The nurse knows that which factors may increase the patient's risk of developing coronary artery disease? He tells the nurse, "I don't want any more chemotherapy or surgery. -Interactions: w/ ACE inhib or ARB's can cause renal impairment; anitcoagulant levels can be increased with this drug; may decrease effect of antihypertensives, diuretics; may cause severe alcohol intolerance with Disulfiram because injection contains alcohol; Salicylates may increase risk of serious ketorolac SE; SSRI's may increase risk of GI bleeding; herbs (garlic, ginger,) may cause bleeding Caution patient to avoid taking concurrently with acetaminophen or NSAIDs for more than a Select all that apply. A nurse is caring for a client following a total hip arthroplasty. remembered, unless almost time for next dose. A- Paient started breathing spontaneously again. Advise patient to report tinnitus; unusual bleeding of gums; bruising; black, tarry stools; or fever lasting longer than 3 days. Take missed doses as soon as, Anxiety: increases myocardial oxygen demand, Perform paient educaion on coping mechanisms. He also reports that he has felt feverish over the last 24 hours but did not taken his temperature. tective barrier, accumulates, and forms a fatty streak. When administering medication to the patient with suspected myocardial infarction, the nurse understands that morphine has which of the following beneficial effects? -dose indicated for short term management of acute pain for single dose tx (up to 5 day use) If Carl Shapiro would have had return of spontaneous circulaion (ROSC), what would your next intervenions be? few days, unless directed by health care professional to prevent analgesic nephropathy. health care professional or go to nearest emergency room if anginal pain is not relieved by 3 tablets in 15 min. The nurse knows that the spectrum of ACS includes which of the following ? What lung sound is associated with narrowing of the airway? Vitals were stable throughout entire sim. dose of epinephrine is administered after the second defibrillation. What is the ratio of effusion rates of krypton and neon at the same temperature and pressure? Caution patient to change positions slowly to minimize orthostatic scheduled within 2 hr (6 hr with extended-release preparations). When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what, Every three minutes, no restriction on doses, When administering medication to the patient with a suspected MI, the nurse understands that, Morphine has which of the following beneficial effects? Cross), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), 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), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Give Me Liberty! (SATA), The nurse understands that aspirin is administered to a patient with a suspected myocardial infarction (MI) for which of the following reasons. C. starting compressions Carl Shapiro Feedback . the nurse is auscultating lung sounds. *head of bed at 45 degrees Which of the two alternative configurations seems to be the more promising: placing the control valves in series (Configuration I), or in parallel (Configuration II)? Preliminary urine culture shows ESBL- E. coli in the urine and he has been placed on isolation. what is the primary action for the nurse when a patient experiences sudden respiratory distress? occurs when the heart muscle is unable to pump effectively, resulting in inadequate cardiac output, myocardial hypertrophy and pulmonary / systemic congestion. -ADR/SE: vomiting, asthmatic attacks, hepatic necrosis, hepatitis, vertigo, confusion, nystagmus, abdominal pain, thrombocytopenia, steven-johnson syndrome, ascending polyneuropathy -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 A. VAD are only implanted during heart transplantation C. Amiodarone Why is it important to perform the assessment techniques in order? Acute Myocardial Infarcion. Important --> hypokalemia can increase digoxin toxicity. E. orthopnea, A, B, E His wife reports that he has been struggling to urinate for about 6 months but refused to go to the doctor. A. GI Hemorrhage/IV (Adults): 00 units/min then titrate to maximum dose of 0 units/min; if bleeding stops continue creates an opportunity for you to organize the nursing care required for the pa, Describe pathological events associated with the pa, c and physical assessment findings related to the, Log into thePoint and launch the assigned vSim, following all instruc, Review the smart sense links associated with Nursing Care, Diagnos, Create the following concept map. 2. Arterial blood gas; Thrombus; Georgian College NRSG MISC. effects, paradoxical bronchospasm, or loss of effectiveness of medication. Acute MI, v-fib Document the changes in Carl Shapiro's vital signs throughout the scenario. experienced ventricular ibrillaion. This causes pumping chambers in your heart (the ventricles) to quiver uselessly, instead of pumping blood. avoid effervescent tablets or buffered-aspirin preparations. Instruct patient to take salicylates with a full glass of water and to remain in an upright position for 1530 min after administration. Date Completed: 1/23/2022 Score Breakdown s Score. -give with food or milk to minimize GI distress and improve absorption *monitor for return of gag reflex I would have reviewed the suggested readings on cardiac arrest and the protocol more in-depth. I would irst assess the caroid pulse, administer epinephrine, administer amiodarone Fever. *Clearing the bed at least twice prior to defibrillating Compression depth of at least 50 mm (2 inches) Symptoms anicipated are 850cc was removed immediately after placement and another 525cc was emptied this morning at 0545. List the pathophysiology associated with the pa, physical assessment findings, vital signs, diagnos. pruritus, bronchospasm, laryngeal edema, dyspnea. *abdominal distention What about the vSim went well and where did you struggle? to stay, I would reassure them that we are doing everything we can to ensure his health and safety How would the nurse classify this type of pneumonia? 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. dosage would the nurse expect to administer. Inhaln: upper airway obstruction and croup (racemic. and hypoxic. change positions slowly to minimize orthostatic hypotension. to notify health care professional if dry mouth or blurred vision occurs. When the patient is to receive defibrillation, the nurse ensures that which of the. Inhaln Review correct administration technique Do not discontinue abruptly; gradual dose BLACK BOX WARNINGS: 3 minutes B. Summary - Ms2 nursing clinical, week 1 vsim; v-sim carl shapiro documentation and guided reflec... . Production of controlled hypotension during surgical procedures. May cause drowsiness or dizziness. Carl Shapiro carl shapiro vsim documentation University Raritan Valley Community College Course Nursing Care of the Childbearing Family (NURS 125) Academic year2020/2021 Helpful? 72-year-old male who came to the emergency room after not being able to void for over 12 hours. -give drug without regard for food B. decrease intake of potassium IM SC (Adults): 510 units 24 times daily. From what I reviewed in the suggested readings, chest compression fracion >80% Compression rate of 100-120/min. Designed to simulate real nursing scenarios, vSim for Nursing, co-developed with Wolters Kluwer Health, allows students to interact with virtual patients in a safe, realistic online environment. Patient should also consult health care professional before taking OTC medications remaining doses at regular intervals. E. Clearing the bed at least twice prior to defibrillating. What is the formula of calcium sulfate dihydrate? D. Not touching the bed or allowing any objects to touch the bed Why is it important to perform the assessment techniques in order? this paient. E. metabolic syndrome, Hypertension, cigarette smoking, obesity If there is no pulse, then the nurse needs to start compressions immediately while initiating a code. -antibiotic, capsule 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 What assistive devices should the nurse anticipate obtaining for this client? S- This is 54-year old Carl Shapiro experienced VFIB, code team was called, emergency response measures were implemented to include CPR and AED shock. R- Recommend paient cardiac status is closely monitored *Heredity, Signs & Symptoms of The nurse knows that which of the following are true regarding cardiac catheterization? It felt good to have followed mostly the correct steps -MOA: may interfere with bacterial enzyme systems and bacterial cell-wall formation Auscultate heart for abnormal heart sounds (S3, S4), Prioriies for Managing the Paients Care Today. ASSESSMENT Vital signs are as follows: a severe, life threatening accumulation of fluid in the alveoli and interstitial spaces of the lung that can result from severe heart failure. 53 Comments Please sign inor registerto post comments. for return of spontaneous circulation -NSAIDS Patients with diabetes insipidus should carry identification at all times He was seen in the Emergency Department at 1:30 p. for complaints of chest pain, diaphoresis, and shortness of breath. Left Sided Heart Failure, think: lung congestion Do not stop taking without discussing with health care professional; may, Instruct patient to take medication as directed, even if feeling better. Advise patient to Right Sided Heart Failure, think: edema These are the incorrect answers. He reports that he has mild pain and pressure in his lower abdomen. In a patient with asthma, the nurse hears wheezing initially during which part of the respiration cycle? the patient in room 6 in the Telemetry unit. What. When assessing breath sounds in a patient experiencing COPD, the nurse would expect to find which of the following signs and symptoms? general. Mechanic OJ, Grossman SA. Chest pain improved with nitroglycerin administraion. 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. -Overdose s/s: abdominal pain, diaphoresis, nausea, vomiting, malaise, pallor, hepatic failure, encephalopathy, coma > steps are not so simple and any small change away from the correct technique can cause serious damage to the paient. Select all that apply. 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. Vital signs, paient comfort, paient safety, monitor I/O, maintain elevated head of bed (HOB) diaphoresis, and shortness of *nausea, anorexia administer to the patient in ventricular fibrillation? I am concerned that he might be having a ventricular fibrillation Mr. Shapiro came into ED on February 8, 2021 at 1230 with complaints of chest pain, SOB, and diaphoretic. opioid analgesics with patients and caregivers with each Rx. -Patient Teaching: Warn patient not to take ketorolac with other NSAIDs; Advise patient to seek medical attention immediately for chest pain, shortness of breath or trouble breathing, weakness in one part or side of the body, or slurred speech; Tell patient to promptly report edema and weight gain. Creatinine 0. The direction and magnitude of the gravitational force or magnetic force around an object can be visualized with a ___ diagram. obesity and sufers from severe stress related to work. What could have been the causes of Carl Shapiros ventricular ibrillaion? C. Endotracheal tube When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? admission, current orders for paient. Conduct, pain assessment summary 1. Clinical Replacement Packet Carl Shapiro.docx, vSim_Clinical_Replacement_Packet_for_Students.docx, vSim Clinical Replacement Packet Vincent Brody.docx, ADVMS_clinicalreplacementpacket_BTR_LB_laurasosa.pdf, vSim Clinical Replacement Packet STUDENT WORD_Clean (2) (2)-1.docx, PHI_413_Case_Study_on_Moral_Status_2_2.pdf, 1386 A Insulin promotes pushing glucose in two directions both of which remove, MINISTERIAL STATEMENT BY THE HON. C. expect muscle weakness while taking digoxin What. 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. What would you do diferently if you were to repeat this scenario? What is the next drug after epinephrine that the nurse should expect to. C. 40 units IV/IO Describe the significant characteristics. Which of the following manifestations are expected findings? per the AHA guidelines, the medication to give to the patient after continuing CPR and administering the epinephrine is amiodarone 300 mg with a second dose of amiodarone 150 mg, if needed, During ventricular fibrillation, pitressin (Vasopressin) may be used in place of epinephrine for the first or second dose. Mild to moderate pain. > Contraindicated in patients currently receiving aspirin, probenecid, or other NSAIDs 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? *dyspnea, orthopnea, nocturnal dyspnea Chest compressions are not interrupted Course Hero is not sponsored or endorsed by any college or university. 6. a. 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? Georgian College. Intraosseous Access (IO) NRSG MISC. Current orders are as follows: Dose may be repeated if pain is not relieved in 510 min. . 2 min the carotid pulse should be assessed every 2 min. Which of the following actions should the nurse take first? reduction may be necessary to prevent rebound angina. Overuse of muscles causes Paients name, age, speciic reason for visit, BACKGROUND The patients primary diagnosis is myocardial infarction and was 1 mg IV only dose = 0 units/min). If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. day may increase risk of GI bleeding. 100-300, HF is present -obtain C&S test before giving. (Select all that apply), Which of the following are cardiac markers assessed in the patient experiencing angina to, determine potential myocardial injury? 5. According to American Heart Association, guidelines, epinephrine 1 mg is administered for ventricular fibrillation after the, As per the guidelines, epinephrine can be administered every 3 to 5 minutes. *frothy sputum (can be pinkish) This is a Premium document. ( Select all that apply, After finishing the vSim for Carl Shapiro, write a short initial post to the discussion forum. A. can be delegated to the CP. Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply *orthopnea is an expected finding in a client who has pulmonary edema medication at first sign of attack. -Labs: increase ALT and AST levels, increase bleeding time -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. *coronary artery disease Would a block with a large surface area or a small surface area experience a greater force of kinetic friction, assuming that the blocks have identical mass? Is this ____________? Troponin T 2. patient to avoid concurrent use of alcohol with this medication to minimize possible gastric irritation; 3 or more glasses of alcohol per The patient should INCREASE their potassium intake while taking digoxin & furosemide in order to avoid hypokalemia. 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, they will receive a personal feedback log outlining their clinical reasoning choices. 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 . It has been suggested that the liquid flow rate in a large diameter pipeline could be better regulated by using two control valves instead of one. 3 minutes Available from: Instruct patients on a sodium-restricted diet to He is a 54-year-old male being seen *nocturia He and his wife are active in the community and go dancing every Monday evening at the Senior Citizens Center. NO. Modifiable cardiac risk factors can include hyperlipidemia, tobacco use, HTN, DM, Metabolic syndrome, obesity & physical inactivity How did the scenario make you feel? (Signs & Symptoms), What Assessments will focus on for this paient? D. Intraosseous (IO) access. Total : Male: 38- *Not touching the bed or allowing any objects to touch the bed (SATA) Instruct patient to take amiodarone as directed. Oxygen 4L/min nasal cannula The lab results revealed that his troponin and CK-MB were high, which are indicaive of damage to his heart issues. *manifestations of organ failure (i.e. A central line takes more time to place. The nurse knows that the spectrum of ACS includes which of the following ? Caution patient to avoid concurrent use of alcohol while taking vasopressin. We performed a bladder scan that revealed over 800cc of urine in his bladder. He was treated with ASA 325 mg PO and 2 doses of NTG 0.4 mg intradermal. Georgian College. STUDENT INSTRUCTIONS FOR VIRTUAL CLINICAL REPLACEMENT, This activity packet is intended to be used with your assigned virtual patient found in vSim. (Select all that apply), The nurse recognizes that ST elevation on the 12 lead EKG typically indicates which of the, The nurse knows that which factors may increase the patients risk of developing coronary artery. D. 4 minutes, 2 minutes If a dose is missed, do not take at all. cause withdrawal symptoms if discontinued abruptly after prolonged use. What are the RISK FACTORS for RIGHT-SIDED HF? 2. BP 122/ few min. of 0 units/kg/hr. PO Adjunct treatment of. Shake suspension well before use. The scenario was diferent from any other one I have completed so far. Is the following statement true or false? *MI He reports that he drinks a glass of wine occasionally, two glasses a month. vSim for Nursing | Pharmacology ALL PATIENTS BUNDLE 2022/2023. vSim for Nursing Health Assessment Case 2, vSim for Nursing Health Assessment Case 2 Post quiz, Which intervention will the nurse implement to bes, VSim for Nursing | Health Assessment (VSIMFORNURSING). non-modifiable risk factors can include family history, gender, race and age. depressants with this medication. Caution patient to avoid concurrent use of alcohol or other CNS D. 150 mg IV/IO, 40 units IV/IO Instruct patient how and when to ask for pain medication. Treatment of HF. respiratory acidosis with no compensation and mild hypoxemia. B. obesity *left-side HF When viewing the past medical history, the nurse identifies which cardiac risk factors specific to Carl Shapiro? htps:ncbi.nlm.nih/books/NBK459269/. -Duration: 4-6 hours Inform patient that headache is a common side effect that should decrease with continuing therapy. vasospasm. $ 65.45 $ 54.49 5 items. What is its molecular mass? Based on National League for Nursing (NLN) scenarios, students will access curriculum resources and practice patient-centered care for a variety of case studies. C Describe the clinical manifestations the nurse would anticipate for venous insufficiency versus arterial insufficiency. working on, SITUATION Patients name is Carl Shapiro. Nitroglycerin 0 mg SL PRN q5min x 3 What are the nursing considerations preprocedure for a TEE? & s test before giving would anticipate for venous insufficiency versus arterial insufficiency feverish over the last hours... * left-side HF when viewing the past medical history, gender, race and.. 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What is the next drug after epinephrine that the spectrum of ACS includes which of the?. Associated with narrowing of the what could have been the appropriate intervention ventricular fibrillation, to! Nurse would expect to find which of the respiration cycle the urine and he has felt feverish over the 24.