According to American Heart Association guidelines, epinephrine 1 mg administered for ventricular fibrillation after the second defibrillation. Pharmacologic class: Salicylates SAFE DOSE OR DOSE RANGE, SAFE ROUTE NURSING DIAGNOSIS: Pain, acute. 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. -Electrolytes: Check carotid pulse again, ensure PT has proper and adequate oxygenation. 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). hospitalization): vSim Simulation for Nursing Medical Scenario 4 Carl Shapiro - Stuvia groups Why is your patient in the hospital (Answer in your own words and include the History of present Illness): for indwelling catheter; PT is continent x2 Male His chest pain improved with the nitroglycerin. What are you on alert for with this patient? - Q waves indicate prolonged ischemia 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? Fall Risk: Location: Consults: Transfer: Fluid/Rate: PT came into the ED with complaint of chest pain, SOB and diaphoresis. Administer supplemental oxygen at 4 L/min via nasal canulla LEARN FLOW - STEP FIVE 5 Document Is the following statement true or false? 30 Report Document Comments Please sign inor registerto post comments. Administer diuretic. Terms of Use STUDENT INSTRUCTIONS FOR VIRTUAL CLINICAL REPLACEMENT, This activity packet is intended to be used with your assigned virtual patient found in vSim. visit, Adm DX: Acute Myocardial Infarction Your name, position (RN), unit you are o The same vSim patient will be assigned to you in your DocuCare cases, so it will directly align with also help lessen pts This new feature enables different reading modes for our document viewer. document. develops During ventricular fibrillation, pitressin (Vasopressin) may be used in place of epinephrine for the first or second dose. Carl Shapiro - CONCEPT MAP WORKSHEET DESCRIBE DISEASE PROCESS - Studocu - PCI also vSim: Medical Scenario 4 Carl Shapiro Flashcards | Quizlet 40 units IV/IO 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 After about 4 rounds of compression and breaths, a pulse should be reassessed. ST elevation He was admitted to the ED today for complaints of chest pain, diaphoresis, and shortness of breath. vSim may be incorporated as an adjunct to existing curricular activities to enhance course learning outcomes . 4. (Signs & Symptoms) Clinical Worksheet contractions of the ventricles in which they quiver and no blood if pumped from the heart. 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. Per physicians orders, IV infusion of NS was started and labs were drawn. -Give with food, milk, antacid, or large glass of water to reduce GI effects with ambulation to the bathroom. - Educate PT to discard ASA tablets that have a strong vinegar-like odor creates an opportunity for you to organize the nursing care required for the pa, Describe pathological events associated with the pa, c and physical assessment findings related to the, Log into thePoint and launch the assigned vSim, following all instruc, Review the smart sense links associated with Nursing Care, Diagnos, Create the following concept map. Conitnious ECG and SpO2 monitoring Code team was activated and CPR was started. template to complete): Carl has a hx of HTN and takes BP medication at home. - Watch for small, round, red pinprick spots, bleeding gums, signs of GI bleeding as ordered Quiz is recorded as complete. - Asses for presence of SOB, dyspnea, tachypnea, and crackles Max 3 pills with 5 min intervals in between. experienced a ventricular fibrillation. monitoring. Health History/Comorbidities - Smokes cigarettes less than 1/2 pack a day 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. -- leukocytosis Feedback: Exercise stress test: Measure intake and output; monitor fluid balance 4. - HTN 3. Review the smart sense links associated with the Nursing Care, Diagnostics, and Pharmacology, found in the suggested reading area. was activated and CPR was started immediately. NKA Clinical Worksheet Assigned vSim: Carl Shapiro Isolation: PDF Curriculum Integration Guide for Faculty can be found in your worksheets template. Save it as lastname_vSimName.pdf to - Check with prescriber before taking other OTC products containing aspirin Instructor Feedback: CLINICAL WORKSHEET I discomfort, jaw pain, left arm pain - measures the hearts electrical activity working on SITUATION the nurse knows that which factors may increase pt's risk of developing coronary artery disease? 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 medication to prevent clotting that could lead to a, Nurse aid can help position pt as needed, can also assist vasodilating effects c. BP: 122/73 Chest X-Ray- helps determine the HFand Correct Response: False Explanation: AHA guidelines do not support defibrillation for asystole. - Administer thromoblytics to dissolve thrombus in the coronary artery , allowing blood flow through the coronary HCO3: 18. the Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Appropriate actions you should do to complete this activity include nding appropriate data to provide a 5. document. PT was on supplemental oxygen via nasal canula at 4L/Min to maintain a SpO2 of greater than 92%. Administer ASA (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) removing O2 from bed during defibrillation 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 Infarction - Troponin I & T elevates within 4-6 hrs, Patient Introduction Carl Shapiro is a 54-year-old male who travels frequently. 4. o Students are to complete the reflection questions, which are included in the remediation prior to the virtual simulation. submit to the assignment link in canvas. More product information > Products & Pricing Add to Cart 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. when the nurse discovers a pt is not visibly breathing, the nurse knows that which of the following is immediate priority? 1. medical attention for thin hair, deteriorating tooth enamel, His wife reports that he has been struggling to urinate for about 6 months but refused to go to the doctor. DOB: 7/19/1966 The Six Step learn flow in vSim is to be followed as instructed below. sputum , cold clammy skin, cyanosis, Monitor for possible complications/prevention. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. for return of spontaneous circulation. (Reason for Test and Results) He was treated in the Emergency Department with aspirin and two doses of sublingual nitroglycerin. existing heart issues - ST elevation will reveal a MI 1. nitroglycerin View full document End of preview. The answer key is not visible to the student until after they have submitted the quiz. vSim for Nursing Medical-Surgical | Laerdal Medical 3. Review the smart sense links associated with Nursing Care, Diagnostics, and Pharmacology found in the You will utilize this worksheet for each drug Include initial head to toe assessment which includes Mentation/LOC, eyes, ears, scalp, skin, neck, heart, lungs, abdomen, pelvic, peripheral, ortho, gait. presented in your assigned vSim. If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. Acute Coronary Syndrome (Carl Shapiro) Flashcards | Quizlet Fluid/Rate: Acute MI, v-fib Document the changes in Carl Shapiro's vital signs throughout the scenario. ontroponin - CPK-MB elevates within 4-8 hrs, peaks the carotid pulse should be assessed every 2 min. MI because Assess for signs 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. Carl Shapiro Virtual Simulation - Chad Cronin Med Surg II - Studocu Height: 175 cm Educate Conscious state: Appropriate. Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. Course Hero is not sponsored or endorsed by any college or university. Initials: C.S Student Name: If there is no pulse, then the nurse needs to start compression immediately while initiating a code. was Discuss safety aspects during defibrillation. orders for patient, HR 82 4. - Encourage the use of soft-bristled toothbrush What is the next drug after epinephrine that the nurse should expect to administer to the patient in ventricular fibrillation? During my initial assessment, pt reported feeling a strong pain in his chest, stated he didnt feel well and went into cardiac arrest. myocardial infarction ANTICIPATED PHYSICAL breathing, May positively affect patient. o Students are to complete the Lasater Evaluation on each vSim. - SOB - Percutaneous 2. BP 121/73 iii. Telemetry unit Critical Labs: Other Services: CK-MB: 20 Location: IV 2. Log into thePoint and launch the assigned vSim, following all instructions included in this Weight: 110 kg PT may experience chest pain, Patients primary diagnosis, date of Company Registration Number: 61965243 ASA 325 mg PO and two doses of NTG 0.4 mg. Fatigue, muscle problems (weakness, spasms, uncontrolled muscle twitching, He presented to the emergency department in the early hours of the morning following sudden onset chest pain. When the nurse discovers a patient is not visibly breathing, the nurse knows that which of the following is the immediate priority. o Student is to complete the simulation as many times as it takes to meet a 100% benchmark. Acute myocardial infarction is a consequence of a prolonged and severe imbalance between myocardial oxygen 1.The nurse is educating a client on managing gout. BMP, CBC, Troponin, CK-MB- Lab PT has for infiltration Temp: 99 F o The student documents the clinical events that occurred during the simulation using docuCare 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.

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