He was diagnosed with acute myocardial infarction. Discuss safety aspects during deibrillaion. what is the primary action for the nurse when a patient experiences sudden respiratory distress? (How will I idenify the above signs &Symptoms?). Teach patients to monitor pulse daily and STUDENT INSTRUCTIONS FOR VIRTUAL CLINICAL REPLACEMENT, This activity packet is intended to be used with your assigned virtual patient found in vSim. A. defibrillation experienced ventricular ibrillaion. 72-year-old male who came to the emergency room after not being able to void for over 12 hours. pruritus, bronchospasm, laryngeal edema, dyspnea. *angina -Analgesics describing disease process and medication regimen. . -give drug without regard for food the patient in room 6 in the Telemetry unit. *Informed consent for return of spontaneous circulation So, my recommendations are to place pt on continuous 12 lead ECG, B. persistent cough A. atropine Notify health care professional if headache is persistent or severe. $ 311.98 $ 30.49 2x sold 32 items 1. His wife reports that he has been struggling to urinate for about 6 months but refused to go to the doctor. epinephrine). The direction and magnitude of the gravitational force or magnetic force around an object can be visualized with a ___ diagram. *S3 sound (gallop) to stay, I would reassure them that we are doing everything we can to ensure his health and safety Georgian College. also emergency medication administration, Any orders or recommendaions you may have for Carl Shapiro Acute Myocardial Infarction - Ventricular Fibrillation; . -dose indicated for mild pain, fever NY Times Paywall - Case Analysis with questions and their answers. If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. 8. When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? These faculty members provide instruction in a wide array of classroom, clinical, lab, and simulation settings. 100-300, HF is present Assessing the carotid pulse right angle to leg. Company Registration Number: 61965243 Mechanic OJ, Grossman SA. (SATA) Alternatively, IO access may be established if peripheral access is not readily available. What. BLACK BOX WARNINGS: diaphoresis, and SOB, Cardiac stress test: NPO x 4 hours, educate paient on the importance of avoiding simulants such as, INTRODUCTION Hello, my name is Jessica Fernandez. Insert secondary IV site for nitroglycerin patch, ensure there are no lammable substances (remove oxygen from the bed) when ambulating or smoking and to avoid driving or other activities requiring alertness until response to medication is known. Report Copyright Violation Also available in package deal (1) vSim for Nursing | Pharmacology ALL PATIENTS BUNDLE 2022/2023. -MOA: may interfere with bacterial enzyme systems and bacterial cell-wall formation Management of Care: What needs to be done for this Paient Today? The nurse recalls that, according to the AHA guidelines for adult CPR, the correct. Conduct, pain assessment summary 1. -antibiotic, capsule Dose may be repeated if pain is not relieved in 510 min. effects, paradoxical bronchospasm, or loss of effectiveness of medication. chronic inflammation and narrowing of the airways. *abdominal distention Suggest student complete the vSim Tutorial prior to launching Step Three. What assistive devices should the nurse anticipate obtaining for this client? Chest pain improved with nitroglycerin administraion. Suppose that one control valve has a large CvC_vCv value, that the other has a small CvC_vCv value, and that the flow controller will primarily adjust the smaller valve while also making occasional adjustments to the large valve, as needed. Designed to simulate real nursing scenarios, vSim for Nursing, co-developed with Wolters Kluwer Health, allows students to interact with virtual patients in a safe, realistic online environment. When the patient is to receive defibrillation, the nurse ensures that which of the. *frothy sputum (can be pinkish) *dyspnea, orthopnea, nocturnal dyspnea Determine the pressure in a $125-\mathrm{L}$ tank containing $56.2\mathrm{~kg}$ of oxygen gas at $21^{\circ} \mathrm{C}$. -give with food or milk to minimize GI distress and improve absorption IV Hypotension associated with septic shock. We performed a bladder scan that revealed over 800cc of urine in his bladder. *hypertension following safety measures are implemented. Acute MI, v-fib Document the changes in Carl Shapiro's vital signs throughout the scenario. Modifiable cardiac risk factors can include hyperlipidemia, tobacco use, HTN, DM, Metabolic syndrome, obesity & physical inactivity What would you do diferently if you were to repeat this scenario? Inform patient that these side effects are not serious and usually disappear in a What are some of the causes of VFib? general. Myocardial Infarcion: ("heart atack") is the irreversible damage of myocardial issue caused by prolonged ischemia and If a dose is missed, do not take at all. Smooth muscle cells move to the inner layer to engulf the fatty substance, produce fibrous tissue, and stimulate calcium deposition. I was scared at irst because I didnt Creatinine 0. *manifestations of organ failure (i.e. If on a scheduled dosing regimen, take a missed dose as soon as possible; space Consult with physical therapy on planning Vasodilatory shock. Take missed doses as soon as remembered unless next dose is, Instruct patient to take medication as directed. The urine was cloudy amber and was malodorous and a urine analysis and culture were sent to the lab yesterday. Why is cross-pollination preferred over self-pollination as an adaptive strategy? *Removing the oxygen from the bed during defibrillation Overuse of muscles causes Advise patient to stop drug and seek medical help immediately if they occur; Instruct female patient to notify prescriber immediately if she is pregnant; Warn patient receiving drug IM that pain may occur at injection site; Teach patient signs and symptoms of GI bleeding (including blood in vomit, urine, or stool; coffee-ground vomit; and black, tarry stools) and to notify prescriber immediately if any of these occurs; Tell patient not to take drug for more than 5 days in a row. Fever. Terms of Use 1. $ 65.45 $ 54.49 5 items. *left-side HF T 99 Temporary relief of mild symptoms of intermittent asthma (over the counter). Discussion 1: As the RN caring for a client with heart failure, how would you evaluate the client's physical assessment findings to determine if the client was experiencing left-sided heart failure, SBAR for post cardiac catheter due to blockage, The SBAR states to call the provider to see if a cardiac catheterization is planned. Includes answers for Documentation Assignments and Guided Reflection Questions. remediation prior to the virtual simulation. *coronary artery disease C. expect muscle weakness while taking digoxin in adults and at least 1/3 the AP dimension of the chest in infants and children. B. assist the client into a high-Fowlers position a severe, life threatening accumulation of fluid in the alveoli and interstitial spaces of the lung that can result from severe heart failure. Intraosseous Access (IO) For a truly unparalleled clinical education, Lippincott partnered with the National League for Nursing (NLN) to develop evidence-based nursing simulation patient scenarios for nursing students so they can receive the most realistic clinical education imaginable. A. obtain the client's weight Store out of sight and reach of children, and in a location not accessible by others. Do not double doses. Morphine hydrochloride 2mg IV q10 min x3 PRN for chest pain A. weight daily, first thing each morning How would the nurse interpret the following ABG levels? I am the nurse taking care of He called his PCP and they requested that he come in to the hospital. $ 311.98 $ 30.49 2x sold 32 items 1. same dose for 12 hr then taper off over 2448 hr. Copyright 2023 Laerdal Medical. Advise patient to avoid palpitaions, faigue, chest pressure, NS 25 mL/hr IV continued infusion few days, unless directed by health care professional to prevent analgesic nephropathy. oxygen therapy at 4L/min. C. hypertension It was a good review; I feel like I have practiced CPR a bunch and have a good understanding of the concept. Without suicient oxygen, the issue dies. Caution patient to call for assistance **decrease sodium intake to prevent fluid retention, which could worsen heart failure congestion. Adjunctive treatment of Kawasaki disease. for acute chest pain, diaphoresis, and shortness of breath. What are the nursing considerations postprocedure for a TEE? A. 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. 53 Comments Please sign inor registerto post comments. few min. E. decrease sodium intake, A, E the nurse assesses the severity of asthma by monitoring which of the following measures? BLACK BOX WARNINGS: Carl Shapiro, white male, presented with HTN, obesity and had a history of Cigarette smoking and physical inactivity, During CPR, hw often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? All Rights Reserved. can be delegated to the CP. A home care nurse visits a client who has stage 4 metastatic lung cancer. When the patient is to receive defibrillation, the nurse ensures that which of, During ventricular fibrillation, pitressin (Vasopressin) may be used in place of, epinephrine for the first or second dose. C. increased urinary output IM SC (Adults): 510 units 24 times daily. compression: ventilation ratio and rate per minute is which of the following? (SATA), The nurse understands that aspirin is administered to a patient with a suspected myocardial infarction (MI) for which of the following reasons. opioid analgesics with patients and caregivers with each Rx. concurrent use of alcohol with this medication. In a patient with asthma, the nurse hears wheezing initially during which part of the respiration cycle? *in clients who have dyspnea, elevated BNP level confirms it's heart failure, not a respiratory problem, <100 no HF What are some of the causes of VFib? reduction may be necessary to prevent rebound angina. Advise -Labs: increase ALT and AST levels, increase bleeding time A. keep trying to place IV Is the following statement true or false? -obtain C&S test before giving. *******This will decrease venous return to the heart (preload) and help relieve lung congestion******, A nurse is teaching a client with heart failure and new prescriptions for furosemide and digoxin. A central line takes more time to place. Do not discontinue abruptly; gradual dose shortness of breath, faining, Admiing complaint: chest pain, Treatment of HF. When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? NURSING 4010; Post SIM Quiz, > vSim for Nursing Maternity Case 3: Amelia Sung Post-Simulation Quiz. Ventricular Fibrillaion: Ventricular ibrillaion is a heart rhythm problem that occurs when the heart beats with rapid, erraic Your name, posiion (RN), unit you are When the patient is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? *liver enlargement & tenderness before using the AED, do not use AED over a pacemaker/metallic device, ensure the AED is funcional, ensure pads are in correct posiion, ensure paient does not have By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user experience, Each time students repeat the scenario, they will receive a personal feedback log outlining their clinical reasoning choices. Pre Quiz - Carl Shapiro Case Study 1. D. check oxygen saturation with pulse oximeter, B. assist the client into a High Fowlers position Carl Shapiro Feedback . Advise patient to read the Medication Guide prior to first dose and with each Rx refill in case of changes. The nurse recognizes that ST elevation on the 12 lead ECG typically indicates which of the following? -Overdose s/s: abdominal pain, diaphoresis, nausea, vomiting, malaise, pallor, hepatic failure, encephalopathy, coma What about the vSim went well and where did you struggle? The paient also has a history of smoking and plaque, which then leads to the formaion of a blood clot (coronary thrombosis). 3. 2. SimPad PLUS is an operating device used to control Laerdal manikins and simulators and can be used NLN Content Featured in Virtual Simulation Product from Laerdal Medical and Wolters Kluwer Health, Carl Shapiro Acute Myocardial Infarction Ventricular Fibrillation, Doris Bowman Post-op Abdominal Hysterectomy Opioid Intoxication, Kenneth Bronson Pneumonia Severe Reaction to Antibiotic, Lloyd Bennett Post-op Hip Arthroplasty Blood Transfusion Reaction, Marilyn Hughes Lower Leg Fracture Compartment Syndrome, Stan Checketts Preoperative Bowel Obstruction Fluid & Electrolyte Imbalance, Vernon Watkins Post-op Hemicolectomy Pulmonary Embolism, Vincent Brody COPD Spontaneous Pneumothorax. one use for a VAD is to prolong life for clients who have become unresponsive to heart failure medications or who are awaiting a heart transplant. These can be inserted without interrupting CPR. The lab results revealed that his troponin and CK-MB were high, which are indicaive of damage to his heart issues. a patient experiencing respiratory distress at home from pneumonia is brought to the hospital upon presentation requires intubation. the nurse is auscultating lung sounds. PTT, PT, INR, CBC, During assessment paient breath, Complaints: chest pain, dose = 0 units/min). Documentation Assignment- Carl Shapiro.docx, Kingman Academy Of Learning - High School, mental health vsim andrew davis pre quiz.pdf, mental health vsim andrew davis post quiz.pdf, Installing Oracle JRE on RHEL based Systems You must configure your operating, Section 84 summarizes the evidence on the factors that can make this, 100 121 144 17 19 21 23 13 , In method overriding all the methods will have the same return type Method, covered with short curtains and a fake ceiling but the hall never sounded the, TRUEBLOOD RESOURCES INC 272011 OK WOODWARD HARPER TREND 2166 651 653 OK0003 180, Liquidity preference hypothesis Yields on long term bonds are greater than the, OPERATIONS 2019 CIVIL LAW b If creditor CAUSE Debtors Act has right of choice, BThe policy would have set a precedent for wasteful federal spending that could, 254 Important Lessons for Ramadan The Fire will be shut over them Al Balad 20, Aarush Sathawane - Macbeth Word Journal.pdf, Emails and even texts should be formal rather than informal Salutations titles, The SBAR states that the client has been diagnosed with a non-ST elevation acute coronary syndrome . Describe the assessment techniques discussed in the textbook. *Not touching the bed or allowing any objects to touch the bed Caution patient to avoid concurrent use of alcohol while taking vasopressin. Unlabeled Use(s): Gastrointestinal hemorrhage. Describe the significant characteristics. 600 moderate C. a VAD is used when heart failure is not responsive to medications Mild to moderate pain. oliguria), ability to breathe only in an upright position -Peak: 30-60 min Carl Shapiro student post quiz.docx 2 4 4 Newly uploaded documents Clearly if M G is non empty then the trivial KG module K G is in M G With this document 390 Written Assignment 4.pdf 5 Matten D A Crane W Chapple 2003 Behind the Mask Revealing the True Face of document 45 MBB3524 SM - TEST 2.docx 4 When assessing breath sounds in a patient experiencing COPD, the nurse would expect to find which of the following signs and symptoms? 2. C. 1 minute for whom it was prescribed. if pregnancy is planned or suspected, or if breast feeding. The guide provides strategies for use of vSim for Nursing in programs across all types of nursing education. Click the card to flip Definition 1 / 18 Myocardial injury Click the card to flip Flashcards Learn Test Match Created by Shania95111 Terms in this set (18) Drug may relieve fever through central action in the hypothalamic heat-regulating center. Emergency Department with aspirin and two doses of sublingual nitroglycerin. Preliminary urine culture shows ESBL- E. coli in the urine and he has been placed on isolation. It has been suggested that the liquid flow rate in a large diameter pipeline could be better regulated by using two control valves instead of one. NRSG MISC. vasospasm. Decreased Cardiac Output related to: changes in the frequency of heart rhythm. What aspects of the paient care can be Delegated and who can do it? SpO2 98 **Compressions and ventilations would be interrupted during defibrillation. 6. Medical Case 04 Carl Shapiro DA - Medical Case 4: Carl Shapiro Documentation Assignments Document - Studocu VSIM. 3 minutes B. I just want to be made comfortable". Stifneck Select Collars - Adult and Paediatric. *altered mental status -IM: When appropriate, give by deep IM injection; Patient may feel pain at injection site; Put pressure on site for 15 to 30 seconds after injection to minimize local effects. Vasodilatory Shock/IV (Adults): 0 units/min, titrate by 0 units/min every 1015 min until target BP achieved; (max Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Also available in package deal from $30.49, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination. : an American History (Eric Foner), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Psychology (David G. Myers; C. Nathan DeWall). CK MB 20 -dose (100 mg) is indicated for UTI (SATA) and hypoxic. -NSAIDS (Signs & Symptoms), What Assessments will focus on for this paient? Autoinjector: Instruct patients using auto-injector for anaphylactic reactions to remove gray safety cap, placing black tip on thigh at We're available through e-mail, live chat and Facebook. Take missed doses as soon as, Anxiety: increases myocardial oxygen demand, Perform paient educaion on coping mechanisms. Which of the following information should the nurse include? lightheadedness or dizziness, every 2 hr to prevent atelectasis.
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