Tijuana T. Milton

Western Governor's University

Apr 2012

Topic:

It is imperative in today’s medical profession to know how to handle any situation that may present to the emergency department. It is especially important to recognize a patient in myocardial distress. It is essential to optimize services for patients presenting with cardiac problems to enhance the continuing downtown in death rates from cardiovascular disease (Department of Health and Children, 1999). When student are rotating to various areas of the hospital it is imperative for the student to receive as much hands on training as possible. Some situations are never seen or dealt with because the student nurse has never experience the illness. The first time a patient present with symptoms maybe the first time the nurse has ever seen the illness. Thanks to technology and information that may no longer be the case. I will demonstrate proper care for a patient suffering from a myocardial infarction in the emergency department.

There is a mannequin referred to as “Sim-Man”. The Sim-Man allows the nursing education staff to create signs and symptoms of different illness or disease processes. Through simulation with a mannequin the student can get an example of how a patient may present with different illnesses. The student will also get the opportunity to interact with the mannequin. When the student makes the correct suggestions and treatment with the mannequin, the mannequin’s health status and symptoms improve, but if the wrong nursing intervention is performed, the instructor may create worse signs and symptoms with the mannequin. Through the use of “Sim-Man” the education staff will present a patient with the similar symptoms of a patient suffering from a myocardial infarction.

Learning Outcomes:

The learning objectives and evaluation of the measurement outcomes are:

1. The student RN can recall at least 3 of the signs and symptoms of a Myocardial infarction with an accuracy of at least 90%

2. The RN student can properly take a history from a patient suffering from a myocardial infarction with an accuracy of 90% using the P-Q-R-S-T method.

3. The student RN can state at least 4 of the comfort measures for providing care of a patient with acute MI with an accuracy of at least 90%

StoryBoard:

1. The patient present to the Emergency Department with complaint of Chest pain

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2. Call for assistance from other RNs and notify the Doctor of a patient with possibility of Myocardial Infarction.

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3. The patient is immediately placed in the cardiac room for EKG and cardiac monitoring, and obtaining vital signs.

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4. Start intravenous fluids and collect blood tubes for testing.

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5. Begin the MONA routine (Morphine, Oxygen, Nitroglycerin, and Aspirin)

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6. Perform an electrocardiogram.

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7. Call for a stat chest x-ray

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8. All labs are collected and sent to the laboratory to determine if patient is having a heart attack, along with the reading if the EKG, and chest x-ray. Now it is just a matter of waiting to get results and further informing the patient and family.

Student actions:

A patient presents to the emergency department with complaint of chest pain. The department personnel shall perform the following actions: The nurse is expected to collect a patient history. The history is to include the P-Q-R-S-T chest pain assessment (Urden et al, 2002) method. The P- stands for precipitating and palliative factors. Asking the patient what makes the pain worse and what makes it better. The Q- stands for quality, as in please describe the pain in your own