-ADR/SE: arrhythmias, GI hemorrhage, renal failure, h/a, sedation, palpitations, dyspepsia, N/V/D, pain at injection site oxygen therapy at 4L/min. Central Line Advise patient to avoid Excessive alcohol use may increase the risk of liver damage; Caution patient to contact health care provider if signs and symptoms of liver damage (illogical thinking, severe dyspepsia, jaundice, inability to eat, weakness) occur; Warn patient to stop drug and seek medical attention immediately if rash or other reactions occurs while using acetaminophen. vsim Carl Shapiro (Coronary Artery Disease), vSim Carl Shapiro (Myocardial Infarction), Julie S Snyder, Linda Lilley, Shelly Collins, Essentials of Strength Training and Conditioning. attacks and MI. A. *Informed consent *angina The vSim for Nursing | Medical-Surgical solution features 10 virtual patient simulation scenarios and other curricular content based on the National League for Nursing (NLN) Complex Care Medical-Surgical Scenarios (Volume 1): Carl Shapiro - Acute Myocardial Infarction: Ventricular Fibrillation a patient experiencing anaphylactic reaction may experience which of the following signs and symptoms? dose = 0 units/min). diaphoresis, and shortness of Instruct patient how and when to ask for pain medication. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. R- Recommend paient cardiac status is closely monitored He received acetaminophen with his evening meds for a 3/10 pain in his lower abdomen and an elevated temperature of 101.4F. The paient is the main concern during this situaion, but I would ensure they were escorted out of the room so the focus could be on the paient, but if they insisted PO Adjunct treatment of. Medical Case 04 Carl Shapiro DA - Medical Case 4: Carl Shapiro Documentation Assignments Document - Studocu VSIM. It felt good to have followed mostly the correct steps B. Georgian College. LATE manifestations: First dose should be taken while in a sitting or reclining position, especially in geriatric patients. Correct Response: False Correct Response : False Explanation: AHA guidelines do not support defibrillation for asystole. Alerts: IM SC (Adults): 510 units 24 times daily. C. expect muscle weakness while taking digoxin administer to the patient in ventricular fibrillation? If administering Vasopressin, what. These can be inserted without interrupting CPR. Advise patient to drink 12 glasses of water at time of administration to minimize side 2 min the carotid pulse should be assessed every 2 min. throughout the scenario. effects (blanching of skin, abdominal cramps, nausea). Click the card to flip Definition 1 / 20 community-acquired pneumonia Protective clothing and sunblock are recommended during and for 4 mo after therapy. 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. this paient. When administering medication to the patient with suspected myocardial infarction, the nurse understands that morphine has which of the following beneficial effects? 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 to stay, I would reassure them that we are doing everything we can to ensure his health and safety 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. -obtain C&S test before giving. (Signs & Symptoms), What Assessments will focus on for this paient? He also reports that he has felt feverish over the last 24 hours but did not taken his temperature. clinical replacement (see syllabus for details). 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? It was a good review; I feel like I have practiced CPR a bunch and have a good understanding of the concept. Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation. Press hard into thigh until auto-injector functions, hold in place for 10 sec, remove, and discard properly. No excessive venilaion.-High-quality CPR includes compressing hard and fast, allowing Current perinent assessment data using head to D. A VAD is useful for clients who also have a chronic lung issue. *blood circulation to the lungs is impaired when the cardiac pump is compromised, *Coronary Artery Disease be useful. -unknown onset, peak, duration NY Times Paywall - Case Analysis with questions and their answers. Take missed doses as soon as remembered unless next dose is, Instruct patient to take medication as directed. 5. *nausea, anorexia 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. *monitor for return of gag reflex plaque, which then leads to the formaion of a blood clot (coronary thrombosis). *polyuria at rest (fluids are reabsorbed into circulation when lying down) A nurse is caring for a client who has heart failure and reports increased shortness of breath. Why is it important to perform the assessment techniques in order? These faculty members provide instruction in a wide array of classroom, clinical, lab, and simulation settings. What is its molecular mass? His other VS have been stable. View example . **decrease sodium intake to prevent fluid retention, which could worsen heart failure congestion. 2 minutes C. 1 minute D. 4 minutes 2 minutes If Carl Shapiro would have had return of spontaneous circulaion (ROSC), what would your next intervenions be? *Clearing the bed at least twice prior to defibrillating 80 units IV/IO RR 12 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. An indwelling Foley catheter was ordered and placed at 1730 with some difficulty. Every three minutes, no restriction on doses b. Alternatively, IO access may be established if peripheral access is not readily available. Each clinical experience in the simulation lasts a maximum of 30 minutes. experienced ventricular ibrillaion. while taking nitroglycerin. What about the vSim went well and where did you struggle? few days, unless directed by health care professional to prevent analgesic nephropathy. the nurse understands that the pathophysiology of chronic obstructive pulmonary disease (COPD) is related to which of the following? occurs when the heart muscle is unable to pump effectively, resulting in inadequate cardiac output, myocardial hypertrophy and pulmonary / systemic congestion. B. persistent cough -ADR: leukopenia, neutropenia, pancytopenia, anemia, hypoglycemia, hypokalemia, muscle spasms, HTN, pruritus Briefly justify your answer. describing disease process and medication regimen. Student is to complete the simulation as many times as it takes to meet an 80% benchmark. Why is cross-pollination preferred over self-pollination as an adaptive strategy? They have 3 adult children, 2 who live nearby and are very supportive. *S3 sound (gallop) 900 severe, the use of pressure monitoring devices to directly measure cardiovascular function, an ultrasonic imaging technique that is performed from inside the esophagus to evaluate heart structures. patient to avoid concurrent use of alcohol with this medication to minimize possible gastric irritation; 3 or more glasses of alcohol per He is a 54-year-old male being seen I am the nurse taking care of STUDENT LEARNING OUTCOMESThis activity creates an opportunity for you to prepare for a virtual clinical experience. > Contraindicated in patients with suspected or confirmed cerebrovascular bleeding, hemorrhagic diathesis, or incomplete hemostasis, and in those at high risk for bleeding because drug inhibits platelet function. general. The answer key is not visible to the student until after they have submitted the quiz. 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Vasodilatory Shock/IV (Adults): 0 units/min, titrate by 0 units/min every 1015 min until target BP achieved; (max Advise patient to report tinnitus; unusual bleeding of gums; bruising; black, tarry stools; or fever lasting longer than 3 days. Determine the pressure in a $125-\mathrm{L}$ tank containing $56.2\mathrm{~kg}$ of oxygen gas at $21^{\circ} \mathrm{C}$. MI, Lipid proile, c-reacive protein, BNP, the nurse recognizes that risk factors for COPD include which of the following? Fever. -Patient Edu: Advise patient or caregiver that many OTC products contain acetaminophen and should be counted when calculating total daily dose; Warn patient that high doses or unsupervised long-term use can cause liver damage. -Interactions: Barbiturates may reduce therapeutic effects and enhance hepatotoxic effects of acetaminophen; alcohol use may increase risk of hepatic damage > Many OTC and prescription products contain acetaminophen; be aware of this when calculating total daily dose. -dose indicated for short term management of acute pain for single dose tx (up to 5 day use) **shortness of breath while lying down**, Signs & Symptoms of STUDENT INSTRUCTIONS FOR VIRTUAL CLINICAL REPLACEMENT, This activity packet is intended to be used with your assigned virtual patient found in vSim. Based on National League for Nursing (NLN) scenarios, students will access curriculum resources and practice patient-centered care for a variety of case studies. by a marginal (or border) zone that can either recover normal funcion or become irreversibly damaged. of 0 units/kg/hr. B. assist the client into a high-Fowlers position A. diabetes Students also viewed Brittany Long v SIM Care Plan Sabrina Vasquez v Sim Complete Care Plan B. decrease intake of potassium What two factors keep the lungs from collapsing? Smooth muscle cells move to the inner layer to engulf the fatty substance, produce fibrous tissue, and stimulate calcium deposition. *Not touching the bed or allowing any objects to touch the bed He reports that he drinks a glass of wine occasionally, two glasses a month. the nurse is auscultating lung sounds. Dose may be repeated if pain is not relieved in 510 min. titrate up to 00 mg/hr. Create classes and monitor students results by viewing pre-simulation and post-simulation quiz data and student debrief logs. 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. *Tachypnea is an expected finding in a client with pulmonary edema Advise patient to avoid drinking grapefruit juice during therapy. -Labs: increase ALT and AST levels, increase bleeding time same dose for 12 hr then taper off over 2448 hr. Oxygen 4L/min nasal cannula What are the RISK FACTORS for LEFT-SIDED HF? Advise patient to notify health care professional Why is it important to perform the assessment techniques in order? How can the nurse, A client is receiving radioactive iodine therapy (RAI) to treat papillary carcinoma. oliguria), ability to breathe only in an upright position Inhaln: upper airway obstruction and croup (racemic. creainine to spill out. 4. 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? The nurse knows that which factors may increase the patient's risk of developing coronary artery disease? How did the scenario make you feel? Carl Shapiro pre-quiz 100%.docx. (Select all that apply), Which of the following are cardiac markers assessed in the patient experiencing angina to, determine potential myocardial injury? *pulmonary congestion (dyspnea, cough, crackles) The patient should INCREASE their potassium intake while taking digoxin & furosemide in order to avoid hypokalemia. the carotid pulse should be assessed every 2 minutes for return of spontaneous circulation. B. Based on this ECG waveform, the nurse recognizes that the patient is experiencing which dysrhythmia? I felt that I knew what to do, but this simulaion showed me that the > Acute Myocardial Infarcion. It is important during defibrillation that the bed be cleared at least twice prior to discharging the paddles to prevent injury to any staff: that O2 be removed from the bed to prevent the danger of starting a fire: and that no person or object s touching the bed, in order to prevent any conduction of electrical current that might injure the patient or staff member. The guide is based on data collected from faculty who participated in pilot testing of vSim for Nursing | Medical-Surgical during spring 2014 and who submitted feedback to the National League for Nursing. What is the formula of calcium sulfate dihydrate? Is the following statement true or false? -Nursing Considerations: Treatment may turn urine brown or dark yellow; Monitor patient for signs and symptoms of superinfection, which can occur up to 2 months after therapy ends; Monitor CBC, renal function, and pulmonary status regularly U/L; Female: 26-140 U/L, Troponin Level Test: Less than 0. nitroglycerin patch, ensure there are no lammable substances (remove oxygen from the bed) $ 311.98 $ 30.49 2x sold 32 items 1. remaining doses at regular intervals. -Nursing Considerations: drug is indicated for short-term managment (up to 5 days in adults); watch out for s/s of heart attack and observe pt taking anticoagulants; NSAIDS may increase risk of serious thrombotic events (MI or stroke) Advise patients that photosensitivity reactions may occur through window glass, thin clothing, and sunscreens. C. a VAD is used when heart failure is not responsive to medications *dyspnea, orthopnea, nocturnal dyspnea Course Hero is not sponsored or endorsed by any college or university. When viewing the past medical history, the nurse identifies which cardiac risk factors specific to Carl Shapiro? for whom it was prescribed. 2. Course Hero is not sponsored or endorsed by any college or university. Which of the following actions should the nurse take first? When administering medication to the patient with suspected myocardial infarction, the nurse understands that morphine has which of the following beneficial effects? vSim for Nursing allows each student to have a different experience with the patient. *fatigue 2. 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? What. Consider the SBAR (situaion, background, assessment, recommendaion) format. report abnormalities. B. Total : Male: 38- additon to this Clinical Replacement Activity Packet, submit for grading as instructed in your syllabus. admission, current orders for paient. . FALSE -antibiotic, capsule NURSING 4010; Post SIM Quiz, vSim for Nursing Maternity Case 3: Amelia Sung Post-Simulation Quiz. C. auscultate lung sounds -Do you urinate more than usual (frequency/pattern, urgency, nocturia)? Includes answers for Documentation Assignments and Guided Reflection Questions. 3 minutes This causes pumping chambers in your heart (the ventricles) to quiver uselessly, instead of pumping blood. B. obesity breath, Complaints: chest pain, $ 311.98 $ 30.49 2x sold 32 items 1. admitted on 8/25/2020. > Drug can cause acute liver failure, which may require a liver transplant or cause death. Medical Case 4: Carl Shapiro Guided Reflection Questions 1. Conduct, pain assessment summary 1. He tells the nurse, "I don't want any more chemotherapy or surgery. Consider the model Fk=kFNF_k=\mu_k F_NFk=kFN. -Labs: increase wbc, rbc, platelet counts; decrease Hb, glucose, albumin depressants with this medication. 100-300, HF is present What would you do diferently if you were to repeat this scenario? When performing CPR for Carl Shapiro, what are quality indicators you are performing resuscitaion correctly? He reports that he has mild pain and pressure in his lower abdomen. Shake suspension well before use. If you think the statement is false, rewrite it to make it true. Give two reasons the lungs tend to recoil. 6. B. inserting an airway htps:ncbi.nlm.nih/books/NBK459269/. What about the vSim went well and where did you struggle? *NPO for 6 hours prior D. Intraosseous (IO) access. > Contraindicated in patients currently receiving aspirin, probenecid, or other NSAIDs 3 children are alive and well. The nurse recalls that, according to the AHA guidelines for adult CPR, the correct. What is the ratio of effusion rates of krypton and neon at the same temperature and pressure? A. *JVD Auscultate heart for abnormal heart sounds (S3, S4), Prioriies for Managing the Paients Care Today. 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. Teach patient the warning signs and symptoms of hepatotoxicity (nausea, fatigue, lethargy, pruritus, jaundice, right upper quadrant abdominal tenderness, flulike symptoms). What assistive devices should the nurse anticipate obtaining for this client? Production of controlled hypotension during surgical procedures. Is the following statement true or false? Mechanic OJ, Grossman SA. decreased urinary output is an expected finding, A nurse is talking with a client who has CLASS I heart failure and asks about obtaining a ventricular assist device (VAD).Which of the following statements should the nurse make? *displaced apical HR (hypertrophy) using the information contained in step five. NS 25 mL/hr IV continued infusion medications, and allow 5 min to elapse before administering other inhalant medications, unless otherwise directed. What are some of the causes of VFib? Consult with physical therapy on planning -Overdose s/s: Abdominal pain, nausea, vomiting, peptic ulcers, GI bleeding, hyperventilation, renal dysfunction, metabolic acidosis, HTN, lethargy, drowsiness, respiratory depression, coma, anaphylaxis. -dose indicated for mild pain, fever These are the incorrect answers. *orthopnea is an expected finding in a client who has pulmonary edema *altered mental status What, SBAR for post cardiac catheter due to blockage, Please can you provide me with Carl Shapiro step by step Vsim, Describe the assessment techniques discussed in the textbook. Or reclining position, especially in geriatric patients 3 adult children, 2 who live nearby and are supportive. Normal funcion or become irreversibly damaged cramps, nausea ) access is not relieved in 510 min assistive...: IM SC ( Adults ): 510 units 24 times daily COPD. Upright position Inhaln: upper airway obstruction and croup ( racemic pain is not visible to the formaion a... 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