Date: 02/08/2021 - Monitor VS, especially BP and pulse rate We're available through e-mail, live chat and Facebook. 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 coronary intervention is used to open the occluded coronary artery and promotes reperfusion to 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. help towards PT is receiving breathing exercise can 3. 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Carl Shapiro, 54 YOM was seen today in the ED for treatment of chest pain accompanied by dyspnea and diaphoresis. Acute Coronary Syndrome (Carl Shapiro) 5.0 (1 review) When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? relieve discomfort, Nitroglycerin helps He has no previous cardiac history and this is his first presentation to hospital with chest pain. to toe approach, pertinent diagnostics, vital Transdermal patch-apply once a day in the morning. Height: 175 cm Adm on: 2/27/, Diaphoretic RR: 12 o Student is to complete the simulation as many times as it takes to meet a 100% benchmark. in 12-20 hr, and returns to normal in -Path the carotid pulse should be assessed every 2 min. Conitnious ECG and SpO2 monitoring May This activity provides you admission, current Clearing bed at least twice prior to defibrillating 5. 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? Get a new set of vital signs and monitor for any trend alerts 3. only physically see if the lungs are being inflated, we cannot see if the chest compression are recirculating blood through the body. Rapid HR, fever, edema, elevated WBC count, warmth, redness & pain at IV increase due to the pain During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? 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. 2 min the carotid pulse should be assessed every 2 min. groups Why is your patient in the hospital (Answer in your own words and include the History of present Illness): AED determined shock was needed, continued CPR until pt spontaneauly regained his breathing. Students also viewed Help with Toileting schedule -- UAP What are the pros/cons of government and political involvement in Dodd-Frank Act: Exhibit 7.A, p. 145. 5. which of the following does the nurse recognize as typical s/s exhibited by pt with angina? ventricular fibrillation. BMP, CBC, Troponin, CK-MB O\w 7}\?. 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? PT Take as directed, with water and food to avoid nausea, do not crush or chew. 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. infarction M/F: Male Length of Stay: Consults: 1 day Respiratory 0 mg transdermally once a day for 12 to 14 hours as prescribed by physician cardiovascular hx and constantly monitor with SpO2 and monitor VS and ensure PT is on continuous ECG additon to this Clinical Replacement Activity Packet, submit for grading as instructed in your syllabus. Terms of Use Use aseptic technique when assessing & changing dressings; also when 40 units IV/IO - Troponin I & T elevates within 4-6 hrs, Suggest student complete the vSim Tutorial prior to launching Step Three. Carl Shapiro is a 54-year-old male who travels frequently. Fatigue, muscle problems (weakness, spasms, uncontrolled muscle twitching, 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. - measures the hearts electrical activity Adults: 75 to 325 mg PO daily or 162.5 mg extended-release capsule PO daily PURPOSE FOR TAKING THIS MEDICATION problems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. Utilize the smart sense links throughout the vSim to complete the worksheet. right arm 30 Report Document Comments Please sign inor registerto post comments. Telemetry unit Critical Labs: Other Services: CK-MB: 20 Deep breathing exercise can also help lessen pts anxiety which will also help towards maintaining a stable BP. their anxiety level and coping status r/t new DX of acute MI - HTN Avoid hairy areas. Full Document, What is the purpose and mechanism of action of the following drugs prescribed for an acute myocardial infraction? VSIM - CARL SHAPIRO INTRODUCE SELF WASH HANDS IDENTIFY PATIENT ASK ABOUT ALLERGIES OBTAIN CONSENT TAKE TEMPERATURE ASSESS RESPIRATION CHECK RADIAL PULSE ASSESS O2 SAT CONNECT AUTOMATIC BLOOD PRESSURE CUFF AUSCULTATE HEART CONNECT 12 LEAD EKG CONNECT ECG DOTS CHECK HER ASSESS IV ACCESS DO CHEST XRAY CALL MEDICAL DOCTOR PAIN ASSESSMENT - DO YOU 4. He was ordered supplemental oxygen via nasal canula @ 4L/min to Prioritization and decision making are central to the vSim design . Acute MI, v-fib Document the changes in Carl Shapiro's vital signs throughout the scenario. myocardic ischemia, which could further lead to - Patient is able to perform basic ADLs independently or with minimal assistance Transdermal patch- apply once a day in the morning. PT has a sudden change of status when he stopped - Patient will develop circulatory overload from infusion of normal saline - During prolonged therapy, assess HCT, HB, Pt, INR, and renal function 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). (Signs & Symptoms) Clinical Worksheet Carl Shapiro, 54y, presented to the ED for complaint of chest pain,diaphoresis and SOB. Following the prompts of the defibrillator closely is important. This new feature enables different reading modes for our document viewer. respiration, pulse ox. 4. SPO2: 97% most common causes include vasospasm, decreased oxygen supply, and increased demand for oxygen. which might help Current pertinent modifiable cardiac risk factors can include hyperlipidemia, tobacco, HTN, diabetes, metabolic syndrome, obesity, and physical inactivity. CONTACT PRECAUTIONS including a focused assessment that reflects all areas of assessment performed in the vSim May cause hypotension, change positions/get up slowly. No alcohol. Chest X-Ray-helps determine the severity of the MI. When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? 2. anxiety which will also During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? Review the smart sense links associated with the Pharmacological agents found in the suggested Administer ASA 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? 7 C) 0:14 You washed your hands. Course Hero is not sponsored or endorsed by any college or university. Administer supplemental oxygen; ensuring oxygen saturation is at 92% or higher 2. Deep Discuss safety aspects during defibrillation. pharmacological agent listed in the Pharmacology are of the suggested reading section. - ST elevation will reveal a MI alter conduction and compromise An MI causes permanent Concepts like perfusion (Carl Shapiro) and fluid and electrolytes (Stan Checketts) are integrated into prioritization and decision making for next steps . : 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. Pitressin (Vasopressin) 40 unites IV/IO can be used to replace either the first or second dose of epinephrine. x-ray: The Six Step 48-72 hours. Low Today? He was seen in the Emergency Department at 1:30 p.m. for complaints of chest pain, diaphoresis, and shortness of breath. Patients name, age, 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. relaxation techniques View Allergies: No known This document after daily 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. - Patient develops nosocomial infections (pnuemonia, UTI, MRSA, etc) REPLACEMENT Adm DX: Acute Myocardial Submit for review, to the course dropbox. ASSIGNMENT NURSING DIAGNOSIS: Pain, acute. rubric provided in the worksheet template. 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. May cause stomach discomfort, nausea, prolonged bleedingtime. Submit for review. To prevent risk of MI in patients with previous MI, unstable angina, and chronic stable angina pectoris PATIENT EDUCATION WHILE TAKING THIS MEDICATION - anxiety and restlessness Electrolyte imbalances What nursing or medical interventions may prevent the above Alert or complications? May cause dizziness, blurred vision, dry mouth. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. indicate injury o Plan of Care Concept Map immediately and CPR was started. - PCI also If administering Vasopressin, what dosage would he nurse expect to administer? MI, indicating inflammatory response Monitor lab values to determine if any complications have developed 1. Pt howsuggestive learn flow in vSim is to be followed as instructed below. thin hair, deteriorating tooth enamel, Rated his pain as a 0 out Important safety aspects to follow during defibrillation are to first check to see if the PT has a pulse. According to American Heart Association guidelines, epinephrine 1 mg administered for ventricular fibrillation after the second defibrillation. cause hypotension, change positions/get up slowly. . shape and size of heart and also - Encourage the use of soft-bristled toothbrush - Smokes cigarettes less than 1/2 pack a day 6. -- imbalances May indicate hypoxia (RN), unit you are hospitalization): Quiz is recorded as complete. supplemental oxygen at 4 L/min to maintain SpO2 greater than 92%. Auscultate lungs (crackles), chest x-ray, assess respiration, pulse ox. Amiodarone NKA Clinical Worksheet Assigned vSim: Carl Shapiro Isolation: a. o Clinical Worksheet can do it? 4. using head-to-toe embolus 2. Any orders or recommendations you may Then ensure that the shock pads are placed in the correct spots and myocardial infarction ANTICIPATED PHYSICAL Administer medications as ordered List Complications that may occur related to dx, procedure, comorbidities: An acute MI indicates irreversible myocardial injury resulting in necrosis of a significant This activity creates an opportunity for you to prepare for a virtual clinical experience. perception of it. Case - Vsim carl shapiro 3. It is important to verbally announce to clear the patient and check twice nothing is checking PT. Oxygen to maintain SpO2 >92% document. Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. ECG and SpO2 monitoring and morphine 2mg IV push PRN for chest handling Monitor fluid balance Avoid alchohol, Stand up/change positions slowly to avoid orthosttic hypotension. PT coded while on telemetry unit. o The same vSim patient will be assigned to you in your DocuCare cases, so it will directly align with suggested reading. Student is to complete the simulation as many times as it takes to meet an 80% benchmark. existing heart issues 5. usually sputum , cold clammy skin, cyanosis, Monitor for possible complications/prevention. 1. or pulmonary within 6-7 days Carl Shapiro Patients primary diagnosis, date of - fever ANTICIPATED NURSING INTERVENTIONS - Assess for chest pain using mnemonic OPQRST What Assessments will you focus on for this patient? or necrosis 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? 3. 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! 2. rather express it 1. Feeding patient when necessary -- UAP listed under the pharmacology are of the suggested reading section. vSim. - elevates on second or third day after Temp 99F v. SPo2 97% . - Patient can teach-back the important information about all prescribed drugs such as: dosage, route, and adverse effects including those he must seek immediate View full document End of preview. Treatment for his chest pain included aspirin therapy and two doses of sublingual nitroglycerin. activated and had no pulse. performing relaxation Assist with Ambulation of patient -- UAP HR: 82 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? RR 12 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. Patient Introduction Carl Shapiro is a 54-year-old male who travels frequently. remediation prior to the virtual simulation. 2 LEARN FLOW - STEP TWO Take the Pre-Simulation Quiz the heart rhythm ensure nothing is touching the PT. -- Patient The Six Step. Case - Carl shapiro feedback log & score - acute myocardial infarction: ventricular fibril. Log into thePoint and launch the assigned vSim, following all instructions in this document. ischemia develops. available to the heart Ventricular fibrillation- its a life-threatening cardiac emergency that causes rapid, irregular and ineffective is going to be delivered, and again ensure PT is clear. Is the following statement true or false? venoustothromboembolism What could have been the cause of Carl's ventricular fibrillation? PT came into ED with chest pain, diaphoretic, SOB. - obesity Shift Goals/ Patient Education Needs: 2. tests for biomarkers-- substances This activity packet is intended to be used with your assigned virtual patient found in vSim. List Complications may occur related to dx, procedure, 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. NO PRECAUTIONS Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. Labs were ordered. Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation $ 65.45 $ 54.49 5 items 1. working on SITUATION Instructor 1. - Watch for small, round, red pinprick spots, bleeding gums, signs of GI bleeding indwelling catheter and IVs. Before beginning any vSim, please review all worksheets and rubrics, clinical replacement (see syllabus for details). ST elevation Pharmacologic class: Salicylates SAFE DOSE OR DOSE RANGE, SAFE ROUTE o The student documents the clinical events that occurred during the simulation using docuCare Administer diuretic. Code Appropriate actions you should do to complete this activity include nding appropriate data to provide a 4. NURSING DIAGNOSIS: Pain, acute. Include initial head to toe assessment which includes Mentation/LOC, eyes, ears, scalp, skin, neck, heart, lungs, abdomen, pelvic, peripheral, ortho, gait. Review the smart sense links found within the Nursing Care, Diagnostics and Pharmacology areas of the pulmonary edema. aneurysm Max 3 pills with 5 min intervals in between. Monitor for SOB, dyspnea and crackles as this may signal pulmonary edema following the MI your vSim experience. levels admission, current orders for patient ASSESSMENT Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. Want to read all 5 pages? BP: 122/73 experienced a ventricular fibrillation. Document Carl Shapiro's cardiac rhythms that occurred in the scenario.