$14.45 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. Symptoms). g. I cleared the patient before shocking HR: 81, B/P: --, R: --, O2 --. 6. Case Study for Carl Shapiro (VSIM) New York City College of Technology 1. Prior to him coding, his heart rate dropped instantaneously, and his rhythm became Decreased Cardiac Output related to: changes in the frequency of heart rhythm. a. I introduced myself and verified the patient. Conscious stat. b. Now is my chance to help others. Conscious state: Unconscious. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Temp: 99 F B: Patient smokes a pack of cigarettes a day and had a history of high blood Document Carl Shapiro's cardiac rhythms that occurred in the scenario. 1. 4. Karen. Docmerit is a great platform to get and share study resources, especially the resource contributed by past students and who have done similar courses. visit, Adm DX: Acute Myocardial Infarction c. Third set of vitals: 80bpm- irregular, patient is breathing again, 97% SpO, Identify and document key nursing diagnoses for Carl Shapiro. Normal Sinus Medical case 4 : Carl Shapiro Guided reflection questions 2. 1. 4. Pulse: Absent. for return of spontaneous circulation Background: Carl has a hx of HTN and takes BP medication at home. Management of Care: What needs to be done for this Patient a. Patient status - ECG: Ventricular fibrillation. c. A: After code, patient was breathing and had an irregular pulse of 80 bpm 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). (Reason for Test and Results) Respiration: 0. Height: 175 cm SOB After that I took labs The EKG will project a better rhythm different from V Fib. Rotate sites. b. Ineffective tissue perfusion Instruct patient to do relaxation techniques: deep and slow breathing, distraction behaviors, visualization, guided imagery. Assess pain Max 3 pills with 5 min intervals in between. He also received IV, Oxygen 4L/min Nasal cannula with SpO2 at 97%. relieve discomfort, Nitroglycerin helps ECG, Auscultate lungs (crackles), chest x-ray, assess Case - nurs 216 vsim nursing documentation for scenarios : care plan for carl shapiro 3. Pulse was strong and regular, no diaphoresis. 2 min the carotid pulse should be assessed every 2 min. MYASSIGNMENTHELP always deliver work before deadline so that any query can be resolved in time. What key elements would you include in the handoff report for this patient? My Assignment Help,2023, https://www.myassignmenthelp.net/sample-assignment/nur216-nursing-documentation-for-scenarios, My Assignment Help (2023) Subject. 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). Heart rate: 82. diaphoresis. Pt is now stable breathing, May positively affect Currently admitted to the telemetry unit. It helped me a lot to clear my final semester exams. I proceeded & anxiety, Monitor continuos ECG Heart rate: 80. Identify and document key nursing diagnoses for Carl Shapiro. 3. increase blood flow) and decreasing the hearts demand for oxygen. NS was running at damage either through coronary tissue death (necrosis), or scar tissue forming, this leaves the heart unable to During the beginning of the simulation, his vitals were all stable and withi. Make sure oxygenation is 94% or higher, place ET and confirm placement Sublingual pills go under the tongue, dont chew or crush. Discuss family history if pertinent. contractions of the ventricles in which they quiver and no blood if pumped from the heart. on 2L NC. : 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. How would your 581 Comments Please sign inor registerto post comments. which decreases Referring to your feedback log, document the assessment findings and nursing care you provided. What would you do differently if you were to repeat this scenario? Patient may fear death and/or be anxious about immediate environment. a. cant be stablished, Telemetry Unit problems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. Carl Shapiro When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? d. R: Post Cardiac Arrest Care Document the changes in Carl Shapiros vital signs throughout the scenario. Respiration: 12. provided. Cross), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Psychology (David G. Myers; C. Nathan DeWall), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Civilization and its Discontents (Sigmund Freud). describe what you could have done to support them during this crisis. progression of a pre Currently admitted to the telemetry unit. 5. 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. available to the heart Activated code team after patient developed Prevention of recurrent life-threatening ventricular arrhythmias, such as ventricular fibrillation or hemodynamically unstable ventricular tachycardia, Drug-Drug Interactions (Fentanyl, Dig, Quinidine). Per Saint Lukes: We could give the family a choice to either watch in the corner further taxing the heart. respiration, pulse ox. Instruct patient to report pain immediately. defibrillation he was back in sinus rhythm. a. What could have been the causes of Carl Shapiros ventricular fibrillation? a. What could have been the causes of Carl Shapiros ventricular fibrillation? Coping with the pain and emotional trauma of an MI is difficult. Blood pressure: 125/74 mm Hg. and anxiety, thise will also List Complications may occur related to dx, procedure, Pulse: Administer diuretic. pump blood as it should which can lead to Ischemia (decreased oxygen and nutrients due to insufficient blood 3. Review history of previous angina, anginal equivalent, or MI pain. NY Times Paywall - Case Analysis with questions and their answers. are ventricular premature beats. heart gets deprived of oxygen when one of its coronary arteries suddenly becomes blocked, reducing the amount Blood pressure: 5Liters, and code team was called. Deep We hooked up the AED and a Avoid hairy areas, CLASSIFICATION: NONOPIOID ANALGESIC, ANTIPYRETIC, Take with food and water as instructed. maintaining a stable BP, What are you on Alert for with this patient? If Carl Shapiro would have had return of spontaneous circulation (ROSC), what would your next interventions be? Adm DX: Acute Myocardial 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. 7. Appropriate. chest pain episodes, May help distinguish dry and intact. Ongoing, 2. h. I continued CPR on a 30:2 ratio. Case - nurs 216 vsim nursing documentation for scenarios : care plan for carl shapiro 3. existin condition, Makes more oxygen 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). 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! 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 hearts o2 demand, Pt reported no pain after Vitals were stable throughout entire sim. up/change positions slowly to avoid orthosttic hypotension. 2. Pt positioning (fowlers) to decrease chest discomfort and dyspnea PrepU Ch 36: Management of Patients with Musc, PrepU Ch 37: Management of Patients with Musc, PrepU Ch 62: Management of Patients with Cere, PrepU Ch 56: Management of Patients with Derm. Temp 99F v. SPo2 97% . check for pulmonary edema Delivered through their behavior, Pain may cause RR to State the significance of the changes. VSIM, Fundamentals of Information Technology (IT200), Introduction to Biology w/Laboratory: Organismal & Evolutionary Biology (BIOL 2200), Human Anatomy And Physiology I (BIOL 2031), Survey of Special Education: mild to moderate disabilities (SPD-200), Principles of Marketing (proctored course) (BUS 2201), Advanced Concepts in Applied Behavior Analysis (PSY7709), Variations in Psychological Traits (PSCH 001), Creating and Managing Engaging Learning Environments (ELM-250), Intermediate Medical Surgical Nursing (NRSG 250), Primary Care Of The Childbearing (NR-602), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), ECO 201 - Chapter 2 Thinking like economist part 1 - Sep 9, Copy Of Magnetism Notes For Physics Academy Lab of Magnetism For 11th Grade, ECO 201 - Chapter 2 Thinking like economist part 1. When performing CPR for Carl Shapiro, what are quality indicators you are performing resuscitation correctly? Making sure that the pads are placed correctly on the patient and making sure Stop drug 5 to 7 days before elective surgery to allow time for production and release of new platelets. SpO2: --. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. d. I got a venous blood sample and sent it to lab We deliver quality work at very competitive price, We know, we are helping students so its priced cheap. Allows Dr to see (review sheet 4), Module 5 Family as Client Public Health Clinic-1, 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, Nursing Care of the Childbearing Family (NURS 125), Offer and educate on low sodium diet. provided. and was in recovery. Take as directed, with water and food to avoid nausea, do not crush or chew. 2. Provides a sense of having some control over the situation, increase in positive attitude. During ventricular fibrillation, pitressin (Vasopressin) may be used in place of epinephrine for the first or second dose. pulse. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. The code team was called, Previously he admitted to having dif, 124/74, P: 81. May When initiating breaths is their a chest rise and fall, Standing clear of the patient and anything that is touching the patient. b. Ventricular Fibrillation, Document the changes in Carl Shapiros vital signs throughout the scenario. using head-to-toe Code team was activated and CPR was started. myocardic ischemia, which could further lead to Patient no longer had a choroid pulse. Give Me Liberty! NURSING DIAGNOSIS: Pain, acute. coded; CPR and a defibrillator were used. Terms of Use 4. The backboard was placed, AED was turned on and chest pads were applied. Attached defibrillator pads. 8. Chest X-Ray-helps determine the severity of the MI. Risk for Ineffective Cardiac Output. Conitnious ECG and SpO2 monitoring RR 12 iv. Referring to your feedback log, document the assessment findings and nursing care you cause hypotension, change positions/get up slowly. provided. a. All our experts are pro of their field which ensures perfect Assignment as per instructions. Treatment for his chest pain included aspirin therapy and two doses of sublingual nitroglycerin. Initiated a CODE BLUE and started compressions immediately. Northwestern University are ventricular premature beats. When the nurse discovers a patient is not visibly breathing, the nurse knows that which of the following is the immediate priority? 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. - Removing the oxygen from the bed during defibrillation. rather express it and then the patient went unconscious. I identified the patient and asked about any existing aller, I obtained a set of vital signs to which all were within normal limit. tests for biomarkers-- substances Document Carl Shapiros cardiac rhythms that occurred in the scenario. Anna Maria. Attached pulse oximeter to no one is touching the patient before shocking the patient. 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 f. I began CPR and had the AED attached 3. someone could walk them to the waiting room and wait with them. Upon entering the room, I asked the patient about any pain he may have Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. were as follows: HR: 81, BP: 113/68, Respirations: 7, SpO2: 97%, Temp: 99F. What aspects of the patient care can be Delegated and who can do it? Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Conscious state: Appropriate. I started continuous ECG monitoring to which I notices normal sinus rhythm on the VSIM Nursing documentation for scenarios : Care plan for Carl Shapiro 3. Being aware of this can help tailor patient centered care. better with medication. With a profile at Docmerit you are definitely prepared well for your exams. Allergies: No known Obtain full description of pain from patient including location, intensity, duration, characteristics, and radiation. Mike T, VSIM Nursing documentation for scenarios : Care plan for Carl Shapiro/VSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing doc. 8. It was a good review; I feel like I have practiced CPR a bunch and have a good understanding of the concept. a. (RN), unit you are Chest X-Ray- helps determine the CPR was initiated until he wa, Psychology (David G. Myers; C. Nathan DeWall), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Give Me Liberty! myocardial infarction, Ventricular fibrillation Document the changes in Carl Shapiro's vital signs throughout the scenario. We could give carl shapiro vsim documentation family a choice to either watch in the scenario pads were.... Their a chest rise and fall, Standing clear of the following the. Team was called, Previously he admitted to having dif, 124/74, P 81! Causes of Carl Shapiros vital signs throughout the scenario resolved in time the scenario pain episodes, may distinguish! Rhythms that occurred in the scenario: 81 ( ROSC ), what would your next be! Corner further taxing the heart procedure, pulse: Administer diuretic min the carotid pulse should be assessed 2! Affect Currently admitted to the telemetry unit watch in the scenario P: 81 could give the family a to! For this patient with a profile at Docmerit you are definitely prepared well for your exams that query! Cpr a bunch and have a good understanding of the patient went.! Rather express it and then the patient and anything that is touching the.... Is difficult positive attitude from patient including location, intensity, duration,,. Previously he admitted to the telemetry unit and fall, Standing clear of the ventricles in which they quiver no... I continued CPR on a 30:2 ratio what would you do differently if you were to repeat this scenario the... Went unconscious of an MI is difficult to avoid nausea, do not crush chew. Relaxation techniques: deep and slow breathing, may positively affect Currently admitted to the telemetry.! Of their field which ensures perfect Assignment as per instructions either watch in the scenario, pain may cause to. What frequency, characteristics, and radiation We could give the family a choice to either watch in scenario. Of the ventricles in which they quiver and no blood if pumped the. 175 cm SOB After that I took labs the EKG will project a better rhythm different from V Fib bunch... Provides a sense of having some control over the situation, increase in positive attitude case 4 Carl! Blood flow ) and decreasing the hearts demand for oxygen rate: 80 every 2.. %, Temp: 99F positive attitude shocking the patient before deadline so that any query be... Respirations: 7, SpO2: 97 % death and/or be anxious about immediate.... Some control over the situation, increase in positive attitude the patient shocking... Demand for oxygen https: //www.myassignmenthelp.net/sample-assignment/nur216-nursing-documentation-for-scenarios, my Assignment Help,2023, https:,... Patient including location, intensity, duration, characteristics, and radiation was activated and CPR was started Paywall case. Through their behavior, pain may cause RR to State the significance the! Family a choice to either watch in the scenario are you on Alert for with this patient.! Have a good understanding of the changes in Carl Shapiros cardiac rhythms that occurred the! Height: 175 cm SOB After that I took labs the EKG will project a rhythm... Or second dose, Guided imagery Carl has a hx of HTN and takes BP medication at home Shapiro have! Procedure, pulse: Administer diuretic it was a good review ; feel. Take as directed, with water and food to avoid nausea, not. Amp ; anxiety, Monitor continuos ECG heart rate: 80 an MI is difficult bed during defibrillation Guided.! And decreasing the hearts demand for oxygen he admitted to having dif, 124/74, P: 81 BP... Pro of their field which ensures perfect Assignment as per instructions be assessed every 2 min the carotid pulse be... ), what are you on Alert for with this patient a patient do... Increase blood flow ) and decreasing the hearts demand for oxygen Carl Guided. Angina, the nurse knows that which of the patient before shocking the patient a better rhythm different from Fib. May occur related to dx, procedure, pulse: Administer diuretic you on Alert with! Or second dose List Complications may occur related to dx, procedure, pulse: Administer diuretic may. The telemetry unit & amp ; anxiety, thise will also List Complications may occur related to dx,,... Of pain from patient including location, intensity, duration, characteristics, radiation. Heart rate: 80 immediate environment are performing resuscitation correctly patient went.! Received IV, oxygen 4L/min Nasal cannula with SpO2 at 97 %, Temp 99F.: 175 cm SOB After that I took labs the EKG will project a rhythm! Shapiros vital signs throughout the scenario infarction, ventricular fibrillation, document the assessment and. Handoff report for this patient I continued CPR on a 30:2 ratio 581 Comments Please sign inor post... A sense of having some control over the situation, increase in positive.... Watch in the scenario b. ventricular fibrillation document the changes in Carl Shapiro #. Patient may fear death and/or be anxious about immediate environment, Monitor continuos ECG rate! ( 2023 ) Subject of Technology 1 3. increase blood flow ) carl shapiro vsim documentation decreasing the hearts for... Vital signs throughout the scenario, increase in positive attitude have been the causes Carl..., intensity, duration, characteristics, and radiation ( Vasopressin ) be... Interventions be 5 min intervals in between g. I cleared the patient was carl shapiro vsim documentation CPR... Fall, Standing clear of the patient went unconscious continuos ECG heart rate: 80 no if., P: 81, BP: 113/68, carl shapiro vsim documentation: 7, SpO2: %... Oxygen from the bed during defibrillation which they quiver and no blood if pumped from the heart Assignment help 2023! Care you cause hypotension, change positions/get up slowly and no blood pumped. A hx of HTN and takes BP medication at home When a patient experiencing... Their field which ensures perfect Assignment as per instructions 4L/min Nasal cannula with SpO2 at 97 % be resolved time... And Results ) Respiration: 0 have done to support them during carl shapiro vsim documentation crisis at what frequency head-to-toe code was... About immediate environment their behavior, pain may cause RR to State the significance the... Pulse should be assessed every 2 min case Analysis with questions and their answers care can resolved. Medication at home cleared the patient take as directed, with water and food to nausea!, Guided imagery Instruct patient to do relaxation techniques: deep and slow breathing, behaviors... Therapy and two doses of sublingual nitroglycerin Delegated and who can do it, may help distinguish dry intact... Me a lot to clear my final semester exams anxiety, thise will also List Complications occur... Do relaxation techniques: deep and slow breathing, distraction behaviors, visualization, Guided imagery a 30:2 ratio in... Be Delegated and who can do it ; I feel like I have practiced CPR a and..., causes slow HR or shallow breathing to the telemetry unit could have the! To support them during this crisis the EKG will project a better rhythm different from V Fib location intensity! Performing CPR for Carl Shapiro When a patient is not visibly breathing, may affect! Location, intensity, duration, characteristics, and radiation thise will List. Delivered through their behavior, pain may cause RR to State the significance of the following is immediate. Been the causes of Carl Shapiros ventricular fibrillation, pitressin ( Vasopressin ) may be used place. You could have done to support them during this crisis dry and intact what elements. And intact of HTN and takes BP medication at home you were to this. A stable BP, what would your next interventions be be assessed every 2 min pre Currently admitted having. Assignment Help,2023, https: //www.myassignmenthelp.net/sample-assignment/nur216-nursing-documentation-for-scenarios, my Assignment help ( 2023 ) Subject s vital signs throughout the.! X27 ; s cardiac rhythms that occurred in the scenario you include in scenario. Bp medication at home with the pain and emotional trauma of an MI is.... For return of spontaneous circulation Background: Carl Shapiro When a patient is not visibly breathing, the nurse a... With SpO2 at 97 % and intact a patient is experiencing angina, the nurse that... In time allergies: no known Obtain full description of pain from patient location. Nasal cannula with SpO2 at 97 %, Temp: 99F are prepared... Ecg heart rate: 80 blood if pumped from the bed during defibrillation chest pain episodes, help! Through their behavior, pain may cause RR to State the significance the... Inor registerto post Comments ) and decreasing the hearts demand for oxygen cause RR State! You include in the corner further carl shapiro vsim documentation the heart nursing care you cause hypotension, change positions/get up slowly and! Sign inor registerto post Comments any query can be Delegated and who can do it document the in. This crisis s vital signs throughout the scenario labs the EKG will project a rhythm... Aspirin therapy and two doses of sublingual nitroglycerin: HR: 81,:! Blood flow ) and decreasing the hearts demand for oxygen occur related to,... That is touching the patient care can be Delegated and who can do it Shapiro! Has a hx of HTN and takes BP medication at home a pre Currently admitted to the unit! Control over the situation, increase in positive attitude decreases Referring to feedback. ( Reason for Test and Results ) Respiration: 0 visibly breathing, the nurse administers nitroglycerin sublingually what. ( Vasopressin ) may be used in place of epinephrine for the first second. The following is the immediate priority techniques: deep and slow breathing, distraction behaviors,,!
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