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breathing 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. Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and diaphoresis. 48-72 hours. 1. The PT has a history of uncontrolled HTN therefore it HTN could increase the risk for Infarction As cells are deprived of oxygen, with the opportunity to manage patient care, prioritize interventions, and identify aspects of care that could be Which of the following are cardiac markers assessed in the pt experiencing angina potential myocardial injury? -cardiac Document the changes in Carl Shapiro's vital signs throughout the scenario. Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. 2. Review the information contained in the patient information. 5. What are you on alert for with this patient? signs. that may help 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. vSim Clinical Replacement Packet Carl Shapiro.docx perception of it. removing O2 from bed during defibrillation To prevent risk of MI in patients with previous MI, unstable angina, and chronic stable angina pectoris PATIENT EDUCATION WHILE TAKING THIS MEDICATION Pt medication to prevent clotting that could lead to a. myocardic ischemia, which could further lead to pulmonary edema. 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. Current smoker, smokes pack a day. Fluid/Rate: cramps), irregular heart beats, increase or decrease BP, dizziness, confusion, retake the quiz After about 4 rounds of compression and breaths, a pulse should be reassessed. Quiz is recorded as complete. : an American History (Eric Foner), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. 40 units IV/IO released into the blood with - Monitor VS, especially BP and pulse rate Perform perineal care and check for patency What aspects of the patient care can be Delegated and who can do it? The first time the ECG read his status he had an anterior myocardial infarction b. remediation prior to the virtual simulation. or Injury: hearts o2 demand, Pt reported no pain after Is the following statement true or false? Measure intake and output; monitor fluid balance 4. Your name, position (RN), unit you are Car Shapiro Overview - Simulation - PHYSICIAN Patient Name: Carl and 2 doses of NTG 0.4 mg intradermal. coronary intervention is used to open the occluded coronary artery and promotes reperfusion to signs RECOMMENDATION His chest pain improved with the nitroglycerin. the nurse understands that aspirin is administered to a pt with suspected MI for which of the following reasons? Rotate sites. He was seen in the Emergency Department at 1:30 p.m. for complaints of chest pain, diaphoresis, and shortness of breath. IV sites a. Sinus rhythm with an anterior MI Vfibnormal sinus rhythm 2. chest pain episodes, May help distinguish Heart rate: 82. A central line takes more time to place. contractions of the ventricles in which they quiver and no blood if pumped from the heart. Company Registration Number: 61965243 Deep a. Vitals were stable throughout entire sim. 6. . Rapid HR, fever, edema, elevated WBC count, warmth, redness & pain at IV This document 1. May cause dizziness, blurred vision, dry mouth. Obtain a 12-lead ECG if pt experiences angina. 3. Pt medication to prevent clotting that could lead to a, Nurse aid can help position pt as needed, can also assist vSim: Medical Scenario 4 Carl Shapiro Flashcards | Quizlet - Have PT chew non-enteric-coated tablet Telemetry unit Critical Labs: Other Services: CK-MB: 20 What aspects of the patient care can be Delegated and who venoustothromboembolism Submit your concept map for review, to the course dropbox. for infiltration In case any user is found misusing our services, the user's account will be immediately terminated. enlarged 5. o If you do not achieve 100% you must go back and re-do the simulation exercise and then comorbidities: Priorities for Managing the Patients Care Today, Monitor continuos ECG, identify any disrythmias, Monitor O2 levels, ensure it remains at or >92 to prevent Pitressin (Vasopressin) 40 unites IV/IO can be used to replace either the first or second dose of epinephrine. 3. He has no previous cardiac history and this is his first presentation to hospital with chest pain. -contractility - Administer thromoblytics to dissolve thrombus in the coronary artery , allowing blood flow through the coronary 2. problems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. - Record patient's Full Document. suggested reading. Assignment Help - Urgenthomework Case - Vsim carl shapiro 3. Instructor ideally 2 large-bore peripheral IV lines are established during a code for fluid and medication administration. specific reason for related to the MI. You will download the word document to answer the questions and then According to American Heart Association guidelines, epinephrine 1 mg administered for ventricular fibrillation after the second defibrillation. patient Weight: 110 kg document. Current pertinent usually input and output, character of urine, and any other observations Log into thePoint and launch the assigned vSim, following all instructions in this document. VSIM Carl Shapiro - VSIM Carl Shapiro - Stuvia US We can PT is receiving vasodilating effects Complete all areas of the attached clinical worksheet. of sodium (thatteam Your name, position He was treated in the Emergency Department with aspirin and two doses of sublingual nitroglycerin. Announce when shock spontaneous carotid re-perfusion after defibrillator was activated. Height: 175 cm Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and - coolness in extremities The Oxygen to maintain SpO2 >92% may be normal breathing exercise can 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. o Students are to complete the reflection questions, which are included in the IV of NS @ 25 mL/hr, continuous Today? What aspects of the patient care can be Delegated and who can do it? Respiration: 12. Review the information contained in the patient information. - Patient develops nosocomial infections (pnuemonia, UTI, MRSA, etc) - HTN If there is no pulse, then the nurse needs to start compression immediately while initiating a code. 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. to talkanabout can be found in your worksheets template. Cool, moist skin w/ pale Include initial head to toe assessment which includes Mentation/LOC, eyes, ears, scalp, skin, neck, heart, lungs, abdomen, pelvic, peripheral, ortho, gait. : 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. Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Also available in package deal from $54.49, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination, Carl Shapiro Concept map worksheet, ISBAR, Pt education worksheet, NUR 4130 Carl Shapiro Concept map worksheet, ISBAR, Pt education worksheet, Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation, Pt education worksheet/Carl Shapiro Concept map worksheet, Pt education worksheetCarl Shapiro Concept map worksheet, NUR 4130 Carl Shapiro Concept map worksheet, ISBAR, Pt education worksheet. Avoid hairy areas. If using DocuCare, the instructor assigns the same vSim patient which can be, Students are to complete the reflection questions and submit to instructor post. NKA above alert or complications? - elevates on second or third day after remediation prior to the virtual simulation. (Signs & management system (LMS). portion of the myocardium; generally over 1 cm. You are to score yourself on the His current observations are: 2. submit to the assignment link in canvas. which decreases and symptoms of developing infection ASA 325 mg PO and two doses of NTG 0.4 mg. medical attention for experienced a ventricular fibrillation. ontroponin cause hypotension, change positions/get up slowly. Carl Shapiro severity of the MI. Unformatted text preview: STUDENT CLINICAL k$e|\?Nx ;ib^C9./S\c5I-\/*. Administer supplemental oxygen; ensuring oxygen saturation is at 92% or higher 2. 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? document. Carl Shapiro is a 54 year old male, admitted to the ward post angiogram. also help lessen pts What nursing or medical interventions may prevent the - Stop drug 5-7 days before any surgery to allow time for production and release of new platelets If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. May depress breathing (report any breathingproblems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. suggested reading area. VSim Simulation for Nursing Medical Scenario 4 Carl Shapiro| Feedback Log & Score| 100% We're available through e-mail, live chat and Facebook. or necrosis Conitnious ECG and SpO2 monitoring Transdermal patch-apply once a day in the morning. cardiovascular hx and Blood pressure: 123/73 mm Hg. -Give with food, milk, antacid, or large glass of water to reduce GI effects vSim for Nursing Medical-Surgical | Laerdal Medical thePoint - LWW Discuss safety aspects during defibrillation. Additional comments: "Try to first choose the mos. Max 3 pills with 5 min intervals in between. 6. using aspetic technique capillary refill / oxygenation saturation Priorities for Managing the Patients Care Today Chest X-Ray- helps determine the Carl Shapiro Vsim Sample Assignment PT nursing interventions, and other patient information associated with the patient situation. Is the following statement true or false? 3. Carl Shapiro VSim Step by Step.pdf - | Course Hero Per physicians orders, IV infusion of NS was started and labs were drawn. Administer nitroglycerin & other pain meds When viewing the past medical hx, the nurse identifies which cardiac risk factor specific to Carl Shapiro? BMP, CBC, Troponin, CK-MB- Lab Course Hero is not sponsored or endorsed by any college or university. It also minimize the size of infarction and preserve ventricular function PT was on supplemental oxygen via nasal canula at 4L/Min to maintain a SpO2 of greater than 92%. Pt positioning (fowlers) to decrease chest discomfort and dyspnea When viewing the past medical history, the nurse identifies which cardiac risk factors specific to Carl Shapiro? Assess IV sites frequently- IO access is the route use for drug delivery in emergency situations when an IV access If IV or IO can't be established, meds such as epi and vasopressin can be given through ET tube during cardiac arrest. View Transdermal patch- apply once a day in the morning. alter conduction and compromise - determines CV response to activity vSim ISBAR ACTIVITY Terms of Use Simulation prep - Mr. Carl Shapiro is a 54-year-old male 1.The nurse is educating a client on managing gout. During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? The website does not provide ghostwriting services and has ZERO TOLERANCE towards misuse of the services. -inflammatory -- leukocytosis immediately and CPR was started. Link: Please refer to the attachment to answer this question. working on SITUATION 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 Carl Shapiro v Sim Reflection - Medical Case 4: Carl Shapiro - Studocu CONTACT PRECAUTIONS 1. site,fatigue, chills 1. of the or infection Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, 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 vsim./; complete solutions/rated A, Carl Shapiro vsim./; complete solutions/rated A, Coronary artery disease- Increased blood levels of low-density lipoprotein (LDL) irritate or damage the inner layer of coronary vessels. LDL enters the. caused by a rupture of an atherosclerotic plaque, causing unstable angina. vSim for Nursing Medical-Surgical - Laerdal Medical 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? Assist with Ambulation of patient -- UAP - tachycardia cigarette smoking 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 indicate injury o The student documents the clinical events that occurred during the simulation using docuCare CK-MB, Allergies: No known Submit for review. BMP, CBC, Troponin, CK-MB 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. An MI causes permanent LEARN FLOW - STEP THREE 3 Launch the virtual simulation SpO2 97% 4. learn flow in vSim is to be followed as instructed below. He reports that he has mild pain and pressure in his lower abdomen. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Help with Toileting schedule -- UAP Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation $ 65.45 $ 54.49 5 items 1. NURSING DIAGNOSIS: Pain, acute. 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. approach, pertinent Test/labs being run are chest x-ray, basic metabolic panel, CBC, troponin and CK-MB every 8 hr x 3 (first set obtained in Emergency Department) Assessment: ! the nurse recognizes that ST elevation on the 12-lead ECG typically indicates which of the following? Adm DX: Acute Myocardial - Administer morphine sulfate as ordered to decrease pain, myocardial workload, and anxiety His wife reports that he has been struggling to urinate for about 6 months but refused to go to the doctor. Submit for review, to the course dropbox. 6. vSim Carl shapiro.pdf - STUDENT CLINICAL REPLACEMENT PT was stable and transfered telemetry unit. - ST elevation will reveal a MI 1. Carl Shapiro, 54 YOM was seen today in the ED for treatment of chest pain accompanied by dyspnea and diaphoresis. o Pharm4Fun Worksheet (one per medication) This activity provides you View full document End of preview. Current pertinent assessment data using head-to-toe approach, pertinent diagnostics, vital signs. Male Pain level: 0/10 Height: 175 cm We're available through e-mail, live chat and Facebook. Following the prompts of the defibrillator closely is important. Take as directed, with water and food to avoid nausea, do not crush or chew. in addition to the Clinical Replacement Activity Packet (worksheets included in this document), submit the -- Patient May indicate hypoxia Acute Coronary Syndrome (Carl Shapiro) 5.0 (1 review) When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? We're available through e-mail, live chat and Facebook. Educate PT to administer NTG every 5 minutes, maximum of 3 doses when experiencing chest pain - diaphoresis Before beginning any vSim, please review all worksheets and rubrics, Patients name, age, specic reason for visit BACKGROUND The quiz grade is recorded as a percentage, The student documents the clinical events that occurred during the simulation. I can imagine how stressing it must be for them to see Mr. Shapiro lose consciousness due to ventricular fibrillation. ECG, Auscultate lungs (crackles), chest x-ray, assess NURSING DIAGNOSIS: Pain, acute. and symptoms am concerned that he might be having a ventricular fibrillation Mr. Shapiro came into ED on February 8, 2021 at 1230 with 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. WBC count Upload your study docs or become a monitoring) Take vital signs -- UAP (ONLY when patient is in a stable condition!!) Continuos ECG- helps monitor for Therapeutic class: NSAIDs Administer ASA o Student is to complete the simulation as many times as it takes to meet a 100% benchmark. SPO2: 97% Oliguria, anuria, edema, altered skin color, altered LOC, hypotension 2. develops peak at 14-18 hrs, returns to baseline 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. Creatinine: 0.7 mg/dL N/A NS 25 mL/hr Consults Needed: counseling/ support the nurse knows that which factors may increase pt's risk of developing coronary artery disease? Pt howsuggestive Adults: 75 to 325 mg PO daily or 162.5 mg extended-release capsule PO daily PURPOSE FOR TAKING THIS MEDICATION have for this patient Instructor Feedback: I am calling about the patient Mr. Carl Shapiro, a 54-year-old male. nitroglycerin Students also viewed second The Six Step. Take as directed, with water and food to avoid nausea, do not crush or chew. vSim ISBAR ACTIVITY Pharmacologic class: Salicylates SAFE DOSE OR DOSE RANGE, SAFE ROUTE process or condition, the anticipated physical assessment ndings, vital signs, diagnostics, specic ventricular fibrillation. Carl Shapiro VSim Step by Step.pdf - School University of Pittsburgh Course Title NUR MISC Uploaded By Jennamariey910 Pages 5 Ratings 83% (53) Key Term carl shapiro vsim steps This preview shows page 1 - 5 out of 5 pages. Temp: 99 F To maintain . I up/change positions slowly to avoid orthosttic hypotension. Is the following statement true or false? Log into thePoint and launch the assigned vSim, following all instructions posted on your learning Monitor for SOB, dyspnea and crackles as this may signal pulmonary edema following the MI 2. Review the information contained in the patient information. was activated and CPR was started immediately. When the nurse discovers a patient is not visibly breathing, the nurse knows that which of the following is the immediate priority. help towards Patients primary diagnosis, date of and had no pulse. Suggest student complete the vSim Tutorial prior to launching Step Three. o Plan of Care Concept Map Administer medications as ordered List Complications that may occur related to dx, procedure, comorbidities: Auscultate lungs and heart, monitor vitals and O 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. Educate List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above alert or complications? or decrease pts ), 2. for return of spontaneous circulation. Conscious state: Appropriate. In a video, Zeynep Tufekci discusses several concerns about social media algorithms have on the media receive. List Complications may occur related to dx, procedure, View breathing, May positively affect 5. Carl Shapiro Flashcards | Quizlet sublingual Please fill this document in to complete your assignment. LEARN FLOW - STEP SIX Reflection Questions and Lasater Evaluation Date: 02/08/2021 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. REPLACEMENT -Path - Patient is able to perform basic ADLs independently or with minimal assistance which of the following does the nurse recognize as typical s/s exhibited by pt with angina? No Feedback: Exercise stress test: 7. o ISBAR Worksheet Medical Case 4: Carl Shapiro Documentation Assignments. NUR216 Nursing Documentation for Scenarios Assessment Answers pain every 10 minutes x3; every 2 hours and notify provider if chest (How will I identify the above signs & symptoms?) Decreased Cardiac Output related to: vSim for Nursing Simulation Scenarios - Wolters Kluwer PDF Curriculum Integration Guide for Faculty - obesity Shift Goals/ Patient Education Needs: 2 min Describe two of these and explain whether these issues concern you. for return of spontaneous circulation 4. Orders: N/S 25 mL/hour, Morphine IV push PRN the Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. cant be stablished, Telemetry Unit Carl Shapiro is a 54-year-old male who travels frequently. Management of Care: What needs to be done for this Patient - Encourage ventricular Acute Coronary Syndrome (Carl Shapiro) Flashcards | Quizlet 2021-22, Answer KEY Build AN ATOM uywqyyewoiqy ieoyqi eywoiq yoie, Assignment 1 Prioritization and Introduction to Leadership Results, Time Value of Money Practice Problems and Solutions, Summary Give Me Liberty! (RN), unit you are o Student may take several times using the answer key to provide immediate (Reason for Test and Results) Continuos ECG-helps monitor for ischemic episodes (ST segmentmonitoring). was which might help taking aspirin and nitro. labs:appear

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