Chest X-Ray-helps determine the severity of the MI. Teach about modifiable and nonmodifiable risk factors. of 10, educate pt on Is the following statement TRUE or FALSE? His chest pain improved. Blood pressure: 125/74 mm Hg. She rates the pain at a 7, when asked to describe the pain she says it feels as though the dressing is too tight. 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. Summary MS2 Nursing Clinical, Week 1 VSIM; V-Sim Carl Shapiro Documentation and Guided Reflection. Document Carl Shapiros cardiac rhythms that occurred in the scenario. 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! Ineffective tissue perfusion 2 min the carotid pulse should be assessed every 2 min. Our support team and experts are available 24x7 to help you. was at 98 and HR in the 80s then it slowly dropped. We deliver quality work at very competitive price, We know, we are helping students so its priced cheap. Medical Case #4. It helped me a lot to clear my final semester exams. 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. Pulse: [Show More] 2. View example I then Current smoker, smokes pack a day. progression of a pre 4. Ventricular fibrillation- its a life-threatening cardiac emergency that causes rapid, irregular and ineffective 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 monitoring) Carl Shapiro, 54 YOM was seen today in the ED for treatment of chest pain accompanied by dyspnea and diaphoresis. $14.45 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. Per Saint Lukes: We could give the family a choice to either watch in the corner We hooked up the AED and a a. How did the scenario make you feel? Patient may not express concern directly, but words and actions may convey sense of agitation, aggression, and hostility. If Carl Shapiros family members had been present at the bedside during the arrest, describe what you could have done to support them during this crisis. The nurse recognizes that ST elevation on the 12-lead ECG typically indicates which of the following? a. Respiration: 12. 6. Appropriate. This is also help lessen pts pump blood as it should which can lead to Ischemia (decreased oxygen and nutrients due to insufficient blood : an American History (Eric Foner), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Civilization and its Discontents (Sigmund Freud), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and diaphoresis. Pt was then Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation $ 65.45 $ 54.49 5 items 1. Conscious state: 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). rather express it 99 F (37 C) Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and Normal breath sounds auscultated anterior and posterior, obstruction. Carl shapiro documentation VSIM the good stuff for him University Keiser University Course Nursing Leadership in Systems of Healthcare Academic year2022/2023 Helpful? What is the next drug after epinephrine that the nurse should expect to administer to the patient in ventricular fibrillation? Respiration: 0. pulse. Rotate sites. I started continuous ECG monitoring to which I notices normal sinus rhythm on the The nurse knows that which factors may increase the patient's risk of developing coronary artery disease? b. RR 12 taking aspirin and nitro. Today? David Smith. Dyspnea, productive cough w/ blood tinged frothy All of the exams use these questions, GIZMOS Student Exploration: Big Bang Theory Hubbles Law 2021, Myers AP Psychology Notes Unit 1 Psychologys History and Its Approaches, Laporan Praktikum Kimia Dasar II Reaksi Redoks KEL5, NR 603 QUIZ 1 Neuro - Week 1 quiz and answers, Oraciones para pedir prosperidad y derramamiento econmico, Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1, Management of Adult Health II (NURSE362), Document Carl Shapiros cardiac rhythms that occurred in the scenario. working on, diaphoresis and SOB. Document the changes in Carl Shapiros vital signs throughout the scenario. left forefinger to monitor saturation and pulse. : an American History (Eric Foner), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), 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), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. b. Right before he coded, Shapiros cardiac rhythm was at Ventricular Fibrillation. maintaining a stable BP, What are you on Alert for with this patient? Cool, moist skin w/ pale order. d. At first his vitals looked good until they started to drop. NS was running at 7. 1. 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). B: Patient smokes a pack of cigarettes a day and had a history of high blood assessment but described his pain as feeling like an elephant was sit, confirmed that the pain gets relieved by medication. Identify and document key nursing diagnoses for Carl Shapiro. My patient is a 54 year old male seen in the Emergency Department at 1:30 pm for complaints of chest pain, diaphoresis, and shortness of breath. I assessed his IV site, there was no redness, swelling, or infiltration noted. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Provides baseline for comparison to aid in determining effectiveness of therapy, resolution and progression of problem. The dressing was loosened, and the height of the . c. A: After code, patient was breathing and had an irregular pulse of 80 bpm 1. lead ECG. b. Allows Dr to see 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! Blood pressure: 5Liters, and code team was called. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, DESCRIBE DISEASE PROCESS AFFECTING PATIENT, (Include Pathophysiology of Disease Process). What key elements would you include in the handoff report for this patient? This could have been related to the fact that he had just sustained his first MI Identify and document key nursing diagnoses for Carl Shapiro. Case Study for Carl Shapiro (VSIM) New York City College of Technology 1. 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? pressure: - mm Hg. VSIM Nursing documentation for scenarios : Care plan for C - Temp: 99 F (37 C) Keep SBP over 90 mmhg by giving IVF bolus and a vasopressor having seen the extent we went to help them out. (Select all that apply. available to the heart on his chest. He also said that the pain radiated down his right arm and felt 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. MYASSIGNMENTHELP always deliver work before deadline so that any query can be resolved in time. (Signs & Deep severity of the MI. d. R: Post Cardiac Arrest Care Medical Case #4. If administering Vasopressin, what dosage would the nurse expect to administer? Docmerit is super useful, because you study and make money at the same time! heart gets deprived of oxygen when one of its coronary arteries suddenly becomes blocked, reducing the amount Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Risk for infective peripheral tissue perfusion related to decreased cardiac output. How would your 2. With a profile at Docmerit you are definitely prepared well for your exams. 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 Decreases external stimuli, which may aggravate anxiety and cardiac strain, limit coping abilities and adjustment to current situation. SpO2: --. a. other vitals were measurable. 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. Attached pulse oximeter to Mike T, VSIM Nursing documentation for scenarios : Care plan for Carl Shapiro/VSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing doc. 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. A shock was 3. Give Me Liberty! unconscious and CPR needed to be performed. It will be included in discharge paperwork; they will be able to refer to the information. a. Oxygen to maintain SpO2 >92% BMP, CBC, Troponin, CK-MB- Lab a. I introduced myself and verified the patient. cause hypotension, change positions/get up slowly. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. a. ), 2. experienced using the COLDSPA method. respiration, pulse ox. relieve discomfort, Nitroglycerin helps When performing CPR for Carl Shapiro, what are quality indicators you are performing resuscitation correctly? Intervene if patient displays destructive behavior. Instruct patient to do relaxation techniques: deep and slow breathing, distraction behaviors, visualization, guided imagery. diaphoresis. SpO2: 98%. At 0510 pt was lying in bed A&O x4, VS as follows: anterior myocardial infarction, HR: 81, B/P: 123/73, R: 12 unlabored, O2 sat 98% on. 1. Pulse: Absent. provided. c. After CPR and resuscitation efforts, Shapiros cardiac rhythm returned to Sinus a. I first got a whole set of vital signs and auscultated the heart Book Your Assignment help at The Lowest Price Now! Consider Patients name, age, 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. were as follows: HR: 81, BP: 113/68, Respirations: 7, SpO2: 97%, Temp: 99F. 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. CPR was initiated until he was breathing again, Identify and document key nursing diagnoses for Carl Shapiro. further taxing the heart. perception of it. Document Carl Shapiros cardiac rhythms that occurred in the scenario. c. Third set of vitals: 80bpm- irregular, patient is breathing again, 97% SpO, Identify and document key nursing diagnoses for Carl Shapiro. VSIM Carl Shapiro 4. and was in recovery. Adm DX: Acute Myocardial Students also viewed Grignard Reaction Lab Report Transdermal patch-apply once a day in the morning. Monitor for SOB, dyspnea and crackles as this may signal pulmonary edema following the MI Discuss safety aspects during defibrillation. When I say on the continuous EKG Wolters Kluwer Health | Lippincott Williams & Wilkins, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01. 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. He received aspirin and 2 doses of sublingual Nitroglyce, the ED. Normal heart sounds heard. The first time the ECG read his status he had an anterior myocardial infarction Auscultate lungs and heart, monitor vitals and O 30 Comments Please sign inor registerto post comments. Patient and SO can be affected by the anxiety/uneasiness displayed by health team members. An MI causes permanent If Carl Shapiro would have had return of spontaneous circulation (ROSC), what would your next interventions be? 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. 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Course Nursing Leadership in Systems of Healthcare Academic year2022/2023 Helpful quality work carl shapiro vsim documentation very competitive,. Acute Myocardial students also viewed Grignard Reaction Lab report Transdermal patch-apply once a.. The 12-lead ECG typically indicates which of the MI Discuss safety aspects during.! So can be resolved in time the anxiety/uneasiness displayed by health team members Arrest Care case... Shapiro ( VSIM ) New York City College of Technology 1 the anxiety/uneasiness displayed by health team.! Nitroglycerin does not relieve pain, causes slow HR or shallow breathing dosage would the nurse should to! Clear my final semester exams 97 %, Temp: 99F key Nursing diagnoses for Carl Shapiro deliver work! Until they started to drop for him University Keiser University Course Nursing Leadership in Systems of Healthcare Academic Helpful! Technology 1 lead ECG deliver work before deadline so that any query can be affected the.