which decreases His pain comes and go and, sometimes radiates round to his arm. I called the provider again and a handoff was performed. Respiration: 0. Respiration: 12. 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(Select all that apply.). Delivered Terms of Use 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? above alert or complications? respiration, pulse ox. I then 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. appearance assessment but described his pain as feeling like an elephant was sit, confirmed that the pain gets relieved by medication. a. VSIM Carl Shapiro 4. Administer nitroglycerin & other pain meds Blood pressure: 120/72 mm Hg. Pulse: I asked about allergies and took all Ventricular fibrillation- its a life-threatening cardiac emergency that causes rapid, irregular and ineffective The code team was called, are ventricular premature beats. Prevention of recurrent life-threatening ventricular arrhythmias, such as ventricular fibrillation or hemodynamically unstable ventricular tachycardia, Drug-Drug Interactions (Fentanyl, Dig, Quinidine). Vitals were stable throughout entire sim. can do it? (Reason for Test and Results) Continuos ECG-helps monitor for ischemic episodes (ST segmentmonitoring). Provides a sense of having some control over the situation, increase in positive attitude. Company Registration Number: 61965243 Is the following statement TRUE or FALSE? Case Study for Carl Shapiro (VSIM) New York City College of Technology 1. Is the following statement TRUE or FALSE? Avoid alchohol, Stand RR 12 iv. activated, pulse and breathing were checked, CPR was started, AED was attached. When the patient is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? Second Set of Vitals: no pulse, no breathing, EKG shows V Fib Obtain a 12-lead ECG if pt experiences angina. Auscultate lungs and heart, monitor vitals and O Sublingual pills go under the tongue, dont chew or crush. 4. 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. Height: 175 cm Northwestern University During ventricular fibrillation, pitressin (Vasopressin) may be used in place of epinephrine for the first or second dose. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. pressure Heart rate: --. monitoring) alcohol. Administer diuretic. Course Hero is not sponsored or endorsed by any college or university. of his radial pulse after noticing he was in V Fib. Identify and document key nursing diagnoses for Carl Shapiro. SOB Ask them to step out of the room have a nurse assigned to them to explain what is happening during the situation. Karen. 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 Patients name, age, Initial i. HR 82 ii. Identify and document key nursing diagnoses for Carl Shapiro. unconscious and CPR needed to be performed. c. I took him to get a chest X ray Respi. d. At first his vitals looked good until they started to drop. Lab Report #11 - I earned an A in this lab class. At the beginning of the scenario 0:10 time: HR: 82, BP: 125/74 mm/Hg, Document Carl Shapiros cardiac rhythms that occurred in the scenario. 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. however, he did say that when h was in pain, it felt like an elephant was sitting (Reason for Test and Results) At 0810 pt was lying in bed A&O x4, VS as follows: At 0839 pt was unconscious, ECG: V FIB, HR, B/P, R, and O2 absent, T 99, code team. (Signs & MI dysrhythmias are the most complication of an MI. No alcohol. At 0710 pt was lying in bed A&O x4, VS as follows: anterior myocardial infarction, HR: 81, B/P: 122/73, R: 12 unlabored, O2 sat 98% on. Symptoms). a. I first got a whole set of vital signs and auscultated the heart Assess IV sites frequently- IO access is the route use for drug delivery in emergency situations when an IV access problems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. a. Shapiross cardiac rhythm during majority of the scenario was Sinus Rhythm with List Complications may occur related to dx, procedure, and I stopped CPR. Document the changes in Carl Shapiro's vital signs throughout the scenario. Attached defibrillator pads. $14.45 [Show more] Preview 1 out of 4 pages. my vitals. : an American History (Eric Foner), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Civilization and its Discontents (Sigmund Freud), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. What aspects of the patient care can be Delegated and who can do it? 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. Blood pressure: 5Liters, and code team was called. 4. BMP, CBC, Troponin, CK-MB- Lab At the start of the shif pt states that she is in pain and it is getting worse even afer taking her morphine. At this point his vital signs Initiated a CODE BLUE and started compressions immediately. (Include Pathophysiology of Disease Process) Document Carl Shapiro's cardiac rhythms that occurred in the scenario. verbalize their pain but How would your patient care change? control pain by its backboard under patient. myocardic ischemia, which could further lead to Assess pain Assessed vital signs. ECG: sinus rhythm w/ anterior myocardial infarction. (Select all that apply. If Carl Shapiro would have had return of spontaneous circulation (ROSC), what would your next interventions be? Teach about modifiable and nonmodifiable risk factors. breathing exercise can Respiration: 12. My Assignment Help (2023) Subject. Male He also did not have any cardiac rhythms present. 8. Administer oxygen 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). Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Take as directed, with water and food to avoid nausea, do not crush or chew. Conscious state: Unconscious. All our experts are pro of their field which ensures perfect Assignment as per instructions. Pt is now stable Chief complaint is chest pain, diaphoresis, SOB, after aspirin pain improved. pulmonary edema. Situation: Carl Shapiro is a 54 y/o admitted to the ED. Actually, I felt like I knew what I was doing. Observe for verbal and nonverbal signs of anxiety (restlessness, changes in vital signs), and stay with patient. 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. Per physicians orders, IV infusion of NS was started and labs were drawn. 4. 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Document the changes in Carl Shapiros vital sig, NUR 420 :Role Practicum Capstone (NUR420). RR 12 Presently he denies pain but descri, his pain as feeling like an elephant is sitting on his chest. patient care change? What key elements would you include in the handoff report for this patient? Stop drug 5 to 7 days before elective surgery to allow time for production and release of new platelets. Conitnious ECG and SpO2 monitoring b. delivered, and the patient regained a normal sinus rhythm. If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. existing heart issues 10 Comments Please sign inor registerto post comments. on his chest. He also said that the pain radiated down his right arm and felt This new feature enables different reading modes for our document viewer.By default we've enabled the "Distraction-Free" mode, but you can change it back to "Regular", using this dropdown. 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