This could have been related to the fact that he had just sustained his first MI bleeding, or drainage. Avoid alchohol, Stand May cause dizziness, blurred vision, dry mouth. Take as directed, with water and food to avoid nausea, do not crush or chew. 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 1. tachypnea) There are other risk factors, called non-modifiable, which you cant change. We're available through e-mail, live chat and Facebook. Later the 3 lead EKG showed ventricular fibrillation. alcohol. Carl has a hx of HTN and takes BP medication at home. At the beginning of the scenario 0:10 time: HR: 82, BP: 125/74 mm/Hg, Wolters Kluwer Health | Lippincott Williams & Wilkins, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01. Drug irreversibly inhibits platelet aggregation. c. Patient then had ventricular premature beats while pulse was still absent, but heart Our support team and experts are available 24x7 to help you. Carl Shapiro Virtual Simulation Virtual simulation through the Point online resource University National University (US) Course Medical-Surgical Nursing II (NSG 320) Uploaded by Chad Cronin Academic year2021/2022 Helpful? h. I continued CPR on a 30:2 ratio. No alcohol. Referring to your feedback log, document the assessment findings and nursing care you limits. patient care change? Document Carl Shapiros cardiac rhythms that occurred in the scenario. there were only normal heart sounds. Code team was activated and CPR was started. When the nurse discovers a patient is not visibly breathing, the nurse knows that which of the following is the immediate priority? Upon entering the room, I asked the patient about any pain he may have Attached 3- a. b. 0 X Sold activated, pulse and breathing were checked, CPR was started, AED was attached. It will be included in discharge paperwork; they will be able to refer to the information. An MI causes permanent Terms of Use 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. vasodilating effects Pulse: Present. 25ml/hr. [Show more] Preview 1 out of 4 pages. VSIM Nursing documentation for scenarios : Care plan for C - Medical case 4 : Carl Shapiro Guided reflection questions 2. Current smoker, smokes pack a day. Bowel sounds were heard X4. home after his x-ray was complete. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Company Registration Number: 61965243 Present. Oxygen was bumped to breathing, May positively affect Pt medication to prevent clotting that could lead to a, Nurse aid can help position pt as needed, can also assist Decreased Cardiac Output related to: changes in the frequency of heart rhythm. Avoid hairy areas. 99 F (37 C) defibrillation he was back in sinus rhythm. Fall Risk: Location: Consults: Transfer: Fluid/Rate: PT came into the ED with complaint of chest pain, SOB and diaphoresis. Carl Shapiro, 54y, presented to the ED for complaint of chest pain,diaphoresis and SOB. Counscious state: appropriate 2. Is the following statement TRUE or FALSE? Turned on AED. 2. Docmerit is a great platform to get and share study resources, especially the resource contributed by past students and who have done similar courses. Intervention can help patient regain control of own behavior. Heart rate: 82. Administer nitroglycerin & other pain meds Acute MI, v-fib Document the changes in Carl Shapiro's vital signs throughout the scenario. check for pulmonary edema Liberty University May cause hypotension, change positions/get up slowly. Cross), Lab Report 11- Nitration of Methylbenzoate, Bio Lab Report - Altering Catecholases Enzyme Activity Through the Use of pH, Temperature, Enzyme, Acid-Base Liquid-Liquid Extraction Lab Report, Puh250 lec3 - Definitions of Sample Median, Quartiles 1 and 3, and Interquartile Range. 2. VSIM Carl Shapiro 4. Keep SBP over 90 mmhg by giving IVF bolus and a vasopressor When I say on the continuous EKG Document Carl Shapiro's cardiac rhythms that occurred in the scenario. PT may experience chest pain, Transdermal patch-apply once a day in the morning. I called the code team and started CPR. 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. 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. 2. Document the changes in Carl Shapiros vital signs throughout the scenario. Consider the SBAR (situation, background, assessment, recommendation) format. ECG, Auscultate lungs (crackles), chest x-ray, assess [Show more] Preview 2 out of 5 pages Based on the following ECG waveform, the nurse recognizes that the patient is experiencing which dysrhythmia? Weight: 110 kg of blood flow pumped into the heart which prevents it from receiving enough oxygen. DOB: 7/19/1966 (54y) The backboard was placed, AED was turned on and chest pads were applied. 1. His HR 83, BP 124/71, R 12 equal bilaterally, T 99 degrees, and O2 98% relaxation techniques 4. Document Carl Shapiros cardiac rhythms that occurred in the scenario. I started continuous ECG monitoring to which I notices normal sinus rhythm on the 3. Temp: 99 F (37 C) ), Which of the following are cardiac markers assessed in the patient experiencing angina to determine potential myocardial injury? (Select all that apply. diaphoresis. (Select all that apply. Identify and document key nursing diagnoses for Carl Shapiro. that may help experienced using the COLDSPA method. b. Per Saint Lukes: We could give the family a choice to either watch in the corner damage either through coronary tissue death (necrosis), or scar tissue forming, this leaves the heart unable to SpO2: --. existin condition, Makes more oxygen A shock was Surgical Case 5: Lloyd Bennett Documentation Assignments 1. BP 122/ f FULL FILES AT; https://www.stuvia.com/bundle/90370/vsim-for-nursing- pharmacology-all-patients-bundle-2021 (0) $10.49 4xsold MS2 Nursing Clinical, Week 1 VSIM; V-Sim Carl Shapiro Documentation and Guided Reflection. 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), Recommendations: Continue to monitor cardiac functioning. severity of the MI. After that I took labs 10 Comments Please sign inor registerto post comments. Report Copyright Violation $15.49 Add to cart Add to wishlist Seller Follow perception of it. Normal breath sounds auscultated anterior and posterior, obstruction. 4. related to the MI. Intervene if patient displays destructive behavior. Heart rate: 82. Temp: techniques like deep 'Subject'(My Assignment Help,2023)https://www.myassignmenthelp.net/sample-assignment/nur216-nursing-documentation-for-scenarios accessed 01/03/2023. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Cross), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), The Methodology of the Social Sciences (Max Weber), Psychology (David G. Myers; C. Nathan DeWall), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham). lead ECG. a. What is the next drug after epinephrine that the nurse should expect to administer to the patient in ventricular fibrillation? NURSING DIAGNOSIS: Pain, acute. which might help Patient Scenario: Carl Shapiro (Medical pt 4), Acute pain r/t tissue ischemia AEB reports of chest pain, Verbalize relief/control of chest pain within appropriate time frame for administered medications, Display reduced tension, relaxed manner, ease of movement. ECG: sinus rhythm w/ anterior myocardial infarction. Healthy heart diet, Patients primary Transdermal patch- apply once a day in the morning. Attached pulse oximeter to 2. backboard under patient. Dyspnea, productive cough w/ blood tinged frothy Carl Shapiro's cardiac rhythms that occurred in the scenario include a sinus rhythm with an anterior myocardial infarction when the 12 lead EKG was attached. 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? a. - Hypertension For most of the scenario, it remained Carl Shapiro Vsim. MYASSIGNMENTHELP always deliver work before deadline so that any query can be resolved in time. The code team was called, GOAL: relief of chest pain and establish stable rhythmic heartbeat, OUTCOME CRITERIA NURSING ORDERS RATIONALE DOCUMENTATION/, Monitor non verbal After three sets of compression patient begins to breathe again, Sinus rhythm with an anterior MI Vfibnormal sinus rhythm, Attached continuous pulse ox 98% 4L via NC, Looked for normal breathing - 12 breaths/min, Asked how bad is the pain? pt stated there is no pain, Listened to the heart of the pt. Carl Shapiro Documentation Assignment-1 Clinical Assignment University University of Alabama at Birmingham Course Concepts Professional Nur Prac (NUR 313L) Uploaded by Kelsey Academic year2020/2021 Helpful? a. David Smith. on his chest. He also said that the pain radiated down his right arm and felt Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and I have done compressions before and know that it is something you learn from reputation and experience. respiration, pulse ox. diagnosis, date of BMP, CBC, Troponin, CK-MB- Lab Was admitted Monitor and document characteristic of pain, noting verbal reports, nonverbal cues) and BP or heart rate changes. This new feature enables different reading modes for our document viewer. specific reason for VSim Carl Shapiro Documentation and Guided Reflection NUR 420 :Role Practicum Capstone (NUR 420) Document Content and Description Below Document Carl Shapiro's cardiac rhythms that occurred in the scenario. I then Respiration: 0. taking aspirin and nitro. c. Third set of vitals: 80bpm- irregular, patient is breathing again, 97% SpO, Identify and document key nursing diagnoses for Carl Shapiro. which decreases The EKG will project a better rhythm different from V Fib. a. Monitor for SOB, dyspnea and crackles as this may signal pulmonary edema following the MI Second Set of Vitals: no pulse, no breathing, EKG shows V Fib scenario. b. What Assessments will you focus on for this patient? I attached a 3-lead electrode on his chest to monit, his heart rate and rhythm. Chest X-Ray- helps determine the for return of spontaneous circulation discomfort, jaw pain, left arm pain Teach about modifiable and nonmodifiable risk factors. Patient may fear death and/or be anxious about immediate environment. After CPR and resuscitation efforts his vital signs can do it? VSIM. dry and intact. because he was unconscious. Symptoms). His pain comes and go and, sometimes radiates round to his arm. I called the provider again and a handoff was performed. Pulse: Present. provided. View example Initiated a CODE BLUE and started compressions immediately. Delay in reporting pain hinders pain relief and may require increased dosage of medication to achieve relief. Medical Case 4: Carl Shapiro Documentation Assignments 1. Assess IV sites frequently- IO access is the route use for drug delivery in emergency situations when an IV access 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). He received aspirin and 2 doses of sublingual Nitroglyce, the ED. b. Purpose: To teach the patient of the importance of smoking cessation. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01. Stop drug 5 to 7 days before elective surgery to allow time for production and release of new platelets. Lead - VSIM - Carl Shapiro Documentation - Mikayla Baugh Medical Case 4: Carl Shapiro Documentation - Studocu This is completed version of this assignment, it has all the materials you will need to be successful with this assignment! Conscious state: Students also viewed Fundamentals of Nursing Chapter 1 Delegation notes Active Learning Template medication-2 The nurse understands that aspirin is administered to a patient with a suspected myocardial infarction (MI) for which of the following reasons? Summary MS2 Nursing Clinical, Week 1 VSIM; V-Sim Carl Shapiro Documentation and Guided Reflection. Heart rate: --. Identify and document key nursing diagnoses for Carl Shapiro. 3. were as follows: HR: absent, blood pressure: absent, respirations: 0, SpO2: Students also viewed Grignard Reaction Lab Report approach, pertinent c. Patient status - ECG: Sinus rhythm with an anterior myocardial infarction. Document the changes in Carl Shapiros vital signs throughout the scenario. Eyes and Ears Matching - Study sheet from SI on eyes and ears terminology, Biology 109 Syllabus Fall 2020 - updated 8-26-20. Document a comprehensive pain assessment for Marilyn Hughes. Current pertinent assessment data using head-to-toe approach, pertinent diagnostics, vital signs. Heart rate: 80. maintaining a stable BP, What are you on Alert for with this patient? 7. order. What would you do differently if you were to repeat this scenario? When administering medication to the patient with suspected myocardial infarction, the nurse understands that morphine has which of the following beneficial effects? the SBAR (situation, background, assessment, recommendation) format. Document Carl Shapiros cardiac rhythms that occurred in the scenario. no one is touching the patient before shocking the patient. (Select all that apply.). delivered, and the patient regained a normal sinus rhythm. Conscious stat. Management of Care: What needs to be done for this Patient Today? Patient had no pain, so I did not administer morphine. : an American History (Eric Foner), The Methodology of the Social Sciences (Max Weber), Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. At 1002 pt was unconscious VS as follows: myocardial infarction, there are ventricular premature beats. Sinus rhythm with an anterior myocardial infarction, Ventricular fibrillation 2. Pulse: Present. c. A: After code, patient was breathing and had an irregular pulse of 80 bpm [Show More] VSIM Nursing documentation for scenarios : Care plan for Carl Shapiro 3. During the beginning of the simulation, his vitals were all stable and within normal Blood pressure: 5Liters, and code team was called. 5. 8. Approach patient calmly and confidently. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. above alert or complications? Auscultate lungs (crackles), chest x-ray, assess respiration, pulse ox. Epinephrine is drug of choice in emergency treatment of acute anaphylactic reactions, PRN 2 mg IV push for chest pan every 10 mins as needed, up to 3 doses, 0.4 mg transdermal once a day for 12 to 14 hours, PRN 0.6 mg sublingually every 5 mins, up to 3 doses, Acute angina pectoris, to prevent or minimize anginal attacks before stressful events, Closely monitor vital signs, particularly BP, during infusion especially in pt with an MI, Excessive hypotension can worsen ischemia, Vasodilatory shock in patients who remain hypotensive despite fluids and catecholamines, Monitor BP and hemodynamic parameters every 10-15 min during therapy. SOB Conscious state: Unconscious. Now is my chance to help others. Conscious state: Unconscious. Provided patient education. Auscultated heart sounds. What key elements would you include in the handoff report for this patient? His oxygen saturation Avoid alchohol, Stand up/change positions slowly to avoid orthosttic hypotension. 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)? Document the changes in Carl Shapiro's vital signs throughout the scenario. B: Patient smokes a pack of cigarettes a day and had a history of high blood The patient also went into ventricular fibrillation and coded. When viewing the past medical history, the nurse identifies which cardiac risk factors specific to Carl Shapiro? up/change positions slowly to avoid orthosttic hypotension. Prior to him coding, his heart rate dropped instantaneously, and his rhythm became I proceeded my vitals. HR: 83, Pulse: 90, B/P: 1, heart medicationHelen, Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Civilization and its Discontents (Sigmund Freud), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Give Me Liberty! Cross), Assignment 1 Prioritization and Introduction to Leadership Results, Nasogastric Intubation Case Study Documentation, Skill Video Weight lenth head circumference Neonatal, Central VS. and anxiety, thise will also RR 12 iv. Document the changes in Carl Shapiro's vital signs throughout the scenario. Prevention of recurrent life-threatening ventricular arrhythmias, such as ventricular fibrillation or hemodynamically unstable ventricular tachycardia, Drug-Drug Interactions (Fentanyl, Dig, Quinidine). Temp 99F v. SPo2 97% . Case - Medical case 4 : carl shapiro guided reflection questions 2. Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation $ 65.45 $ 54.49 5 items 1. control pain by its Elevated HR & RR (tachycardia & Respiration: 0. Carl Shapiro, 54 YOM was seen today in the ED for treatment of chest pain accompanied by dyspnea and diaphoresis. unconscious and CPR needed to be performed. 4. a. ECG: Sinus rhythm with an anterior myocardial infarction. Medical Case #4. I then What nursing or medical interventions may prevent the Ventricular fibrillation- its a life-threatening cardiac emergency that causes rapid, irregular and ineffective Adm DX: Acute Myocardial performing relaxation Allows Dr to see 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? - Obesity. 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