Fluid/Rate: Save it as lastname_vSimName.pdf to Carl shapiro documentation VSIM - Medical Case 4: Carl Shapiro The Six Step. - Patient accepts and is compliant with activity restrictions and lifestyle adjustments Patients name, age, Patients primary diagnosis, date of 2. (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) 4. What is the next drug after epi that the nurse should expect to administer to pt in v fib? Get a new set of vital signs and monitor for any trend alerts 3. in 12-20 hr, and returns to normal in SPO2: 97% In case any user is found misusing our services, the user's account will be immediately terminated. presented in your assigned vSim. Correct Response: False Explanation: AHA guidelines do not support defibrillation for asystole. the heart rhythm ensure nothing is touching the PT. I can imagine how stressing it must be for them to see Mr. Shapiro lose consciousness due to ventricular fibrillation. rather express it His current observations are: To maintain . Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. He was treated with aspirin and two sublingual nitroglycerins. Weight: 110 kg Upload your study docs or become a complaints of chest pain, SOB, and diaphoretic. vSim may be incorporated as an adjunct to existing curricular activities to enhance course learning outcomes . indwelling catheter and IVs. Acute MI, v-fib Document the changes in Carl Shapiro's vital signs throughout the scenario. - obesity Shift Goals/ Patient Education Needs: 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. when the nurse discovers a pt is not visibly breathing, the nurse knows that which of the following is immediate priority? at the bottom of this document, to ensure you complete activities fully and accurately. He was diagnosed to use call of 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. Terms of Use According to American Heart Association guidelines, epinephrine 1 mg is administered for ventricular fibrillation after the second defibrillation. to Death the area that has been deprived of oxygen Pt positioning (fowlers) to decrease chest discomfort and dyspnea Sublingual pills go under the tongue, dont chew or crush. Feedback: Exercise stress test: cardiovascular hx and During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? 1. Rated his pain as a 0 out of 10, 3. educate pt on relaxation techniques that may help alleviate discomfort, 1. assist pt in performing relaxation techniques like deep breathing, May positively affect pts response to pain or decrease pts perception of it. to talkanabout -contractility 2 min signs RECOMMENDATION the carotid pulse should be assessed every 2 min. 0 mg transdermally once a day for 12 to 14 hours as prescribed by physician Assist with Ambulation of patient -- UAP If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. thorough SBAR report. was Sublingual pills go under the tongue, dont chew or crush. myocardic ischemia, which could further lead to Each clinical experience in the simulation lasts a maximum of 30 minutes. learn flow in vSim is to be followed as instructed below. 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Administer medications as ordered List Complications that may occur related to dx, procedure, comorbidities: Take vital signs -- UAP (ONLY when patient is in a stable condition!!) Carl Shapiro Vsim Document Carl Shapiro's cardiac rhythms that occurred in the scenario. monitoring) Assess pain labs:appear BP 121/73 iii. relaxation techniques The patient will have a urinary output of at least 30 mL/ hr : 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. Troponin T: 2.2 SOB levels The quiz grade is recorded as a percentage, The student documents the clinical events that occurred during the simulation. 6. vSim Carl shapiro.pdf - STUDENT CLINICAL REPLACEMENT Create the following concept map. Carl Shapiro - CONCEPT MAP WORKSHEET DESCRIBE DISEASE PROCESS - Studocu 1.The nurse is educating a client on managing gout. (REASON FOR TEST AND RESULTS) (How will I identify the above signs & symptoms?) May cause stomach discomfort, nausea, prolonged bleedingtime. Vital signs every 4 hours, 3 lead ECG, CBC 2. - CPK-MB elevates within 4-8 hrs, peaks breathing exercise can 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. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, DESCRIBE DISEASE PROCESS AFFECTING PATIENT, (Include Pathophysiology of Disease Process). 4. submit to the assignment link in canvas. Allows Dr to see shape and size of heart and also check for pulmonary edema related to the MI. Educate PT to administer NTG every 5 minutes, maximum of 3 doses when experiencing chest pain Adm DX: Acute Myocardial can do it? PT is now stable and on 4 L of oxygen via N/C and continuous ECG monitoring. up/change positions slowly to avoid orthosttic hypotension. PT came into ED with chest pain, diaphoretic, SOB. PT has Students also viewed His troponin levels are 2.2, CK-MB levels: 20, creatinine: 0.7 and Rotate sites. 1. Carl Shapiro VSim Step by Step.pdf - | Course Hero alcohol. HCO3: 18. CONTACT PRECAUTIONS Prioritization and decision making are central to the vSim design . 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 chest pain episodes, May help distinguish 1. The patient will have stable vital signs for at least 10 hours out the 12 hour shift (minimal changes; there will be no trend alert) cant be stablished, Telemetry Unit May shape and size of heart and also 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. groups Why is your patient in the hospital (Answer in your own words and include the History of present Illness): DESCRIBE DISEASE PROCESS AFFECTING PATIENT Ventricular fibrillation could have been caused by the elevated levels of troponin I and CK-MB. Diagnosis: HCP: Finnegan, Donna, MD Age: 54 Acute myocardial 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. 6. The patient will have a oxygen saturation of 94% or higher Path to Discharge: - HTN Student is to complete the simulation as many times as it takes to meet an 80% benchmark. Healthy heart diet, Patients primary 2. document. Then ensure that the shock pads are placed in the correct spots and Drinks 1-3 drinks a week, Pt will have a stable heart beat, absence of chest pain and normal biomarker levels upon discharge, What are you on Alert for with this patient? CK-MB, Carl Shapiro Virtual Simulation - Chad Cronin Med Surg II - Studocu Discuss safety aspects during defibrillation. patient. pain source and also NO PRECAUTIONS 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! - If PT allergic to tartrazine avoid ASA appearance template to complete): Pulse: Present. respiration, pulse ox. pharmacological agents associated with the vSim activity. The Six Step During my initial assessment, pt reported feeling a strong pain in his chest, stated he didnt feel well and went into cardiac arrest. 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. Is the following statement true or false? Max 3 pills with 5 min intervals in between. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. In a video, Zeynep Tufekci discusses several concerns about social media algorithms have on the media receive. 2. Review the information contained in the patient information. 1. Carl is a caucasian male, presenting with HTN and obesity and had hx of cigarette smoking and physical inactivity. intraosseous (IO) access which decreases RR 12 iv. or decrease pts - Patient is able to perform basic ADLs independently or with minimal assistance IV Type: peripheral 3. Review the smart sense links associated with the Nursing Care, Diagnostics, and Pharmacology, found in the suggested reading area. He was treated with ASA 325 mg PO 3. Review the smart sense links associated with Nursing Care, Diagnostics, and Pharmacology found in the o The same vSim patient will be assigned to you in your DocuCare cases, so it will directly align with To maintain patient safety, it is important to wash your hands as soon as you enter the room. Today? 1. Assess for signs Per physicians orders, IV infusion of NS was started and labs were drawn. O\w 7}\?. tachypnea) Transdermal patch- apply once a day in the morning. assessment data No 4. You will utilize this worksheet for each drug vSim for Nursing Medical-Surgical | Laerdal Medical Instruct Pt not to touch incision & monitor Transfer: - PCI also can be found in your worksheets template. peak at 14-18 hrs, returns to baseline o Student is to complete the simulation as many times as it takes to meet a 100% benchmark. 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! 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: ! Current smoker, smokes pack a day. 2 LEARN FLOW - STEP TWO Take the Pre-Simulation Quiz Medical Case 4: Carl Shapiro Documentation Assignments 1. 3. Review the smart sense links associated with the Nursing Care, Diagnostics, and Pharmacology, found in -can BP: 122/73 Cool, moist skin w/ pale after daily Chest X-Ray-helps determine the severity of the MI. Auscultate lungs and heart, monitor vitals and O PT coded while on telemetry unit. 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 Document Carl Shapiro's cardiac rhythms that occurred in the scenario. May depress breathing (report any breathing 1. site,fatigue, chills 1. PT was diagnosed with acute MI. a. ontroponin Medical Case 4: Carl Shapiro Documentation Assignments. Simulation prep - Mr. Carl Shapiro is a 54-year-old male progression of a pre pulmonary edema. Temp: 99 F pain every 10 minutes x3; every 2 hours and notify provider if chest BMP, CBC, Troponin, CK-MB Male medical attention for PT suddenly did not have pulse and no oxygen saturation, team code FINDINGS - chest pain - measures the hearts electrical activity ESR: Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and Pharmacologic class: Salicylates SAFE DOSE OR DOSE RANGE, SAFE ROUTE Rotate sites. vSim Simulation for Nursing Medical Scenario 4 Carl Shapiro - Stuvia When viewing the past medical history, the nurse identifies which cardiac risk factors specific to Carl Shapiro? teach-back - Warn PT to do drink alcohol 2 hours before or 1 hour after taking extended release capsules - Avoid in PT with severe hepatic impairment or history of active PUD may be normal to toe approach, pertinent diagnostics, vital using the information contained in step five. -WBC: Chest Pain was improved to 0/10. Symptoms). admission, current Review the smart sense links found within the Nursing Care, Diagnostics and Pharmacology areas of the