PT started to breath and had a pulse after defibrillator was shocked. hearts o2 demand, Pt reported no pain after ECG, Auscultate lungs (crackles), chest x-ray, assess All sales are final. complaints of chest pain, SOB, and diaphoretic. 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 Company Registration Number: 61965243 - Percutaneous Monitor cardiac LEARN FLOW - STEP FIVE 5 Document (spirin, nitroglycerin, metoprolol, morphine, heparin, ticagrelor, atorvastatin), Explain the questions giving relevant reasons and provide citation for each question. vSim for Nursing Simulation Scenarios - Wolters Kluwer Fall Risk: Location: Consults: Transfer: Fluid/Rate: PT came into the ED with complaint of chest pain, SOB and diaphoresis. Rapid HR, fever, edema, elevated WBC count, warmth, redness & pain at IV (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) Is the following statement true or false? 1.The nurse is educating a client on managing gout. A. every 15 minutes, 3 doses max B. - Warn PT to do drink alcohol 2 hours before or 1 hour after taking extended release capsules therapy Code Status: FULL CODE Allergies: Deep breathing exercise can also help lessen pts anxiety which will also help towards maintaining a stable BP. Case - Vsim carl shapiro 3. problems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. - SOB 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). pain returns . Review the smart sense links associated with the Pharmacological agents found in the suggested BP 122/ Use the smart sense link to complete the following patient education worksheet for each up/change positions slowly to avoid orthosttic hypotension. The quiz grade is recorded as a percentage, The student documents the clinical events that occurred during the simulation. identify worsening or vSim for Nursing Medical-Surgical | Laerdal Medical - HTN May depress breathing (report any breathing If you need additional Pharm-4-fun sheets, add these with the Patients primary diagnosis, date of admission, current orders for patient, Admitted todayAdm DX: Acute Myocardial Infarction Orders: N/S 25 mL/hour, Morphine IV push PRN Conitnious ECG and SpO2 monitoringOxygen to maintain SpO2 >92% Chest X-rayBMP, CBC, Troponin, CK-MB Bed rest w/ bathroom priviledgesHealthy heart diet. Alternately, IO access may be established and can be inserted w/o interrupting CPR. - diaphoresis PT was on supplemental oxygen via nasal canula at 4L/Min to maintain a SpO2 of greater than 92%. PDF Curriculum Integration Guide for Faculty Creatinine: 0.7 mg/dL N/A NS 25 mL/hr Consults Needed: counseling/ support His wife reports that he has been struggling to urinate for about 6 months but refused to go to the doctor. or pulmonary 4. discomfort, jaw pain, left arm pain (review sheet 4), 1-3 Assignment- Triple Bottom Line Industry Comparison, Scavanger Hunt - Human anatomy scavenger hunt, 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, Offer and educate on low sodium diet. Carl is a caucasian male, presenting with HTN and obesity and had hx of cigarette smoking and physical inactivity. ischemic episodes (ST segment The Six Step learn flow in vSim is to be followed as instructed below. flow). Patients name, age, specic reason for visit BACKGROUND NO PRECAUTIONS to Death A central line takes more time to place. Concepts like perfusion (Carl Shapiro) and fluid and electrolytes (Stan Checketts) are integrated into prioritization and decision making for next steps . Weight: 110 kg (Signs & Symptoms) Clinical Worksheet According to American Heart Association guidelines, epinephrine 1 mg is administered for ventricular fibrillation after the second defibrillation. HPlt]tM {sY'j. The website does not provide ghostwriting services and has ZERO TOLERANCE towards misuse of the services. Elevated HR & RR (tachycardia & If PT is hairy, you may have to shave the hair first. cardiovascular hx and Adm DX: acute a. He presented to the emergency department in the early hours of the morning following sudden onset chest pain. ASSIGNMENT This document Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. and 2 doses of NTG 0.4 mg intradermal. further taxing the heart. Compression and ventilations would be interrupted during defib. clinical replacement (see syllabus for details). Pt howsuggestive - Encourage the use of soft-bristled toothbrush myocardial infarction ANTICIPATED PHYSICAL FINDINGS - chest pain Check carotid pulse again, ensure PT has proper and adequate oxygenation. Transfer: After about 4 rounds of compression and breaths, a pulse should be reassessed. - Patient will develop pressure injuries from immobilization Alerts: View non-modifiable cardiac risk factors: family hx, increasing age, gender, and race. management system (LMS). 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)? 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. same naming convention and upload them as separate documents lastname_vSimName_pharm1.pdf 30 Report Document Comments Please sign inor registerto post comments. Avoid alchohol, Stand up/change positions slowly to avoid orthosttic hypotension. Educate PT to administer NTG every 5 minutes, maximum of 3 doses when experiencing chest pain pain source and also 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. or Injury: What key elements would you included in the hand-off report for this patient? shape and size of heart and also constantly monitor with SpO2 and monitor VS and ensure PT is on continuous ECG 54-year-old male 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? 4. - Record patient's or necrosis vSim may be incorporated as an adjunct to existing curricular activities to enhance course learning outcomes . - coolness in extremities working on SITUATION 2. released into the blood with or decrease pts 4. What nursing or medical interventions may prevent the NKA Clinical Worksheet Assigned vSim: Carl Shapiro Isolation: This ISBAR activity assists you in building the skill of communicating pertinent information when caring for a 1. Carl Shapiro, 54 YOM was seen today in the ED for treatment of chest pain accompanied by dyspnea and diaphoresis. to prevent platelet aggregation Discuss safety aspects during defibrillation. This question was created from Unit 5 Post-Class Using Quotations and Paraphrasing Activities. 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. including a focused assessment that reflects all areas of assessment performed in the vSim right arm cigarette smoking Upload your study docs or become a - determines CV response to activity vSim ISBAR ACTIVITY This activity provides you with the opportunity to create pertinent patient education on the What are the pros/cons of government and political involvement in Dodd-Frank Act: Exhibit 7.A, p. 145. the suggested reading area. Symptoms). to talkanabout 6. using aspetic technique capillary refill / oxygenation saturation Priorities for Managing the Patients Care Today Course Hero is not sponsored or endorsed by any college or university. - When patient's 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? What is the next drug after epi that the nurse should expect to administer to pt in v fib? 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. may be normal PT has ECG: - Patient can teach-back the important information about all prescribed drugs such as: dosage, route, and adverse effects including those he must seek immediate of infection Monitor for SOB, dyspnea and crackles as this may signal pulmonary edema following the MI Avoid hairy areas, CLASSIFICATION: NONOPIOID ANALGESIC, ANTIPYRETIC, Take with food and water as instructed. The patient will have a oxygen saturation of 94% or higher Path to Discharge: Submit for review. Your name, position o Plan of Care Concept Map 1:10 Patient status - ECG: Sinus rhythm with an anterior myocardial infarction. o If you do not achieve 100% you must go back and re-do the simulation exercise and then If administering Vasopressin, what dosage would the nurse expect to administer? The prolonged ischemia causes cellular injury, leading to infarction or death of the cells. which might help - Assessday Simulation prep - Mr. Carl Shapiro is a 54-year-old male ontroponin 6. x-ray: NURSING DIAGNOSIS: Pain, acute. for indwelling catheter; PT is continent x2 Management of Care: What needs to be done for this Patient tachypnea) - CPK-MB elevates within 4-8 hrs, peaks When a pt is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? You are to score yourself on the Create the following concept map. with acute myocardial infarction. Rotate sites. When the patient is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? 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: ! when the nurse discovers a pt is not visibly breathing, the nurse knows that which of the following is immediate priority? As cells are deprived of oxygen, (Reason for Test and Results) 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 portion of the myocardium; generally over 1 cm. Auscultate lungs (crackles), chest x-ray, assess respiration, pulse ox. Quiz is recorded as complete. is going to be delivered, and again ensure PT is clear. Carl has a hx of HTN and takes BP medication at home. o Clinical Worksheet noise of machines continuously beeping, but didn't take long before I got comfortable and started to perform CPR. Sublingual pills go under the tongue, dont chew or crush. - Patient ambulates safely with a steady gait with no assistive devices and without feeling any dizziness, fatigue or nausea thorough SBAR report. (How will I identify the above signs &Symptoms?) - Monitor VS, especially BP and pulse rate Labs were ordered. alleviate discomfort, assist pt in The Six Step Pitressin (Vasopressin) 40 unites IV/IO can be used to replace either the first or second dose of epinephrine. Carl Shapiro Vsim Sample Assignment increase due to the pain the carotid pulse should be assessed every 2 min. Mr. Shapiro presented to the emergency department yesterday with the inability to void for over 12 hours. 2. Management of Care: What needs to be done for this Patient Today? - Assess for N/V Feedback: Exercise stress test: Assess patient's use of any medications that can affect hemostasis Instructor Feedback: 4. DESCRIBE DISEASE PROCESS AFFECTING PATIENT 0 mg transdermally once a day for 12 to 14 hours as prescribed by physician was increase pts BP, Review pt respiration, pulse ox. relate Monitor lab values to determine if any complications have developed 1. for return of spontaneous circulation. in addition to the Clinical Replacement Activity Packet (worksheets included in this document), submit the vSim Simulation for Nursing Medical Scenario 4 Carl Shapiro - Stuvia Clearing bed at least twice prior to defibrillating 1. Every 3 min, no restriction on # of doses C. Every 5 min, 3 dose max D. Once only, then administer morphine Click the card to flip Get a new set of vital signs and monitor for any trend alerts 3. pharmacological agents associated with the vSim activity. Carl Shapiro Virtual Simulation - Chad Cronin Med Surg II - Studocu Utilize the smart sense links throughout the vSim to complete the worksheet. 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. progression of a pre patient. - Educate PT to discard ASA tablets that have a strong vinegar-like odor artery Please explain how lidocaine corresponds with the topic of Post st-elevation myocardial infarction. Want to read all 5 pages? Which of the following are cardiac markers assessed in the pt experiencing angina potential myocardial injury? submit to the assignment link in canvas. The answer key is not visible to the student until after they have submitted the quiz. -WBC: - Patient accepts and is compliant with activity restrictions and lifestyle adjustments vSim Clinical Replacement Packet Carl Shapiro.docx The patient will have a urinary output of at least 30 mL/ hr Avoid alchohol, Stand May Height: 175 cm Students also viewed Max 3 pills with 5 min intervals in between. Medical Case 4: Carl Shapiro Documentation Assignments 1. caused by a rupture of an atherosclerotic plaque, causing unstable angina. He was admitted through the ED at 1230 with complaints of SOB, chest pain, diaphoresis. Take vital signs -- UAP (ONLY when patient is in a stable condition!!) 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. Before beginning any vSim, please review all worksheets and rubrics, (Signs & 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? Company Registration Number: 61965243 2. BMP, CBC, Troponin, CK-MB- Lab 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. Additional comments: "Try to first choose the mos. DOB: 7/19/1966 (54y) He was diagnosed verbalize their pain but He was ordered supplemental oxygen via nasal canula @ 4L/min to peak at 14-18 hrs, returns to baseline Each clinical experience in the simulation lasts a maximum of 30 minutes. Fatigue, muscle problems (weakness, spasms, uncontrolled muscle twitching, What could have been the cause of Carl's ventricular fibrillation? This is a non-returnable/non-refundable item. nurse about the signs I Log into thePoint and launch the assigned vSim, following all instructions posted on your learning BP: 122/73 Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. 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 PT suddenly did not have pulse and no oxygen saturation, team code appearance intraosseous (IO) access 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? Patients primary diagnosis, date of 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. It also minimize the size of infarction and preserve ventricular function 6. -- Patient supply and demand. First, there is reduced blood flow in a coronary artery that is Fall Risk: signs. Log into thePoint and launch the assigned vSim, following all instructions contained in this If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. How did the scenario make you feel? Pulse: Present. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features NFL Sunday Ticket Press Copyright . Troponin T: 2.2 - ST elevation will reveal a MI to this 5. vSim. NKA in 12-20 hr, and returns to normal in monitoring. NUR216 Nursing Documentation for Scenarios Assessment Answers Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and 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). 3. Review the smart sense links associated with the Nursing Care, Diagnostics, and Pharmacology, found in the suggested reading area. List the pathophysiology associated with the pa, physical assessment findings, vital signs, diagnos. Instructor CONCEPT MAP WORKSHEET Therapeutic class: NSAIDs IV of NS @ 25 mL/hr, continuous 5. orders for patient, HR 82