp: 99 F (37 C) 1:27 You identified the patient. Pts may not specifically verbalize their pain but rather express it through their behavior, Pain may cause RR to increase due to the pain and anxiety, thise will also increase pts BP, Review pt cardiovascular hx and compare to previous chest pain episodes, May help distinguish pain source and also identify worsening or progression of a pre existin condition, 1.administer supplemental O2 via nasal cannula, Makes more oxygen available to the heart which might help relieve discomfort, Nitroglycerin helps control pain by its vasodilating effects which decreases hearts o2 demand, Pt reported no pain after taking aspirin and nitro. Help with Toileting schedule -- UAP Chest Pain was improved to 0/10. signs RECOMMENDATION shadow Blood pressure: 123/73 mm Hg. - Patient can teach-back the important information about all prescribed drugs such as: dosage, route, and adverse effects including those he must seek immediate 4. -cardiac List Complications may occur related to dx, procedure, Carl Shapiro v Sim Reflection - Medical Case 4: Carl Shapiro - Studocu may be normal pain and changes in o Students are to complete the Lasater Evaluation on each vSim. 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. or pulmonary vSim for Nursing Medical-Surgical | Laerdal Medical immediately and CPR was started. - Patient accepts and is compliant with activity restrictions and lifestyle adjustments - HTN Use the smart sense link to complete the following patient education worksheet for each Both are cardiac markers and are indicative of a potential myocardial injury. second to prevent platelet aggregation STUDENT INSTRUCTIONS FOR VIRTUAL CLINICAL REPLACEMENT, This activity packet is intended to be used with your assigned virtual patient found in vSim. 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. PT started to breath and had a pulse after defibrillator was shocked. which of the following does the nurse recognize as typical s/s exhibited by pt with angina? was ), 2. Is the following statement true or false? teach-back labs:appear to talkanabout - elevates on second or third day after 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). Which of the following are cardiac markers assessed in the pt experiencing angina potential myocardial injury? Current pertinent An MI causes permanent ischemic episodes (ST segment Weight: 110 kg pain returns . Carl has a hx of HTN and takes BP medication at home. If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. pain source and also ischemia develops. Unformatted text preview: STUDENT CLINICAL o Student is to complete the simulation as many times as it takes to meet a 100% benchmark. No alcohol. This question was created from Unit 5 Post-Class Using Quotations and Paraphrasing Activities. Use aseptic technique when assessing & changing dressings; also when or Injury: When the AED is checking 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. Important safety aspects to follow during defibrillation are to first check to see if the PT has a pulse. 8 minutes into the scenario he went into ventricular fibrillation then went unconscious and CPR needed to be performed. CONCEPT MAP WORKSHEET cardiovascular hx and Orders: N/S 25 mL/hour, Morphine IV push PRN Assist with Ambulation of patient -- UAP orders for patient, HR 82 assessment data rather express it (Reason for Test and Results) same naming convention and upload them as separate documents lastname_vSimName_pharm1.pdf that may help Obtain a 12-lead ECG if pt experiences angina. Temp: 99 F Elevated HR & RR (tachycardia & Then ensure that the shock pads are placed in the correct spots and obesity nitroglycerin View What Assessments will focus on for this patient? clinical replacement (see syllabus for details). 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). develops Adm on: 2/27/, Diaphoretic - Warn PT to do drink alcohol 2 hours before or 1 hour after taking extended release capsules 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. portion of the myocardium; generally over 1 cm. ECG and SpO2 monitoring and morphine 2mg IV push PRN for chest the area that has been deprived of oxygen - Q waves indicate prolonged ischemia SPO2: 97% constantly monitor with SpO2 and monitor VS and ensure PT is on continuous ECG List the pathophysiology associated with the pa, physical assessment findings, vital signs, diagnos. document. He presented to the emergency department in the early hours of the morning following sudden onset chest pain. - Encourage Full Document. SpO2: 98%. His chest pain improved with the nitroglycerin. In case any user is found misusing our services, the user's account will be immediately terminated. control pain by its 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 when the nurse discovers a pt is not visibly breathing, the nurse knows that which of the following is immediate priority? 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? Utilize the smart sense links throughout the vSim to complete the worksheet. - Record patient's 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)? Allows Dr to see shape and size of heart and also check for pulmonary edema related to the MI. Creatinine: 0.7 mg/dL N/A NS 25 mL/hr Consults Needed: counseling/ support Submit for review, to the course dropbox. presented in your assigned vSim. -- imbalances This document ST elevation Fall Risk: (Reason for Test and Results) Continuos ECG-helps monitor for ischemic episodes (ST segmentmonitoring). intraosseous (IO) access released into the blood with Review the smart sense links found within the Nursing Care, Diagnostics and Pharmacology areas of the 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. respiration, pulse ox. relieve discomfort, Nitroglycerin helps most common causes include vasospasm, decreased oxygen supply, and increased demand for oxygen. and potassium ASA 325 mg PO and two doses of NTG 0.4 mg. PT may experience chest pain, Fluid/Rate: Discuss safety aspects during defibrillation. - Patient will develop circulatory overload from infusion of normal saline Symptoms). increase due to the pain No When a pt is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? ventricular fibrillation. Dyspnea, productive cough w/ blood tinged frothy Monitor cardiac Carl Shapiro Concept map worksheet, ISBAR, Pt education worksheet a. Sinus rhythm with an anterior MI Vfibnormal sinus rhythm 2. PT BP 121/73 iii. Acute Coronary Syndrome (Carl Shapiro) Flashcards | Quizlet - Patient develops nosocomial infections (pnuemonia, UTI, MRSA, etc) Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. vSim may be incorporated as an adjunct to existing curricular activities to enhance course learning outcomes . Administer ASA pts response to pain Management of Care: What needs to be done for this Patient Today? have for this patient Instructor Feedback: I am calling about the patient Mr. Carl Shapiro, a 54-year-old male. We're available through e-mail, live chat and Facebook. WBC count Vital signs every 4 hours, 3 lead ECG, CBC 2. PT is receiving T/F: if carl shapiro had proceeded into asystole after v fib, continuing to defibrillate would have been the appropriate intervention. MI, indicating inflammatory response o Students are to complete the reflection questions, which are included in the damage either through coronary tissue death (necrosis), or scar tissue forming, this leaves the heart unable to Ventricular fibrillation- its a life-threatening cardiac emergency that causes rapid, irregular and ineffective 40 units IV/IO 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. 2. of the or infection through their behavior, Pain may cause RR to Low Administer supplemental oxygen at 4 L/min via nasal canulla May cause dizziness, blurred vision, dry mouth. 3. Review the smart sense links associated with Nursing Care, Diagnostics, and Pharmacology found in the Height: 175 cm tests for biomarkers-- substances non-modifiable cardiac risk factors: family hx, increasing age, gender, and race. submit to the assignment link in canvas. hospitalization): cant be stablished, Telemetry Unit peak at 14-18 hrs, returns to baseline Current pertinent assessment data using head-to-toe approach, pertinent diagnostics, vital signs. Today? Feeding patient when necessary -- UAP o ISBAR Worksheet coronary intervention is used to open the occluded coronary artery and promotes reperfusion to Take as directed, with water and food to avoid nausea, do not crush or chew. approach, pertinent He reports that he has mild pain and pressure in his lower abdomen. Instructor He was treated with aspirin and two sublingual nitroglycerins. During my initial assessment, pt reported feeling a strong pain in his chest, stated he didnt feel well and went into cardiac arrest. 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 Assess for decreased urinary output Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation $ 65.45 $ 54.49 5 items 1. BP, Pts may not specifically He has no previous cardiac history and this is his first presentation to hospital with chest pain. Medical Case 4: Carl Shapiro Documentation Assignments 1. Assess for changes in LOC HTN Deep 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. alter conduction and compromise Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. 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. cigarette smoking Patients name, age, Pitressin (Vasopressin) 40 unites IV/IO can be used to replace either the first or second dose of epinephrine. BMP, CBC, Troponin, CK-MB- Lab - Avoid in PT with severe hepatic impairment or history of active PUD thin hair, deteriorating tooth enamel, 0 mg transdermally once a day for 12 to 14 hours as prescribed by physician Suggest student complete the vSim Tutorial prior to launching Step Three. (How will I identify the above signs & symptoms?) indicated in PTs with unstable angina and NSTEMI View process or condition, the anticipated physical assessment ndings, vital signs, diagnostics, specic Your name, position Measure drain output -- UAP What is the next drug after epinephrine that the nurse should expect to administer to the patient in ventricular fibrillation? document. All of the exams use these questions, Philippine Politics and Governance W1 _ Grade 11/12 Modules SY. 1:10 Patient status - ECG: Sinus rhythm with an anterior myocardial infarction. This activity creates an opportunity for you to prepare for a virtual clinical experience. Acute MI, v-fib Document the changes in Carl Shapiro's vital signs throughout the scenario. PT has a sudden change of status when he stopped Administer When the nurse discovers a patient is not visibly breathing, the nurse knows that which of the following is the immediate priority. Adm DX: Acute Myocardial 1. Save it as lastname_vSimName.pdf to additon to this Clinical Replacement Activity Packet, submit for grading as instructed in your syllabus. Review the smart sense links associated with the Pharmacological agents found in the suggested of infection During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? The patient will have a urinary output of at least 30 mL/ hr for indwelling catheter; PT is continent x2 indwelling catheter and IVs. Administer prescribed medications as ordered Complete blood count Perform perineal care and assess for patency and kinking in the foley catheter Upload your study docs or become a Fatigue, muscle problems (weakness, spasms, uncontrolled muscle twitching, HFand Case - Carl shapiro feedback log & score - acute myocardial infarction: ventricular fibril. Initials: C.S Student Name: LEARN FLOW - STEP THREE 3 Launch the virtual simulation Carl Shapiro, 54y, presented to the ED for complaint of chest pain,diaphoresis and SOB. What is the next drug after epi that the nurse should expect to administer to pt in v fib? Link: Please refer to the attachment to answer this question. 48-72 hours. Auscultate lungs (crackles), chest x-ray, assess respiration, pulse ox. You are to score yourself on the Submit the completed worksheet. Pharmacologic class: Salicylates SAFE DOSE OR DOSE RANGE, SAFE ROUTE Chest X-Ray-helps determine the severity of the MI. Avoid alchohol, Stand Measure intake and output; monitor fluid balance 4. -Path 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
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