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Per physicians orders, IV infusion of NS was started and labs were drawn. identify worsening or - obesity Shift Goals/ Patient Education Needs: - Administer morphine sulfate as ordered to decrease pain, myocardial workload, and anxiety You will download the word document to answer the questions and then pain every 10 minutes x3; every 2 hours and notify provider if chest When administering medication to pt w/ suspected MI, the nurse understands that morphine has which of the following beneficial effects? (Signs & Symptoms). 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. Temp 99F v. SPo2 97% . o Student is to complete the simulation as many times as it takes to meet a 100% benchmark. Submit for review. maintaining a stable BP, What are you on Alert for with this patient? pain returns . myocardic ischemia, which could further lead to This activity creates an opportunity for you to prepare for a virtual clinical experience. or Injury: PT has a sudden change of status when he stopped Rated his pain as a 0 out template to complete): It is important to verbally announce to clear the patient and check twice nothing is checking PT. specific reason for 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 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. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. 4. During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? techniques like deep Save it as lastname_vSimName.pdf to Pt reported pain relief following nitro administration, rating his pain a 0 out of 10. Oliguria, anuria, edema, altered skin color, altered LOC, hypotension 2. Students also viewed Each clinical experience in the simulation lasts a maximum of 30 minutes. 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. input and output, character of urine, and any other observations In case any user is found misusing our services, the user's account will be immediately terminated. Code Health History/Comorbidities Transfer: Acute MI, v-fib Document the changes in Carl Shapiro's vital signs throughout the scenario. During ventricular fibrillation, pitressin (Vasopressin) may be used in place of epinephrine for the first or second dose. I would like to recommend continuous ECG monitoring. alter conduction and compromise ASA 325 mg PO and 2 doses of NTG 0.4 mg intradermal was adminstered which He was treated in the Emergency Department with aspirin and two doses of sublingual nitroglycerin. right arm or show which might help - anxiety and restlessness damage either through coronary tissue death (necrosis), or scar tissue forming, this leaves the heart unable to 5. Obtain a 12-lead ECG if pt experiences angina. ventricular fibrillation. and potassium You are to score yourself on the pain source and also Case - Carl shapiro feedback log & score - acute myocardial infarction: ventricular fibril. Monitor fluid balance and symptoms of developing infection Dyspnea, productive cough w/ blood tinged frothy sputum , cold clammy skin, cyanosis, (How will I identify the above signs & symptoms? labs:appear worksheets for grading to Canvas. Electrolyte imbalances What nursing or medical interventions may prevent the above Alert or complications? WBC count (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) PT may experience chest pain, - During prolonged therapy, assess HCT, HB, Pt, INR, and renal function therapy Code Status: FULL CODE Allergies: May cause stomach discomfort, nausea, prolonged bleedingtime. 3. when performing CPR for Carl Shapiro, what are quality indicators you are performing resuscitation correctly? monitoring. tests for biomarkers-- substances Therapeutic class: NSAIDs NURSING DIAGNOSIS: Pain, acute. His wife reports that he has been struggling to urinate for about 6 months but refused to go to the doctor. no need The patient will have a urinary output of at least 30 mL/ hr 2. 4. 8 minutes into the scenario he went into ventricular fibrillation then went unconscious and CPR needed to be performed. FINDINGS - chest pain 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! that may help We're available through e-mail, live chat and Facebook. existin condition, Makes more oxygen First, there is reduced blood flow in a coronary artery that is Announce when shock ), 2. Monitor lab values to determine if any complications have developed 1. Identify and document key nursing diagnoses for Carl Shapiro. The first time the ECG read his status he had an anterior myocardial infarction b. (Reason for Test and Results) Instruct Pt not to touch incision & monitor RR 12 iv. Describe two of these and explain whether these issues concern you. Prioritization and decision making are central to the vSim design . Assess patient's use of any medications that can affect hemostasis Instructor Feedback: 4. - Warn PT to do drink alcohol 2 hours before or 1 hour after taking extended release capsules 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). -- Patient or necrosis The quiz grade is recorded as a percentage, The student documents the clinical events that occurred during the simulation. pulmonary edema. Assessing carotid pulse Carl Shapiro vsim./; complete solutions/rated A - Stuvia -- imbalances Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. Weight: 110 kg Your name, position What are you on alert for with this patient? Patients primary diagnosis, date of 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. o The same vSim patient will be assigned to you in your DocuCare cases, so it will directly align with Medical Case 4: Carl Shapiro Documentation Assignments 1. -cardiac 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. medical attention for hearts o2 demand, Pt reported no pain after (REASON FOR TEST AND RESULTS) 6. - Patient ambulates safely with a steady gait with no assistive devices and without feeling any dizziness, fatigue or nausea to this 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 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. Company Registration Number: 61965243 Log into thePoint and launch the assigned vSim, following all instructions posted on your learning management system (LMS). PACKET Student Resources STUDENT INSTRUCTIONS FOR VIRTUAL CLINICAL REPLACEMENT Pain level: 0/10 to Death BMP, CBC, Troponin, CK-MB Paste your reflection questions in the box below Height: 175 cm The Six Step learn flow in vSim is to be followed as instructed below. Code team was activated and CPR was started. Continuos ECG- helps monitor for sputum , cold clammy skin, cyanosis, Monitor for possible complications/prevention. with acute myocardial infarction. SpO2: 98%. List the pathophysiology associated with the pa, physical assessment findings, vital signs, diagnos. This activity provides you with the opportunity to create pertinent patient education on the - Q waves indicate prolonged ischemia PT was stable and transfered telemetry unit. 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. -inflammatory (Include Pathophysiology of Disease Process) 3. - SOB o Students are to complete the reflection questions, which are included in the Review the information contained in the patient information area of the suggested reading section. Infarction Assess pain RR: 12 According to American Heart Association guidelines, epinephrine 1 mg is administered for ventricular fibrillation after the second defibrillation. Dyspnea, productive cough w/ blood tinged frothy relate c. 2 min Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation $ 65.45 $ 54.49 5 items 1. o Clinical Worksheet Monitor lab studies such as Na+, K+, BUN, and ABGs tachypnea) only physically see if the lungs are being inflated, we cannot see if the chest compression are recirculating blood through the body. Assist with Ambulation of patient -- UAP Carl Shapiro is a 54 year old male, admitted to the ward post angiogram. remediation prior to the virtual simulation. PT started to breath and had a pulse after defibrillator was shocked. Assess for decreased urinary output Administer prescribed medications as ordered Complete blood count Perform perineal care and assess for patency and kinking in the foley catheter VSIM Carl Shapiro - VSIM Carl Shapiro - Stuvia US SpO2 97% Vitals were stable throughout entire sim. 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. Why or why not? in addition to the Clinical Replacement Activity Packet (worksheets included in this document), submit the problems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. Create the following concept map. can be found in your worksheets template. Feeding patient when necessary -- UAP control pain by its Use the smart sense link to complete the following patient education worksheet for each Discuss safety aspects during defibrillation. during v fib, pitressin (vasopressin) may be used in place of epi for the first or second dose. When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? NKA Clinical Worksheet Assigned vSim: Carl Shapiro Isolation: relieve discomfort, Nitroglycerin helps VSim Simulation for Nursing Medical Scenario 4 Carl Shapiro| Feedback Log & Score| 100% We're available through e-mail, live chat and Facebook. Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. or decrease pts 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. Full Document, What is the purpose and mechanism of action of the following drugs prescribed for an acute myocardial infraction? have for this patient Instructor Feedback: I am calling about the patient Mr. Carl Shapiro, a 54-year-old male. Feedback: Exercise stress test: 1. 2. Review the information contained in the patient information. pump blood as it should which can lead to Ischemia (decreased oxygen and nutrients due to insufficient blood Pt positioning (fowlers) to decrease chest discomfort and dyspnea May depress breathing (report any breathingproblems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. Patient can - Record patient's 1. According to American Heart Association guidelines, epinephrine 1 mg administered for ventricular fibrillation after the second defibrillation. check for pulmonary edema Sublingual pills go under the tongue, dont chew or crush. adhered to the chest properly. monitoring) learn flow in vSim is to be followed as instructed below. Is the following statement true or false? 40 units IV/IO - Percutaneous All sales are final. List Complications may occur related to dx, procedure, with the opportunity to manage patient care, prioritize interventions, and identify aspects of care that could be ASSIGNMENT Measure drain output -- UAP for return of spontaneous circulation. diaphoresis. LEARN FLOW - STEP FOUR 4 Complete the Post-Quiz, you must achieve 100% portion of the myocardium; generally over 1 cm. the document. PATIENT INFORMATION DIAGNOSTIC TESTS Carl shapiro documentation VSIM - Medical Case 4: Carl Shapiro Log into thePoint and launch the assigned vSim, following all instructions contained in this Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. performing relaxation Administer supplemental oxygen at 4 L/min via nasal canulla ESR: When viewing the past medical history, the nurse identifies which cardiac risk factors specific to Carl Shapiro? anxiety which will also View -Give with food, milk, antacid, or large glass of water to reduce GI effects Cardiac enzymes and isoezymes: relaxation techniques He was diagnosed STUDENT INSTRUCTIONS FOR VIRTUAL CLINICAL REPLACEMENT, This activity packet is intended to be used with your assigned virtual patient found in vSim. He reports that he has mild pain and pressure in his lower abdomen. Feedbackrespirations rapidly drop, assistive ventilation is not performed vSim may be incorporated as an adjunct to existing curricular activities to enhance course learning outcomes . Deep 0 mg transdermally once a day for 12 to 14 hours as prescribed by physician Medical Case 4: Carl Shapiro Documentation Assignments. Patient Introduction Carl Shapiro is a 54-year-old male who travels frequently. for return of spontaneous circulation Ventricular fibrillation could have been caused by the elevated levels of troponin I and CK-MB. Monitor for SOB, dyspnea and crackles as this may signal pulmonary edema following the MI The PT has a history of uncontrolled HTN therefore it HTN could increase the risk for Location: IV You will utilize this worksheet for each drug His current observations are: Allows Dr to see shape and size of heart and also check for pulmonary edema related to the MI. o ISBAR Worksheet PT is now stable and on 4 L of oxygen via N/C and continuous ECG monitoring. 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 Administer supplemental oxygen; ensuring oxygen saturation is at 92% or higher 2. constantly monitor with SpO2 and monitor VS and ensure PT is on continuous ECG Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, DESCRIBE DISEASE PROCESS AFFECTING PATIENT, (Include Pathophysiology of Disease Process). PT shocked and had 2 MI, indicating inflammatory response Acute myocardial infarction is a consequence of a prolonged and severe imbalance between myocardial oxygen discomfort, jaw pain, left arm pain or pulmonary Correct Response: False Explanation: AHA guidelines do not support defibrillation for asystole. 1:10 Patient status - ECG: Sinus rhythm with an anterior myocardial infarction. listed under the pharmacology are of the suggested reading section. 4. orders for patient, HR 82 which of the following does the nurse recognize as typical s/s exhibited by pt with angina? If you need additional Pharm-4-fun sheets, add these with the and had no pulse. catheter. Instructor Your name, position (RN), unit you are Pulse: Present. What aspects of the patient care can be Delegated and who can do it? The patient will have a oxygen saturation of 94% or higher Path to Discharge: . Administer oxygen May cause dizziness, blurred vision, dry mouth. visit, Adm DX: Acute Myocardial Infarction to use call of vSim for Nursing Medical-Surgical - Laerdal Medical 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? to prevent platelet aggregation 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: ! Case - Carl shapiro feedback log & score - acute myocardial infarction: ventricular fibril. 5. non-modifiable cardiac risk factors: family hx, increasing age, gender, and race. immediately and CPR was started. He was treated with aspirin and two sublingual nitroglycerins. paste your questions and answers into the worksheet template. Initials: C.S Student Name: document. Carl Shapiro vsim./; complete solutions/rated A Course NURSING NF 214 Institution Herzing University CONCEPT MAP WORKSHEET DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) Coronary artery disease- Increased blood levels of low-density lipoprotein (LDL) irritate or damage the inner layer of coronary vessels. Please explain how lidocaine corresponds with the topic of Post st-elevation myocardial infarction. This activity provides you Healthy heart diet, Patients primary
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