Clinical Simulation: Real Life Clinical Reasoning Scenario RN Adult Medical

Surgical: Myocardial Infarction Complications

Learning Objectives:

1. Use clinical judgment when caring for a client who is experiencing a myocardial infarction.

2. Identify appropriate nursing actions and prioritize care for the client with a myocardial infarction.

3. Identify important nursing considerations for medications and diagnostic testing used in treating clients who have experienced a myocardial infarction.

4. Intervene effectively and therapeutically with a client experiencing post-

catheterization complications and cardiogenic shock.

5. Provide client education regarding the treatment and management of a myocardial infarction, medications, and lifestyle changes.

6. Communicate effectively and therapeutically with the client, family, and interprofessional team.

7. Complete an accurate and effective SBAR communication.

8. Identify nursing considerations for various classifications of myocardial infarction and potential complications.

Scenario Overview:

This scenario focuses on a 54-year-old male client who has a diagnosis of

myocardial infarction. It addresses client-centered concepts related to cardiac and

respiratory status, allergic reactions, anaphylaxis reaction, and cardiogenic shock.

Nursing-focused concepts include organizing the plan of care for the client,

prioritizing nursing actions, and interprofessional collaboration. Students will be

expected to be knowledgeable of therapeutic communication, safe medication

administration, and drug calculation.

Tasks:

Complete the “Myocardial Infarction Complications” Real Life Scenario

➢ Complete Active Learning Templates:System Disorder: Myocardial InfarctionNursing Skill: Pain AssessmentMedication: NitroglycerinDiagnostic Procedure: Cardiac Catheterization

Clinical Judgment Questions:

Recognize Cues (Assessment)

a. What were subjective objective assessment findings that supported a medical

diagnosis of myocardial infarction?

2. Analyze Cues (Analysis)

a. What are potential complications of a cardiac catheterization?

b. What findings indicate a potential complication may occur post cardiac

catheterization? c. What other findings are of immediate concern?

3. Prioritize Hypotheses (Analysis)

a. What are the top three priority concerns for Rodney Davis when potential

cardiogenic shock is recognized? Provide a rationale for your decision on the rank

order.

4. Generate Solutions (Planning)

a. Identify a client outcome for each of the three priority concerns.

b. Prioritize interventions for a client experiencing respiratory depression after

receiving an opioid.

5. Take Actions (Implementation)

a. How would you monitor for an appropriate response to initiating a dobutamine

drip?

b. Identify nursing actions that should be taken based on the prioritized client

problem.

6. Evaluate Outcomes (Evaluation)

a. What responses by Rodney Davis indicated the nursing actions were effective

with meeting the client outcomes? How would you modify the plan of care if the

client outcomes that were partially met or not met?Reflection:1. What did you learn when you completed this scenario?

2. What were your most successful clinical decisions?

3. What would you do differently in the future when caring for a client with chest pain?