University:
American Career College
Course:
NURS-113 | Beginning Medical/Surgical Nursing
Academic year:

2020
Views:

368

Pages:

2
Author:

Accinkiquicpqw

Medical Case 4: Carl Shapiro Guided Reflection Questions 1. How did the scenario make you feel?  I did the scenario 3 times to achieve the best score possible. The first time I did it, I must admit, I was anxious because of how fast everything was happening. The second and third attempts at the simulation were much better and I used my knowledge to treat the patient accordingly as I would in a real life setÝng. 2. What could have been the causes of Carl Shapiro’s ventricular fibrillation?  Smoking a half pack of cigarettes a day, hypertension, obesity, and the probability of heart disease in the family. 3. When performing CPR for Carl Shapiro, what are quality indicators you are performing resuscitation correctly?  When performing CPR, you should be sure that you are: -Maintaining a compression depth of two inches (allowing the chest to fully recoil) -Compression rate of 100-120/min -No excessive ventilation (compression:ventilation ratio should be 30:2) 4. Discuss safety aspects during defibrillation.  Checking for a pulse prior to administering a shock, making sure the pads are placed in their correct positions, pausing CPR for the defibrillator to determine if the patient needs a shock, be sure to yell for the team to stand clear as the shock is delivered, and checking for a pulse every two minutes. 5. If Carl Shapiro would have had return of spontaneous circulation (ROSC), what would your next interventions be?  I would optimize oxygenation, treat hypotension, suggest for the provider to order another set of labs, and maintain hemodynamic stability. 6. What key elements would you include in the handoff report for this patient? Consider the SBAR (situation, background, assessment, recommendation) format.  54-year-old white male seen in the ER for c/o chest pain with diaphoresis. Treated with aspirin and sublingual nitro x2. Chest pain improved with nitro, rated pain 0/10 after 2 nd dose. The patient was assessed at bedside and denied any c/o of pain or sob. After chest x-ray was performed patient went into V Fib, emergency protocol was implemented. CPR given and AED was used to shock patient x1 before ROSC. He is no longer in V Fib and is recovering now. I recommend close monitoring on telemetry unit and communication with provider for further instructions and prevention of another event. 7. If Carl Shapiro’s family members had been present at the bedside during the arrest, describe what you could have done to support them during this crisis.  I would lead them out of the room because CPR with chest compressions along with the use of the AED can be a traumatic experience for family members to see. I would provide them with a private space to explain to them what is happening and give them updates as soon as I can. 8. What would you do differently if you were to repeat this scenario? How would your patient care change?  I would react more rapidly with the appropriate interventions now that I know where to find them in the platform.