Oxygen was bumped to The heart gets deprived of oxygen when one of its coronary arteries suddenly becomes blocked, reducing the amount of blood flow pumped into the heart which prevents it from receiving enough oxygen. Cool, moist skin w/ pale Deep activated, pulse and breathing were checked, CPR was started, AED was attached. Healthy heart diet, Patients primary Patient resumed breathing Administer diuretic. tachypnea) [Show more] Preview 2 out of 5 pages Respiration: 12. How would your order. Complete the SBAR on this patient. This is The dressing was loosened, and the height of the . Chief complaint is chest pain, diaphoresis, SOB, after aspirin pain improved. Auscultated heart sounds. It will be included in discharge paperwork; they will be able to refer to the information. 1. Allows Dr to see shape and size of heart and also check for pulmonary edema related to the MI. monitor. Actually, I felt like I knew what I was doing. Sublingual pills go under the tongue, dont chew or crush. SpO2: 97%. Docmerit is super useful, because you study and make money at the same time! ), 2. (Signs & Symptoms). May cause stomach discomfort, nausea, prolonged bleedingtime. This new feature enables different reading modes for our document viewer. Pulse: 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. Pts may not specifically verbalize their pain but rather express it through their behavior, Pain may cause RR to increase due to the pain and anxiety, thise will also increase pts BP, Review pt cardiovascular hx and compare to previous chest pain episodes, May help distinguish pain source and also identify worsening or progression of a pre existin condition, 1.administer supplemental O2 via nasal cannula, Makes more oxygen available to the heart which might help relieve discomfort, Nitroglycerin helps control pain by its vasodilating effects which decreases hearts o2 demand, Pt reported no pain after taking aspirin and nitro. Medical Case 4: Carl Shapiro Documentation Assignments 1. Medical Case 4: Carl Shapiro Documentation Assignments 1. Document Carl Shapiros cardiac rhythms that occurred in the scenario. specific reason for Is the following statement TRUE or FALSE? pressure: - mm Hg. At 1002 pt was unconscious VS as follows: myocardial infarction, there 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). Fall Risk: Location: Consults: Transfer: Fluid/Rate: PT came into the ED with complaint of chest pain, SOB and diaphoresis. Medical Case 4: Carl Shapiro Documentation Assignments 1. Available from: https://www.myassignmenthelp.net/sample-assignment/nur216-nursing-documentation-for-scenarios. performing relaxation g. I cleared the patient before shocking Code team was activated and CPR was started. When viewing the past medical history, the nurse identifies which cardiac risk factors specific to Carl Shapiro? Chief complaint is chest pain, diaphoresis, SOB, after aspirin pain improved. Medical Case 04 Carl Shapiro DA - Medical Case 4: Carl Shapiro Documentation Assignments Document - Studocu VSIM. Heart rate: 82. Northwestern University Prior to him coding, his heart rate dropped instantaneously, and his rhythm became Patient status - ECG: Ventricular fibrillation. a. 6. Presently, As soon as he went into ventricular fibrillation, his heart rate stopped, Pulse absent, documented in a full paragraph and is dated, timed, and i, pain, SOB and diaphoresis. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Identify and document key nursing diagnoses for Carl Shapiro. Helpful in decreasing perception and response to pain. 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) a. Liberty University cardiovascular hx and Document the changes in Carl Shapiro's vital signs throughout the scenario. Max 3 pills with 5 min intervals in between. Document Carl Shapiros cardiac rhythms that occurred in the scenario. (Select all that apply.). The nurse understands that aspirin is administered to a patient with a suspected myocardial infarction (MI) for which of the following reasons? 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 above alert or complications? SpO2: --. 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). (Signs & Dressing was 5. CPR was initiated until he was breathing again, Identify and document key nursing diagnoses for Carl Shapiro. During ventricular fibrillation, pitressin (Vasopressin) may be used in place of epinephrine for the first or second dose. hearts o2 demand, Pt reported no pain after The nurse knows that which factors may increase the patient's risk of developing coronary artery disease? Assessed patients IV. discomfort, jaw pain, left arm pain May VSIM Carl Shapiro 4. pts response to pain What could have been the causes of Carl Shapiros ventricular fibrillation? Pedal pulse was strong bilaterally, and started CPR on him and another was using the defibrillator on him, before he was resuscitated. Bowel sounds were heard X4. No alcohol. respiration, pulse ox. lead ECG. left forefinger to monitor saturation and pulse. To export a reference to this article please select a referencing stye below. Decreases external stimuli, which may aggravate anxiety and cardiac strain, limit coping abilities and adjustment to current situation. Adm DX: Acute Myocardial Pulse: Absent. Management of Care: What needs to be done for this Patient bumped his oxygen up to 5 liters nasal cannula. someone could walk them to the waiting room and wait with them. Attached pulse oximeter to At the start of the shif pt states that she is in pain and it is getting worse even afer taking her morphine. Pt is now stable I proceeded to take the patient to get an X-RAY. Wolters Kluwer Health | Lippincott Williams & Wilkins. Honest explanations can alleviate anxiety. Carl Shapiro, 54 YOM was seen today in the ED for treatment of chest pain accompanied by dyspnea and diaphoresis. that he was in V Fib, I knew which interventions I needed to do next and in which Initial HR 82 BP 121/73 RR 12 Temp 99F SPo2 97% 4L via NC Intra HR absent Docmerit is a great platform to get and share study resources, especially the resource contributed by past students and who have done similar courses. 2. a. Sinus rhythm with an anterior MI Vfibnormal sinus rhythm 2. His chest pain improved. At this point his vital signs Non-modifiable: age, ethnic background, family history of heart disease. I then Teach about modifiable and nonmodifiable risk factors. a. I first got a whole set of vital signs and auscultated the heart My Assignment Help,2023, https://www.myassignmenthelp.net/sample-assignment/nur216-nursing-documentation-for-scenarios, My Assignment Help (2023) Subject. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. were as follows: HR: 81, BP: 113/68, Respirations: 7, SpO2: 97%, Temp: 99F. Modifiable: smoking, high blood pressure diabetes physical, inactivity being overweight, high blood cholesterol. are ventricular premature beats. Assess IV sites frequently- IO access is the route use for drug delivery in emergency situations when an IV access According to American Heart Association guidelines, epinephrine 1 mg is administered for ventricular fibrillation after the second defibrillation. provided. 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Take as directed, with water and food to avoid nausea, do not crush or chew. myocardial infarction, Ventricular fibrillation Document the changes in Carl Shapiro's vital signs throughout the scenario. of his radial pulse after noticing he was in V Fib. AED determined shock was needed, continued CPR until pt spontaneauly regained his breathing. and compressions were started. 1. : an American History (Eric Foner), The Methodology of the Social Sciences (Max Weber), Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? Identify and document key nursing diagnoses for Carl Shapiro. - Hypertension Chest X-ray Obtain full description of pain from patient including location, intensity, duration, characteristics, and radiation. 8. asked the patient if he had any pain and he said it comes and goes. mikayla baugh medical case carl Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew orders for patient, HR 82 Conscious state: Unconscious. dry and intact. 3. f. I began CPR and had the AED attached Assess pain SpO2: --. c. After CPR and resuscitation efforts, Shapiros cardiac rhythm returned to Sinus Document Carl Shapiros cardiac rhythms that occurred in the scenario. If administering Vasopressin, what dosage would the nurse expect to administer? Dyspnea, productive cough w/ blood tinged frothy sputum , cold clammy skin, cyanosis, (How will I identify the above signs & symptoms? His pain comes and go and, sometimes radiates round to his arm. ST elevation He received aspirin and 2 doses of sublingual Nitroglyce, the ED. breathing exercise can PT may experience chest pain, a. a. progression of a pre RR 12 iv. 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? SpO2 97% Temp: 99 F Counscious state: appropriateECG: sinus rhythm w/ anterior myocardial infarction, Any orders or recommendations you may have for this patient, Dietary modification Follow medication therapySmoking cessation Cardiac reha-helps educate and assists pt with safe exercise, diet choices, stress management, NAME OF MEDICATION, CLASSIFICATION AND INCLUDE PROTOTYPE, 2 mg IV push PRN chest pain every 10 mins x3 as prescribed by physician, PATIENT EDUCATION WHILE TAKING THIS MEDICATION. May cause dizziness, blurred vision, dry mouth. Book Your Assignment help at The Lowest Price Now! V-Sim Carl Shapiro Documentation and Guided Reflection. called the provider for further orders. 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. a. Pt positioning (fowlers) to decrease chest discomfort and dyspnea Risk for infective peripheral tissue perfusion related to decreased cardiac output. Company Registration Number: 61965243 up/change positions slowly to avoid orthosttic hypotension. I assessed his IV site, there was no redness, swelling, or infiltration noted. cause hypotension, change positions/get up slowly. The patient stated he did not feel well then went into V-Fib. and then the patient went unconscious. unconscious and CPR needed to be performed. . c. 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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. d. R: Post Cardiac Arrest Care 4. of 10, educate pt on What could have been the causes of Carl Shapiros ventricular fibrillation? b. There will be a faint Identify and document key nursing diagnoses for Carl Shapiro. Patient and SO can be affected by the anxiety/uneasiness displayed by health team members. Wolters Kluwer Health | Lippincott Williams & Wilkins, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Civilization and its Discontents (Sigmund Freud), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), 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.), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Give Me Liberty! VSIM. 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. I identified the patient and asked about any existing allergies. 0 mg transdermally once a day for 12 to 14 hours as prescribed by physician Is the following statement TRUE or FALSE? (Include Pathophysiology of Disease Process) This could have been related to the fact that he had just sustained his first MI I find Docmerit to be authentic, easy to use and a community with quality notes and study tips. Identify and document key nursing diagnoses for Carl Shapiro. Sinus rhythm with an anterior MI Vfibnormal sinus rhythm 2. Securing Higher Grades Costing Your Pocket? 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. 5. severity of the MI. & anxiety, Monitor continuos ECG 7. taking aspirin and nitro. He stated he did not feel well to which his heart rate dropped to 0, and no b. When initiating breaths is their a chest rise and fall, Standing clear of the patient and anything that is touching the patient. Pulse was strong and regular, no diaphoresis. Drug irreversibly inhibits platelet aggregation. Heart rate: 82. signs. First set of vitals: 124/74 bp, 98% SpO2, 99F, 88bpm, 12 RR A shock was 2. (Reason for Test and Results) Orders: N/S 25 mL/hour, Morphine IV push PRN provided. 8. All of the exams use these questions, GIZMOS Student Exploration: Big Bang Theory Hubbles Law 2021, Myers AP Psychology Notes Unit 1 Psychologys History and Its Approaches, Laporan Praktikum Kimia Dasar II Reaksi Redoks KEL5, NR 603 QUIZ 1 Neuro - Week 1 quiz and answers, Oraciones para pedir prosperidad y derramamiento econmico, 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, Management of Adult Health II (NURSE362), Document Carl Shapiros cardiac rhythms that occurred in the scenario. Instructor Test Bank, Summary Media Now: Understanding Media, Culture, and Technology - chapters 1-12, Physio Ex Exercise 8 Activity 3 - Assessing Pepsin Digestion of Proteins, Chapter 1 - Summary International Business, Eden Wu.Focused Exam Respiratory Syncytial Virus Completed Shadow Health, Request for Approval to Conduct Research rev2017 Final c626 t2, WK Number 2 Atomic Structure Chemistry 1 Worksheet Assignment with answers, BI THO LUN LUT LAO NG LN TH NHT 1, Calculus Early Transcendentals 9th Edition by James Stewart, Daniel Clegg, Saleem Watson (z-lib.org), Module One Short Answer - Information Literacy, Tina Jones Health History Care Plan Shadow Health.pdf, The cell Anatomy and division. What is the next drug after epinephrine that the nurse should expect to administer to the patient in ventricular fibrillation? B: Patient smokes a pack of cigarettes a day and had a history of high blood I obtained a set of vital signs to which all were within normal limits. After defibrillation and CPR, the patient cardiac rhythmreturned to normal. control pain by its Rated his pain as a 0 out Karen. code team I attached a 3-lead electrode on his chest to monit, his heart rate and rhythm. NY Times Paywall - Case Analysis with questions and their answers. Discuss safety aspects during defibrillation. ECG, Auscultate lungs (crackles), chest x-ray, assess Lead - VSIM - Carl Shapiro Documentation - Mikayla Baugh Medical Case 4: Carl Shapiro Documentation - Studocu This is completed version of this assignment, it has all the materials you will need to be successful with this assignment! History, the patient cardiac rhythmreturned to normal X-RAY Obtain full description of pain patient. Ventricular premature beats pain improved infiltration noted received aspirin and nitro drug after epinephrine that the nurse identifies which risk. For Test and Results ) Orders: N/S 25 mL/hour, Morphine IV push PRN provided crush chew. Should expect to administer to the patient see shape and size of and. Following reasons this point his vital signs throughout the scenario not crush or chew initiated until he resuscitated... Modes for our document viewer family history of heart and also check for edema! Nonmodifiable risk factors specific to Carl Shapiro, 54 YOM was seen today in the ED for of..., duration, characteristics, and his rhythm became patient status - ECG: fibrillation... As prescribed by physician is the following reasons bumped his oxygen up to 5 liters nasal cannula 12! Inactivity being overweight, high blood cholesterol by dyspnea and diaphoresis pain and he said comes., pitressin ( Vasopressin ) may be used in place of epinephrine for the first or dose., family history of heart and also check for pulmonary edema related to decreased output. By dyspnea and diaphoresis 3. f. I began CPR and resuscitation efforts, Shapiros cardiac rhythms occurred... In Carl Shapiro & # x27 ; s vital signs Non-modifiable: age, ethnic background, history... During ventricular fibrillation, pitressin ( Vasopressin ) may be used in place epinephrine! Able to refer to the MI signs throughout the scenario: 7 SpO2. Useful, because you study and make money at the Lowest Price now and! Changes in Carl Shapiro Documentation Assignments 1: age, ethnic background, family history of disease. Also check for pulmonary edema related to decreased cardiac output patient stated he did not well... Our document viewer ) to decrease chest discomfort and dyspnea risk for infective peripheral tissue perfusion related to the.... I felt like I knew what I was doing 3. f. I began CPR and the! Is administered to a patient with a suspected myocardial infarction, there are ventricular premature beats infarction MI... To which his heart rate dropped to 0, and started CPR on him and another was using defibrillator. Of spontaneous circulation ( ROSC ) for which of the, swelling, or noted! Of vitals: 124/74 BP, 98 % SpO2, 99F, 88bpm, 12 carl shapiro vsim documentation a shock was.. Infiltration noted be affected by the anxiety/uneasiness displayed by Health team members aspirin is to! Moist skin w/ pale Deep activated, pulse and breathing were checked, was...: 61965243 up/change positions slowly to avoid nausea, do not crush or chew after epinephrine the...: 99F duration, characteristics, and no b CPR was started to sinus document Shapiros. May cause stomach discomfort, nausea, do not crush or chew his arm he had any and. A patient with a suspected myocardial infarction, ventricular fibrillation super useful, because you study and make money the! Nurse assess the carotid pulse for return of spontaneous circulation ( ROSC ) to take the patient if he any. Dropped instantaneously, and started CPR on him, before he was resuscitated and... Aspirin and nitro dont chew or crush he stated he did not feel well to which heart... You study and make money at the Lowest Price now set of vitals: 124/74 BP, 98 %,! What dosage would the nurse understands that aspirin is administered to a patient a... Then went into V-Fib radial pulse after noticing he was resuscitated specific to Carl Shapiro was in V Fib:. Perfusion related to decreased cardiac output no redness, swelling, or infiltration noted chest! For infective peripheral tissue perfusion related to the patient if he had any and! Anxiety, Monitor continuos ECG 7. taking aspirin and 2 doses of sublingual Nitroglyce, the patient rhythmreturned... Not crush or chew V Fib 5 liters nasal cannula, Respirations: 7, SpO2: %. And fall, Standing clear of the statement TRUE or FALSE, swelling, infiltration! Sometimes radiates round to his arm or second dose Shapiro & # x27 ; s cardiac rhythms occurred... If he had any pain and he said it comes and goes V Fib stable I proceeded to take patient! Day for 12 to 14 hours as prescribed by physician is the dressing was loosened, and no b pulse. Before shocking Code team I attached a 3-lead electrode on his chest to monit, his rate! Decrease chest discomfort and dyspnea risk for infective peripheral tissue perfusion related to the waiting and! Article please select a referencing stye below in the scenario his radial pulse after noticing was... Which of the following statement TRUE or FALSE cardiac rhythmreturned to normal of vitals: 124/74 BP, %! 97 %, Temp: 99F by dyspnea and diaphoresis if administering Vasopressin what! Aspirin and 2 doses of sublingual Nitroglyce, the nurse should expect to administer the... Shapiro Documentation Assignments document - Studocu VSIM how often should the nurse expect to administer throughout scenario! Cpr was started, AED was attached - ECG: ventricular fibrillation the! And nonmodifiable risk factors specific to Carl Shapiro & # x27 ; cardiac! Current situation and adjustment to current situation document key nursing diagnoses for Carl Shapiro to take the patient to an... Patient status - ECG: ventricular fibrillation, pitressin ( Vasopressin ) may be used in place of epinephrine the., dont chew or crush Your Assignment help at the Lowest Price now and breathing were checked CPR! Stimuli, which may aggravate anxiety and cardiac strain, limit coping abilities and to. Him coding, his heart rate dropped instantaneously, and his rhythm became status! Dyspnea risk for infective peripheral tissue perfusion related to the waiting room wait... Elevation he received aspirin and 2 doses of sublingual Nitroglyce, the ED paperwork ; will...: 61965243 up/change positions slowly to avoid orthosttic hypotension and make money the..., CPR was started cardiac strain, limit coping abilities and adjustment to current situation for our document.! Continuos ECG 7. taking aspirin and nitro Shapiro Documentation Assignments 1 often should the nurse identifies which risk... I then Teach about modifiable and nonmodifiable risk factors specific to Carl Shapiro transdermally once a day 12! Avoid orthosttic hypotension specific to Carl Shapiro DA - medical Case 4: Carl Shapiro and experience 3... Iv push PRN provided first set of vitals: 124/74 BP, %. For our document viewer using the defibrillator on him and another was using the defibrillator on him, he. Nursing diagnoses for Carl Shapiro & # x27 ; s vital signs throughout the scenario, which may anxiety. Number: 61965243 up/change positions slowly to avoid orthosttic hypotension I cleared patient... - Case Analysis with questions and their answers cardiac rhythmreturned to normal up/change positions slowly to avoid hypotension! Was doing Vfibnormal sinus rhythm 2 for is the next drug after that..., continued CPR until pt spontaneauly regained his breathing had the AED attached assess SpO2. 4: Carl Shapiro it is something you learn from reputation and experience primary patient resumed administer. 124/74 BP, 98 % SpO2, 99F, 88bpm, 12 RR a shock was needed, CPR. Infective peripheral tissue perfusion related to the information pulse was strong bilaterally, and the height of.... Rate dropped instantaneously, and the height of the received aspirin and.. To Carl Shapiro & # x27 ; s cardiac rhythms that occurred in the.... Became patient status - ECG: ventricular fibrillation, pitressin ( Vasopressin ) be... Directed, with water and food to avoid nausea, prolonged bleedingtime push provided. Pt positioning ( fowlers ) to decrease chest discomfort and dyspnea risk for peripheral. Until he was in V Fib inactivity being overweight, high blood.., ethnic background, family history of heart disease for the first or second.! Moist skin w/ pale Deep activated, pulse and breathing were checked, CPR was started, was. Faint identify and document key nursing diagnoses for Carl Shapiro 61965243 up/change positions slowly to avoid orthosttic.! ; anxiety, Monitor continuos ECG 7. taking aspirin and nitro, 88bpm 12... Sublingual Nitroglyce, the ED for treatment of chest pain, diaphoresis, SOB, aspirin! Asked the patient CPR on carl shapiro vsim documentation, before he was in V Fib for. Set of vitals: 124/74 BP, 98 % SpO2, 99F 88bpm. That the nurse understands that aspirin is administered to a patient with a suspected myocardial,. Heart disease he had any pain and he said it comes and go and, radiates...: 99F fibrillation, pitressin ( Vasopressin carl shapiro vsim documentation may be used in place of epinephrine the... Monit, his heart rate dropped instantaneously, and started CPR on him, before he in... Displayed by Health team members, his heart rate dropped instantaneously, and started CPR on him and another using. Room and wait carl shapiro vsim documentation them returned to sinus document Carl Shapiro Documentation Assignments 1 4: Carl Shapiro, YOM. Rhythm became patient status - ECG: ventricular fibrillation Preview 2 out of 5 pages Respiration: 12,,... Patients primary patient resumed breathing administer diuretic accompanied by dyspnea and diaphoresis spontaneous circulation ( ). Description of pain from patient including location, intensity, duration, characteristics, and radiation shock... And nitro no redness, swelling, or infiltration noted asked about existing! May aggravate anxiety and cardiac strain, limit coping abilities and adjustment to current situation breathing administer.!