Medical Case 4: Carl Shapiro Guided Reflection Questions 1. What two factors keep the lungs from collapsing? CK MB 20 53 Comments Please sign inor registerto post comments. Finish the Suggested Readings, then complete the following four activities: Student may take several times using the answer key to provide immediate. He reports that he has mild pain and pressure in his lower abdomen. Advise patient to avoid this paient. Without suicient oxygen, the issue dies. A- Paient started breathing spontaneously again. He also reports that he has felt feverish over the last 24 hours but did not taken his temperature. **Compressions and ventilations would be interrupted during defibrillation. Do not double doses. A. > NSAIDs can increase risk of heart attack or stroke in patients with or without heart disease or risk factors for heart disease. *displaced apical HR (hypertrophy) ), Rhythm interpretation help please. -Labs: increase ALT and AST levels, increase bleeding time In the patient experiencing asthma, the nurse can expect to find which of the following sounds on percussion of the chest? Includes 10 virtual patient simulation scenarios and other curricular content based on the National League for Nursing (NLN) Complex Care Medical-Surgical Scenarios (Volume 1). The nurse answers a client's call bell to find the client's abdominal wound bleeding and after a brief assessment discovers the wound has eviscerated. ideally 2 large-bore peripheral IV lines are established during a code for fluid and medication administration. NRSG MISC. when ambulating or smoking and to avoid driving or other activities requiring alertness until response to medication is known. IV (Adults and Children): 0 units/kg/hr, double dose every 30 min as needed to a maximum When the patient is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? effects, paradoxical bronchospasm, or loss of effectiveness of medication. *pulmonary congestion (dyspnea, cough, crackles) The urine was cloudy amber and was malodorous and a urine analysis and culture were sent to the lab yesterday. HF. Instruct patient to take salicylates with a full glass of water and to remain in an upright position for 1530 min after administration. List three (3) radiation precautions that will need to be in place for a client receiving brachytherapy. (How will I idenify the above signs &Symptoms?). Dose may be repeated if pain is not relieved in 510 min. Alternatively, IO access may be established if peripheral access is not readily available. Notify HCP when labs are reported, Paients primary diagnosis, date of He is a 54-year-old male being seen 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. Compression depth of at least 50 mm (2 inches) Based on this ECG waveform, the nurse recognizes that the patient is experiencing which dysrhythmia? 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 the patient is to receive defibrillation, the nurse ensures that which of the. 2 minutes in adults and at least 1/3 the AP dimension of the chest in infants and children. What are the nursing considerations postprocedure for a TEE? For the following, write a balanced chemical equation to show how the ions would combine in a double replacement equation: barium nitrate and potassium chromate form barium chromate and potassium nitrate. general. E. metabolic syndrome, Hypertension, cigarette smoking, obesity Unlabeled Use(s): Gastrointestinal hemorrhage. Temporary relief of mild symptoms of intermittent asthma (over the counter). speciic to the heart and is more *NPO for 6 hours prior These are the incorrect answers. What are you on alert for with this paient? Insert secondary IV site for effects (blanching of skin, abdominal cramps, nausea). excessive venilaion Briefly justify your answer. *Various Cancer Treatments Treatment of HF. Carl is a caucasian male, presenting with HTN and obesity and had hx of cigarette smoking and physical inactivity During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? Father deceased at 61 from MI, mother deceased at 75 from pneumonia. 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. oxygen therapy at 4L/min. D. assessing the carotid pulse. for return of spontaneous circulation right angle to leg. The nurse recognizes that ST elevation on the 12 lead ECG typically indicates which of the following? Why is cross-pollination preferred over self-pollination as an adaptive strategy? Date Completed: 1/23/2022 Score Breakdown s Score. Company Registration Number: 61965243 Instruct patient how and when to ask for pain medication. 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 . a severe, life threatening accumulation of fluid in the alveoli and interstitial spaces of the lung that can result from severe heart failure. Arterial blood gas; Thrombus; Georgian College NRSG MISC. Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation. What. NS 25 mL/hr IV continued infusion When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? (SATA). (SATA), Which of the following does the nurse recognize as typical signs and symptoms exhibited by a patient experiencing angina? Julie S Snyder, Linda Lilley, Shelly Collins, Foundations for Population Health in Community and Public Health Nursing, Introduction to Sports Medicine and Athletic Training. The patient should INCREASE their potassium intake while taking digoxin & furosemide in order to avoid hypokalemia. Mechanic OJ, Grossman SA. *fatigue, weakness It was a good review; I feel like I have practiced CPR a bunch and have a good understanding of the concept. Creatinine 0. 3. Arterial blood gas (ABG) levels may be obtained when the patient is experiencing exacerbations of COPD. Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply Your name, posiion (RN), unit you are Press hard into thigh until auto-injector functions, hold in place for 10 sec, remove, and discard properly. Current orders are as follows: 2. What would you do diferently if you were to repeat this scenario? *liver enlargement & tenderness A VAD helps to pace the heart within the border zone may become a site for generaing arrhythmias. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. part of the Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) guidelines for the management of ventricular, fibrillation (VF)/pulseless ventricular tachycardia (VT) after cardiopulmonary resuscitation and defibrillation have failed; also, for other life-. *Informed consent How would the nurse interpret the following ABG levels? Creainine Kinase Isoenzymes (CK- The nurse recalls that, according the AHA guidelines for adult CPR, the correct compression: ventilation ratio and rate per minute is which of the following? -antibiotic, capsule D. check oxygen saturation with pulse oximeter, B. assist the client into a High Fowlers position Ventricular Fibrillaion: Ventricular ibrillaion is a heart rhythm problem that occurs when the heart beats with rapid, erraic NURSING 4010; Post SIM Quiz, vSim for Nursing Maternity Case 3: Amelia Sung Post-Simulation Quiz. > Contraindicated in patients with active peptic ulcer disease, recent GI bleeding or perforation, and a history of peptic ulcer disease or GI bleeding. reduction may be necessary to prevent rebound angina. -Interactions: Barbiturates may reduce therapeutic effects and enhance hepatotoxic effects of acetaminophen; alcohol use may increase risk of hepatic damage *coronary artery disease What assistive devices should the nurse anticipate obtaining for this client? 15 Item ACLS Drill Answers and Rationale.pdf, New workers hired 22 0 0 Workers laid off 0 0 0 Units subcontracted 0 0 0 Units, 25 Humans born blind or kittens raised under restricted conditions do not have, 1386 A Insulin promotes pushing glucose in two directions both of which remove, BSBHRM404 REVIEW HUMAN RESOURCE FUNCTIONS.docx, Equity in earnings of unconsolidated affiliates 00 00 00 00 00 00 00 Foreign, 5 Recording Use of audiocassettes and videotapes videotaping has the advantage, SCS 100 Module Two Activity Template.docx, BSBWHS411_Assessment_Instructions_V1.0921.pdf-convertido.docx, Question 29 1 point Which of the following statements is true of random, Gut Microbes Contribute to Mysterious Malnutrition.pdf, Add Question Here Multiple Choice 0 points Question Which statement best, The SBAR states that the client has been diagnosed with a non-ST elevation acute coronary syndrome . The nurse knows that which of the following are true regarding cardiac catheterization? Discuss safety aspects during deibrillaion. additon to this Clinical Replacement Activity Packet, submit for grading as instructed in your syllabus. *right ventricular MI The nurse understands that a patient with asthma is likely to exhibit which three most common symptoms? What about the vSim went well and where did you struggle? *Prolonged Alcohol Use -obtain C&S test before giving. 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? Take missed doses as soon as remembered unless next dose is, Instruct patient to take medication as directed. When administering medication to the patient with suspected myocardial infarction, the nurse understands that morphine has which of the following beneficial effects? **shortness of breath while lying down**, Signs & Symptoms of Caution patient to avoid taking concurrently with acetaminophen or NSAIDs for more than a Overuse of muscles causes Available from: 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) dose = 0 units/min). following safety measures are implemented. What aspects of the paient care can be Delegated and who can do it? *Infection / Inflammation of the heart muscle avoid effervescent tablets or buffered-aspirin preparations. -Overdose s/s: abdominal pain, diaphoresis, nausea, vomiting, malaise, pallor, hepatic failure, encephalopathy, coma He reports pain and pressure in his lower abdomen and states that he has tried to go several times throughout the day with no luck. throughout the scenario. This is a Premium document. What are the nursing considerations preprocedure for a TEE? *nocturia Consider the SBAR (situaion, background, assessment, recommendaion) format. -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. what is the primary action for the nurse when a patient experiences sudden respiratory distress? B. Epinephrine B- 54-year-old male. The direction and magnitude of the gravitational force or magnetic force around an object can be visualized with a ___ diagram. Give two reasons the lungs tend to recoil. hypoxia. using the information contained in step five. Alerts: The guide provides strategies for use of vSim for Nursing in programs across all types of nursing education. 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)? He was treated with ASA 325 mg PO and 2 doses of NTG 0.4 mg intradermal. Carl Shapiro pre-quiz 100%.docx. *JVD 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. Do not stop taking without discussing with health care professional; may, Instruct patient to take medication as directed, even if feeling better. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). dosage would the nurse expect to administer. D. Nitroglycerin, Amiodarone shortness of breath, faining, Admiing complaint: chest pain, I am the nurse taking care of administer to the patient in ventricular fibrillation? Document Carl Shapiro's cardiac rhythms that occurred in the scenario. 2. Medical-Surgical Scenarios that currently exist as Laerdal simulator scenarios, Nursing students develop clinical reasoning skills by prioritizing and implementing actions within several dimensions, including: Safety Measures Practice safe procedures Communication Interact with the patient through questions that result in text and audio responses. Assessments Conduct specific physical assessments Interventions Take action with the patient to improve their health status Drugs and IV Management Administer medication according to provider orders Testsand Diagnostics Perform lab or diagnostic tests to support clinical decisions Search - Find available interactions to take with the patient Electronic Health Record - Reference provider orders and patient information to influence decision making Call Provider - Request additional information during the scenario Patient Handoff - End the scenario at any time. Dizziness, light-headedness, and syncope (due to postural hypotension) occur most frequently in older adults.Report any increase in frequency, duration, or severity of anginal attack. Why is it important to perform the assessment techniques in order? If administering Vasopressin what dosage would the nurse expect to administer? *orthopnea is an expected finding in a client who has pulmonary edema Inform patient that side effects may not appear until several days, Suggest student complete the vSim Tutorial prior to launching Step Three. -dose indicated for short term management of acute pain for single dose tx (up to 5 day use) Shake suspension well before use. 8. a patient experiencing respiratory distress at home from pneumonia is brought to the hospital upon presentation requires intubation. -Peak: 2-3 hours or acetaminophen may be ordered to treat headache. *monitor for return of gag reflex Is this ____________? C. 40 units IV/IO -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 same dose for 12 hr then taper off over 2448 hr. Caution patient to avoid concurrent use of alcohol or other CNS C. Removing the oxygen from the bed during defibrillation From what I reviewed in the suggested readings, chest compression fracion >80% Compression rate of 100-120/min. few min. (SATA), The nurse understands that aspirin is administered to a patient with a suspected myocardial infarction (MI) for which of the following reasons. -Overdose s/s: Abdominal pain, nausea, vomiting, peptic ulcers, GI bleeding, hyperventilation, renal dysfunction, metabolic acidosis, HTN, lethargy, drowsiness, respiratory depression, coma, anaphylaxis. Inhaln Review correct administration technique 72-year-old male who came to the emergency room after not being able to void for over 12 hours. 8. He was diagnosed with acute myocardial infarction. How would the nurse classify this type of pneumonia? -Duration: 4-6 hours -MOA: may interfere with bacterial enzyme systems and bacterial cell-wall formation IM SC (Adults): 510 units 24 times daily. 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. nitroglycerin patch, ensure there are no lammable substances (remove oxygen from the bed) *pulmonary problems (COPD, pulmonary fibrosis), disease of the heart muscle, the myocardium report abnormalities. Every three minutes, no restriction on doses b. Right Sided Heart Failure, think: edema it leads to heart failure These can be inserted without interrupting CPR. Myocardial Infarcion: ("heart atack") is the irreversible damage of myocardial issue caused by prolonged ischemia and Relief usually occurs within 5 min. Which of the following information should the nurse include? B. Summary - Ms2 nursing clinical&comma; week 1 vsim&semi; v-sim carl shapiro documentation and guided reflec&period;&period;&period; . Case - Medical case 4 : carl shapiro guided reflection questions. B. Ventilations are not interrupted SpO2 98 D. cigarette smoking Caution patient to change positions slowly to minimize orthostatic 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. In a patient with asthma, the nurse hears wheezing initially during which part of the respiration cycle? hypotension. Course Hero is not sponsored or endorsed by any college or university. Total : Male: 38- an appropriate activity program. Mr. Shapiro presented to the emergency department yesterday with the inability to void for over 12 hours. Pain severe enough to require daily, Acute (translingual, SL, ointment) and long-term prophylactic (oral, transdermal) management of angina pectoris. Caution patient not to use more than prescribed amount. Autoinjector: Instruct patients using auto-injector for anaphylactic reactions to remove gray safety cap, placing black tip on thigh at be useful. Mr. Shapiro lives with his wife of 41 years. In a patient experiencing asthma exacerbation, which of the following changes occur? *hormone released in response to ventricular stretching* Course Hero is not sponsored or endorsed by any college or university. the patient in room 6 in the Telemetry unit. 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 . First dose should be taken while in a sitting or reclining position, especially in geriatric patients. clinical replacement (see syllabus for details). *Clearing the bed at least twice prior to defibrillating *angina Protect it from theft, and never give to anyone other than the individual describing disease process and medication regimen. E. orthopnea, A, B, E Select all that apply. the result of an acute or chronic cardiopulmonary problem, such as systemic hypertension, myocardial infarction (MI), pulmonary hypertension, dysrhythmias, valvular heart disease, pericarditis or cardiomyopathy. Instruct patients on a sodium-restricted diet to Symptoms anicipated are *weight gain, abnormal accumulation of fluid in the abdomen, brain natriuretic peptide FALSE Advise patient to read the Medication Guide prior to first dose and with each Rx refill in case of changes. A central line takes more time to place. B. decrease intake of potassium > Contraindicated in patients currently receiving aspirin, probenecid, or other NSAIDs 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? what are the trends in davao city, And medication administration SATA ), Rhythm interpretation help Please 4: Carl Shapiro Guided Reflection Questions for surgical. & # x27 ; s cardiac rhythms that occurred in the Telemetry unit incorrect answers AP dimension of the four. To ventricular stretching * course Hero is not readily available alertness until to... Exhibited by a patient experiencing asthma exacerbation, which of the gravitational force or magnetic force around an can... Sudden respiratory distress at home from pneumonia is brought to the patient is experiencing exacerbations of COPD * * and. 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