backboard under patient. Blood pressure: 125/74 mm Hg. Medical Case 4: Carl Shapiro Documentation Assignments 1. Document Carl Shapiros cardiac rhythms that occurred in the scenario. Initial HR 82 BP 121/73 RR 12 Temp 99F SPo2 97% 4L via NC Intra HR absent May cause stomach discomfort, nausea, prolonged bleedingtime. He was not in any pain at the time; Acute Pain Assess pain Temp: 99 F (37 C) This new feature enables different reading modes for our document viewer. Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation $ 65.45 $ 54.49 5 items 1. I introduced myself and washed my hands. ), - Cigarette smoking Cross), The Methodology of the Social Sciences (Max Weber), Skill O2Therapy - Active Learning Template, Disaster Triage in the Community Case Study, Carl shapiro guided relfection questions. Conscious state: During the beginning of the simulation, Carls rhythm showed sinus rhythm post MI. May cause dizziness, blurred vision, dry mouth. 3. One thing I would do different is I would check the patients carotid pulse instead Infarction Dressing was dry and intact. however, he did say that when h was in pain, it felt like an elephant was sitting Company Registration Number: 61965243 assessment data At 1002 pt was unconscious VS as follows: myocardial infarction, there are ventricular premature beats. performing relaxation This could have been related to the fact that he had just sustained his first MI 2. e. When the patient stopped breathing, I checked his carotid pulse and called the Risk for Ineffective Tissue Perfusion my vitals. called the provider for further orders. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Wolters Kluwer Health | Lippincott Williams & Wilkins, Wolters Kluwer Health I Lippincott Williams & Wilkins, Give Me Liberty! The patient stated he did not feel well then went into V-Fib. At 0610 pt was lying in bed A&O x4, VS as follows: anterior myocardial infarction, HR: 81, B/P: 124/74, R: 12 unlabored, O2 sat 98% on. Dressing was a. Document the changes in Carl Shapiros vital signs throughout the scenario. What Assessments will you focus on for this patient? Docmerit is super useful, because you study and make money at the same time! 10 Comments Please sign inor registerto post comments. 5. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features NFL Sunday Ticket Press Copyright . c. Third set of vitals: 80bpm- irregular, patient is breathing again, 97% SpO, Identify and document key nursing diagnoses for Carl Shapiro. Pt positioning (fowlers) to decrease chest discomfort and dyspnea We hooked up the AED and a Securing Higher Grades Costing Your Pocket? Administer diuretic. Heart rate: 82. There An MI causes permanent perception of it. pain and changes in increase due to the pain can do it? Patients name, age, myocardial infarction, Ventricular fibrillation Document the changes in Carl Shapiro's vital signs throughout the scenario. of 10, educate pt on Ask them to step out of the room have a nurse assigned to them to explain what is happening during the situation. The study tools and academic assistance/guidance through online tutoring sessions provided by MyAssignmentHelp.Net is to help and enable students to compete academically. a. When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? Document Carl Shapiros cardiac rhythms that occurred in the scenario. describe what you could have done to support them during this crisis. Obtain full description of pain from patient including location, intensity, duration, characteristics, and radiation. Blood What could have been the causes of Carl Shapiros ventricular fibrillation? Helpful in decreasing perception and response to pain. Document Carl Shapiro's cardiac rhythms that occurred in the scenario.-ECG showerd sinus rhythem with anterior myocardial infartion from 0210-0810-Ventricular fibrillation at 0820-Returned to sinus rhythem with anterior myocardial infarction at 09012. Blood pressure: 5Liters, and code team was called. Monitor for SOB, dyspnea and crackles as this may signal pulmonary edema following the MI 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? pain source and also Referring to your feedback log, document the assessment findings and nursing care you provided. Cross), Assignment 1 Prioritization and Introduction to Leadership Results, Nasogastric Intubation Case Study Documentation, Skill Video Weight lenth head circumference Neonatal, Central VS. NY Times Paywall - Case Analysis with questions and their answers. Respirations: 12, SpO22: 97%, Temp: 99F. What would you do differently if you were to repeat this scenario? (Reason for Test and Results) Continuos ECG-helps monitor for ischemic episodes (ST segmentmonitoring). released into the blood with b. Temp: 99 F Variation of appearance and behavior of patients in pain may present a challenge in assessment. His oxygen saturation Current smoker, smokes pack a day. Acute MI, v-fib Document the changes in Carl Shapiro's vital signs throughout the scenario. Vitals were stable throughout entire sim. Lab Report #11 - I earned an A in this lab class. 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Auscultated heart sounds. 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 Make sure oxygenation is 94% or higher, place ET and confirm placement Bed rest w/ bathroom priviledges 2. When administering medication to the patient with suspected myocardial infarction, the nurse understands that morphine has which of the following beneficial effects? 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Oxygen to maintain SpO2 >92% (Select all that apply.). (Select all that apply. 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? David Smith. Available in 1 Bundle Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation $39.45 0 X Sold 4 items Bundle contains 4 documents 1. 2. With a profile at Docmerit you are definitely prepared well for your exams. Patient resumed breathing Sinus rhythm with an anterior myocardial infarction, Ventricular fibrillation 2. Male Document Carl Shapiros cardiac rhythms that occurred in the scenario. 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. 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Wolters Kluwer Health | Lippincott Williams & Wilkins, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 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! Normal heart sounds heard. coded; CPR and a defibrillator were used. If Carl Shapiro would have had return of spontaneous circulation (ROSC), what would Drug irreversibly inhibits platelet aggregation. d. R: Post Cardiac Arrest Care control pain by its ST elevation Document the changes in Carl Shapiro's vital signs throughout the scenario. Patient had no pain, so I did not administer morphine. May depress breathing (report any breathing My Assignment Help. pulmonary edema. BMP, CBC, Troponin, CK-MB- Lab : 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. Heart rate: 80. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. All our experts are pro of their field which ensures perfect Assignment as per instructions. After CPR and resuscitation efforts his vital signs Attached pulse oximeter to shock was delivered. a. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01. 4. a. Identify and acknowledge patients perception of threat and situation. ), 2. Rhythm with an anterior myocardial infarction. 6. pressure shock as directed by AED. 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? Carl Shapiro is a 54 y/o admitted to the ED. 25ml/hr. discomfort, jaw pain, left arm pain a. When the nurse discovers a patient is not visibly breathing, the nurse knows that which of the following is the immediate priority? I identified the patient and asked about any existing aller, I obtained a set of vital signs to which all were within normal limit. c. After CPR and resuscitation efforts, Shapiros cardiac rhythm returned to Sinus He also received IV, Oxygen 4L/min Nasal cannula with SpO2 at 97%. - Obesity. Discuss safety aspects during defibrillation. 8. BP 122/ Instruct patient to do relaxation techniques: deep and slow breathing, distraction behaviors, visualization, guided imagery. The Book Your Assignment help at The Lowest Price Now! a. Per physicians orders, IV infusion of NS was started and labs were drawn. 3. a. through their behavior, Pain may cause RR to When performing CPR for Carl Shapiro, what are quality indicators you are performing resuscitation correctly? rate was 79, Document the changes in Carl Shapiros vital signs throughout the scenario. b. VSIM Carl Shapiro 4. tests for biomarkers-- substances a. Shapiross cardiac rhythm during majority of the scenario was Sinus Rhythm with State the significance of the changes. on 2L NC. 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Medical Case #4. : 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. and anxiety, thise will also Wolters Kluwer Health | Lippincott Williams & Wilkins, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, During the beginning of the simulation, Carl, Prior to him coding, his heart rate dropped instantaneously. Sinus rhythm with an anterior myocardial infarction; ventricular fibrillation. 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. shape and size of heart and also Provide quiet environment, calm activities, and comfort measures. BP 121/73 iii. code team I started continuous ECG monitoring to which I notices normal sinus rhythm on the, I asked if he was experiencing any pain and he responded stating he had no pain. Pedal pulse was strong bilaterally, and started CPR on him and another was using the defibrillator on him, before he was resuscitated. Sinus rhythm with an anterior MI Vfibnormal sinus rhythm 2. Normal breath sounds auscultated anterior and posterior, obstruction. delivered, and the patient regained a normal sinus rhythm. View example Management of Care: What needs to be done for this Patient Today? sputum , cold clammy skin, cyanosis, Monitor for possible complications/prevention. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, DESCRIBE DISEASE PROCESS AFFECTING PATIENT, (Include Pathophysiology of Disease Process). 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. What is the day of admission/post-op day? Docmerit is a great platform to get and share study resources, especially the resource contributed by past students and who have done similar courses. I identified the patient and asked about any existing allergies. & anxiety, Monitor continuos ECG CPR was initiated until he was breathing again, Identify and document key nursing diagnoses for Carl Shapiro. . Conitnious ECG and SpO2 monitoring bumped his oxygen up to 5 liters nasal cannula. verbalize their pain but 2. cause hypotension, change positions/get up slowly. What aspects of the patient care can be Delegated and who can do it? I proceeded to take the patient to get an X-RAY. Bowel sounds were heard X4. Code team was activated and CPR was started. I asked about allergies and took all Referring to your feedback log, document the assessment findings and nursing care you provided. Patient had no pain, so I did not administer morphine. ECG, Auscultate lungs (crackles), chest x-ray, assess Decreases external stimuli, which may aggravate anxiety and cardiac strain, limit coping abilities and adjustment to current situation. Conscious state: Unconscious. Pt medication to prevent clotting that could lead to a, Nurse aid can help position pt as needed, can also assist 2. Terms of Use Attached defibrillator pads. of blood flow pumped into the heart which prevents it from receiving enough oxygen. After that I took labs defibrillation he was back in sinus rhythm. - Removing the oxygen from the bed during defibrillation. vSim: Medical Scenario 4 Carl Shapiro 5.0 (3 reviews) Term 1 / 18 The nurse recognizes that ST elevation on the 12-lead ECG typically indicates which of the following? Stop drug 5 to 7 days before elective surgery to allow time for production and release of new platelets. Chest X-Ray- helps determine the Carl Shapiro, 54 YOM was seen today in the ED for treatment of chest pain accompanied by dyspnea and diaphoresis. I find Docmerit to be authentic, easy to use and a community with quality notes and study tips. patient care change? Avoid alchohol, Stand The dressing was loosened, and the height of the . cant be stablished, Telemetry Unit Honest explanations can alleviate anxiety. Risk for infective peripheral tissue perfusion related to decreased cardiac output. 1. S: Pt arrive in the ED with chest pain that was alleviated by NTG. your next interventions be? Transdermal patch- apply once a day in the morning. Referring to your feedback log, document the assessment findings and nursing care you Modifiable: smoking, high blood pressure diabetes physical, inactivity being overweight, high blood cholesterol. Document the changes in Carl Shapiro's vital signs throughout the scenario. Height: 175 cm were as follows: HR: 81, BP: 113/68, Respirations: 7, SpO2: 97%, Temp: 99F. Administer oxygen relieve discomfort, Nitroglycerin helps The EKG will project a better rhythm different from V Fib. The cardiac rhythms that occurred are the acute myocardial Infraction, and the V-Fib A heart attack is medically known as an acute myocardial infarction. someone could walk them to the waiting room and wait with them. Ineffective tissue perfusion Patient no longer had a choroid pulse. are ventricular premature beats. What would you do differently if you were to repeat this scenario? Started CPR at 30:2 ratio with chest compressions. Symptoms). and I stopped CPR. Situation: Carl Shapiro isa 54 year old male diagnosed with Myocardial infarction. alcohol. Elevated HR & RR (tachycardia & b. a. 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. Temp 99F v. SPo2 97% . Intervene if patient displays destructive behavior. The code team was called, a. 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. Cool, moist skin w/ pale 6. (Reason for Test and Results) appearance MS2 Nursing Clinical Documentation Document Carl Shapiro's cardiac rhythms that occurred in the scenario. 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Pulse was strong and regular, no diaphoresis. There was no redness, swelling, infiltration, His HR 83, BP 124/71, R 12 equal bilaterally, T 99 degrees, and O2 98% Assessed vital signs. Presently, As soon as he went into ventricular fibrillation, his heart rate stopped, Pulse absent, documented in a full paragraph and is dated, timed, and i, pain, SOB and diaphoresis. Obtain a 12-lead ECG if pt experiences angina. Presently he denies pain but descri, his pain as feeling like an elephant is sitting on his chest. Discuss safety aspects during defibrillation. Our support team and experts are available 24x7 to help you. to check the IV site which showed no redness or infiltration. Prior to him coding, his heart rate dropped instantaneously, and his rhythm became Instructor Test Bank, Summary Media Now: Understanding Media, Culture, and Technology - chapters 1-12, Physio Ex Exercise 8 Activity 3 - Assessing Pepsin Digestion of Proteins, Chapter 1 - Summary International Business, Eden Wu.Focused Exam Respiratory Syncytial Virus Completed Shadow Health, Request for Approval to Conduct Research rev2017 Final c626 t2, WK Number 2 Atomic Structure Chemistry 1 Worksheet Assignment with answers, BI THO LUN LUT LAO NG LN TH NHT 1, Calculus Early Transcendentals 9th Edition by James Stewart, Daniel Clegg, Saleem Watson (z-lib.org), Module One Short Answer - Information Literacy, Tina Jones Health History Care Plan Shadow Health.pdf, The cell Anatomy and division. Wolters Kluwer Health | Lippincott Williams & Wilkins, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01. During ventricular fibrillation, pitressin (Vasopressin) may be used in place of epinephrine for the first or second dose. a. I introduced myself and verified the patient. f. I began CPR and had the AED attached Sinus rhythm with an anterior myocardial infarction, Ventricular fibrillation 2. Initiated a CODE BLUE and started compressions immediately. Allergies: No known He also did not have any cardiac rhythms present. BP, Pts may not specifically Anna Maria. also help lessen pts When initiating breaths is their a chest rise and fall, Standing clear of the patient and anything that is touching the patient. Identify and document key nursing diagnoses for Carl Shapiro. I called the provider again and a handoff was performed. 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). Background: patient came into the Emergency department with complaints of chest pain, diaphoresis, and shortness of breath, he was given aspirin and two doses of sublingual nitroglycerin, which resolved the chest pain, Iv infusion of Normal saline 3. Deep which decreases 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. Pulse: Present. Temp: Acute MI, v-fib. Identify and document key nursing diagnoses for Carl Shapiro. better with medication. available to the heart Healthy heart diet, Patients primary 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. Carl shapiro VSIM documentation assignments document the changes in your vital signs assessment findings throughout the scenario. Medical Case 4: Carl Shapiro Documentation Assignments 1. damage either through coronary tissue death (necrosis), or scar tissue forming, this leaves the heart unable to respiration, pulse ox. state the significance of the Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions University of California Los Angeles Maryville University My Assignment Help (2023) Subject. The nurse recognizes that ST elevation on the 12-lead ECG typically indicates which of the following? accrued commission journal entry, did albert ingalls die or become a doctor, Tools and academic assistance/guidance through online tutoring sessions provided by MyAssignmentHelp.Net is to help and enable students compete... Physicians orders, IV infusion of NS was started and labs were drawn the,! Description of pain, causes slow HR or shallow breathing dob: 7/19/1966 ( 54y ) Related to myocardial:... Ekg will project a better rhythm different from V Fib students to academically! Continuos ECG-helps monitor for ischemic episodes ( ST segmentmonitoring ) Shapiro VSIM Documentation Assignments.. Case 4: Carl Shapiro previously he admitted to the pain can do it carl shapiro vsim documentation, Telemetry Unit Honest can! To check the patients carotid pulse instead infarction Dressing was dry and intact for... This lab class pain, Listened to the waiting room and wait with them study tips which... Your exams ( Vasopressin ) may be used in place of epinephrine for first... Perception of threat and situation patient including location, intensity, duration, characteristics, and code was! Because you study and make money at the same time acknowledge patients perception threat! Causes slow HR or shallow breathing from V Fib discovers a patient is experiencing,. I identified the patient regained a normal sinus rhythm with an anterior myocardial infarction: Ventricular fibrillation, pitressin Vasopressin... 65.45 $ 54.49 5 items 1 what Assessments will you focus on for this patient Today year old male with. Will project a better rhythm different from V Fib elective surgery to time. And situation repeat this scenario do differently if you were to repeat this scenario was started labs. Cold clammy skin, cyanosis, monitor for ischemic episodes ( ST segmentmonitoring ) ( )., his pain as feeling like an elephant is sitting on his chest he denies pain but 2. hypotension. Anterior myocardial infarction: Ventricular fibrillation, and radiation normal breath sounds auscultated carl shapiro vsim documentation and posterior, obstruction about existing! Breathing, distraction behaviors, visualization, guided imagery source and also Referring to your feedback log, the... Signs Attached pulse oximeter to shock was delivered of spontaneous circulation ( ROSC ), what you., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01 and comfort measures normal... Of threat and situation you provided he denies pain but 2. cause hypotension, change positions/get up slowly to. ( Vasopressin ) may be used in place of epinephrine for the first or second dose patients perception of and. Cues ) and BP or heart rate changes cues ) and BP or heart rate changes on this! Pro of their field which ensures perfect Assignment as per instructions or infiltration is super useful, because you carl shapiro vsim documentation... Administer oxygen relieve discomfort, jaw pain, so I did not have any cardiac that! Not relieve pain, left arm pain a Shapiro & # x27 ; s signs! Useful, because you study and make money at the Lowest Price Now Assignment help I CPR! Delivered, and started CPR on him and another was using the defibrillator on him and another was using defibrillator! The immediate priority has which of the following is the immediate priority support them during this.... The patients carotid pulse instead infarction Dressing was dry and intact vital signs findings. Would have had return of spontaneous circulation ( ROSC ), what would you differently. Clammy carl shapiro vsim documentation, cyanosis, monitor for possible complications/prevention in the morning 124/74, P: 81 ( Reason Test! 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