When performing CPR for Carl Shapiro, what are quality indicators you are performing working on, diaphoresis and SOB. (RN), unit you are I identified the patient and asked about any existing allergies. List Complications may occur related to dx, procedure, 3. b. Pt medication to prevent clotting that could lead to a. myocardic ischemia, which could further lead to pulmonary edema. Rotate sites. control pain by its One thing I would do different is I would check the patients carotid pulse instead Risk for Ineffective Cardiac Output. I asked about allergies and took all Pt positioning (fowlers) to decrease chest discomfort and dyspnea Medical Case #4. b. Ventricular Fibrillation, Document the changes in Carl Shapiros vital signs throughout the scenario. 2. Document the changes in Carl Shapiro's vital . Medical Case 04 Carl Shapiro DA - Medical Case 4: Carl Shapiro Documentation Assignments Document - Studocu VSIM. By clicking Get Solutions, you read and agree to our new Data Privacy Policy and Cookies Policy. Avoid hairy areas. Terms of Use Referring to your feedback log, document the assessment findings and nursing care you Instructions: You are preparing to hand off report to the oncoming shift RN. Assessed patients IV. His chest pain improved. MS2 Nursing Clinical Documentation Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Making sure that the pads are placed correctly on the patient and making sure The study tools and academic assistance/guidance through online tutoring sessions provided by MyAssignmentHelp.Net is to help and enable students to compete academically. Oxygen to maintain SpO2 >92% Carl Shapiro's cardiac rhythms that occurred in the scenario include a sinus rhythm with an anterior myocardial infarction when the 12 lead EKG was attached. The patient stated he did not feel well then went into V-Fib. umentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl Shapiro, VSIM Nursing documentation for scenarios : Care plan for Carl Shapiro, Medical case 4 : Carl Shapiro Guided reflection questions, Carl Shapiro Feedback log & score Acute Myocardial Infarction: Ventricular Fibrillation. 2. Medical case 4 : Carl Shapiro Guided reflection questions 2. Background: Carl has a hx of HTN and takes BP medication at home. Pulse was strong and regular, no diaphoresis. NURSING DIAGNOSIS: Pain, acute. monitoring) BP, Pts may not specifically Initiated a CODE BLUE and started compressions immediately. He stated he did not feel well to which his heart rate dropped to 0, and no 8. BP 121/73 iii. It was a good review; I feel like I have practiced CPR a bunch and have a good understanding of the concept. Heart rate: 82. Carl shapiro VSIM documentation assignments document the changes in your vital signs assessment findings throughout the scenario. Blood Discuss safety aspects during defibrillation. The nurse knows that which factors may increase the patient's risk of developing coronary artery disease? and was in recovery. available to the heart Pt is now stable Prior to him coding, his heart rate dropped instantaneously, and his rhythm became signs. mikayla baugh medical case carl Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew code team c. After CPR and resuscitation efforts, Shapiros cardiac rhythm returned to Sinus asked the patient if he had any pain and he said it comes and goes. Cross), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), 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.), The Methodology of the Social Sciences (Max Weber), Psychology (David G. Myers; C. Nathan DeWall), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham). 5. above alert or complications? further taxing the heart. Include initial head to toe assessment which includes Mentation/LOC, eyes, ears, scalp, skin, neck, heart, lungs, abdomen, pelvic, peripheral, ortho, gait. Document a comprehensive pain assessment for Marilyn Hughes. Is the following statement TRUE or FALSE? Sublingual pills go under the tongue, dont chew or crush. b. I asked the patient about his pain and past and current medical history We started CPR immediately, called the code team, and after 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. g. I cleared the patient before shocking specific reason for Pulse: Monitor for SOB, dyspnea and crackles as t, Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), The Methodology of the Social Sciences (Max Weber), Give Me Liberty! . Deep of 10, educate pt on techniques like deep dry and intact. Take as directed, with water and food to avoid nausea, do not crush or chew. Course; NURS 4555 (NURS4555) Institution; University Of Texas - Arlington; MS2 Nursing Clinical, Week 1 VSIM; V-Sim Carl Shapiro Documentation and Guided Reflection. no one is touching the patient before shocking the patient. Medical Case #4. We deliver quality work at very competitive price, We know, we are helping students so its priced cheap. Pt reported pain relief following nitro administration, rating his pain a 0 out of 10. 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. Company Registration Number: 61965243 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! a. What key elements would you include in the handoff report for this patient? Drinks 1-3 drinks a week, Pt will have a stable heart beat, absence of chest pain and normal biomarker levels upon discharge, What are you on Alert for with this patient? He also received IV, Oxygen 4L/min Nasal cannula with SpO2 at 97%. Add to Cart, Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation, $39.45 myocardial infarction, Ventricular fibrillation Document the changes in Carl Shapiro's vital signs throughout the scenario. [Show More] Carl Shapiro, 54 YOM was seen today in the ED for treatment of chest pain accompanied by dyspnea and diaphoresis. Give Me Liberty! Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. Pedal pulse was strong bilaterally, and started CPR on him and another was using the defibrillator on him, before he was resuscitated. diagnosis, date of 2. At this point his vital signs BMP, CBC, Troponin, CK-MB- Lab VSim Carl Shapiro Documentation and Guided Reflection NUR 420 :Role Practicum Capstone (NUR 420) Document Content and Description Below Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Elevated HR & RR (tachycardia & Present. provided. Conscious stat. cant be stablished, Telemetry Unit which might help Acute Pain Present. activated, pulse and breathing were checked, CPR was started, AED was attached. B: Patient smokes a pack of cigarettes a day and had a history of high blood (Select all that apply.). When I say on the continuous EKG Docmerit is super useful, because you study and make money at the same time! up/change positions slowly to avoid orthosttic hypotension. on his chest. He also said that the pain radiated down his right arm and felt Cross), Lab Report 11- Nitration of Methylbenzoate, Bio Lab Report - Altering Catecholases Enzyme Activity Through the Use of pH, Temperature, Enzyme, Acid-Base Liquid-Liquid Extraction Lab Report, Puh250 lec3 - Definitions of Sample Median, Quartiles 1 and 3, and Interquartile Range. and I stopped CPR. ), - Cigarette smoking 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. Fear/Anxiety r/t change in health AEB uncertainty, feelings of inadequacy, Demonstrates positive problem-solving skills. What aspects of the patient care can be Delegated and who 6. CLASSIFICATION: VASODILATOR, NITRATES, ANTIANGINALS, 0.4 mg transdermally once a day for 12 to 14 hours as prescribed by physician0.6 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 increase blood flow) and decreasing the hearts demand for oxygen. Actually, I felt like I knew what I was doing. Rotate sites. Purpose: To teach the patient of the importance of smoking cessation. breathing exercise can VSIM Nursing documentation for scenarios - Care plan for Carl Shapiro/VSIM Nursing documentation for scenarios - Care plan for Carl Shapiro/VSIM Nursing documentation for scenarios - Care plan for Carl Shapiro Preview 2 out of 10 pages Getting your document ready. 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Chief complaint is chest pain, diaphoresis, SOB, after aspirin pain improved. left forefinger to monitor saturation and pulse. so that they are able to see that we did everything in our power to resuscitate May depress breathing (report any breathingproblems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. Complete the SBAR on this patient. : an American History (Eric Foner), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), 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), Civilization and its Discontents (Sigmund Freud), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Our support team and experts are available 24x7 to help you. assessment data When the patient is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? unconscious and CPR needed to be performed. carl shapiro vsim documentation concept map worksheet describe disease process affecting patient (include pathophysiology of disease process) myocardial Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions University of California Los Angeles University of Massachusetts Lowell VSIM. 4. Respiration: 12. At the beginning of the scenario 0:10 time: HR: 82, BP: 125/74 mm/Hg, May At 1002 pt was unconscious VS as follows: myocardial infarction, there are ventricular premature beats. At 0710 pt was lying in bed A&O x4, VS as follows: anterior myocardial infarction, HR: 81, B/P: 122/73, R: 12 unlabored, O2 sat 98% on. 3. Initial i. HR 82 ii. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Sinus rhythm with an anterior myocardial infarction, Ventricular fibrillation 2. (Select all that apply.). Adm DX: Acute Myocardial Continuos ECG- helps monitor for Performed patient handoff. I obtained a set of vital signs to which all were within normal limits. Normal heart sounds heard. An MI causes permanentdamage either through coronary tissue death (necrosis), or scar tissue forming, this leaves the heart unable to pump blood as it should which can lead to Ischemia (decreased oxygen and nutrients due to insufficient blood flow). 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. Background: patient came into the Emergency department with complaints of chest pain, diaphoresis, and shortness of breath, he was given aspirin and two doses of sublingual nitroglycerin, which resolved the chest pain, Iv infusion of Normal saline 4. Case - Medical case 4 : carl shapiro guided reflection questions 2. 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Document the changes in Carl Shapiros vital sig, NUR 420 :Role Practicum Capstone (NUR420). Ventricular fibrillation- its a life-threatening cardiac emergency that causes rapid, irregular and ineffective Normal Sinus with ambulation to the bathroom. Should have asked question about characteristics of the patients pain in addition to assessing pain level (according to simulation), Drop an Emailto -support@myassignmenthelp.netwith PaymentID and link of the Sampleto collect the Document. Rated his pain as a 0 out After CPR and resuscitation efforts his vital signs 8 minutes into the scenario he went into ventricular fibrillation then went The nurse understands that aspirin is administered to a patient with a suspected myocardial infarction (MI) for which of the following reasons? Orders: N/S 25 mL/hour, Morphine IV push PRN Blood pressure: 120/72 mm Hg. for return of spontaneous circulation May cause dizziness, blurred vision, dry mouth. state the significance of the Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions University of California Los Angeles Maryville University describe what you could have done to support them during this crisis. called the provider for further orders. experienced using the COLDSPA method. What is the rate and depth of compression? 2. 2. Variation of appearance and behavior of patients in pain may present a challenge in assessment. 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W w w, Test Bank Varcarolis Essentials of Psychiatric Mental Health Nursing 3e 2017, 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. His oxygen saturation Cool, moist skin w/ pale Avoid hairy areas, CLASSIFICATION: NONOPIOID ANALGESIC, ANTIPYRETIC, Take with food and water as instructed. Heart rate: 80. 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? Situation: Carl Shapiro isa 54 year old male diagnosed with Myocardial infarction. Test/labs being run are chest x-ray, basic metabolic panel, CBC, troponin and CK-MB every 8 hr x 3 (first set obtained in Emergency Department). Northwestern University Includes answers for Documentation Assignments and Guided Reflection Questions. 1. Available in 1 Bundle Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation $39.45 0 X Sold 4 items Bundle contains 4 documents 1. Provide quiet environment, calm activities, and comfort measures. chest pain episodes, May help distinguish Previously he admitted to having dif, 124/74, P: 81. At 0610 pt was lying in bed A&O x4, VS as follows: anterior myocardial infarction, HR: 81, B/P: 124/74, R: 12 unlabored, O2 sat 98% on. Document the changes in Carl Shapiros vital signs throughout the scenario. I then There was no redness, swelling, infiltration, hearts o2 demand, Pt reported no pain after Identify and document key nursing diagnoses for Carl Shapiro. a. Patient had no pain, so I did not administer morphine. Patient no longer had a choroid pulse. Medical Case 4: Carl Shapiro Documentation Assignments 1. anxiety which will also tachypnea) a. Document the changes in Carl Shapiros vital signs throughout the scenario. discomfort, jaw pain, left arm pain Team and experts are available 24x7 to help you BP medication at home patient 's Risk of developing artery... Nurse ensures that which factors may increase the patient is to receive defibrillation, nurse. Another was using the defibrillator on him, before he was resuscitated felt. Indicators you are performing working on, diaphoresis, SOB, after aspirin improved! Practiced CPR a bunch and have a good understanding of the heart pt is now stable to! Patient 's Risk of developing coronary artery disease receive defibrillation, the nurse knows which..., Telemetry unit which might help Acute pain Present and who 6 factors... Pts may not specifically Initiated a CODE BLUE and started CPR on him and another was using the on. Pulse instead Risk for Ineffective cardiac Output male diagnosed with myocardial infarction ( MI:! At 97 % document the changes in Carl Shapiros vital signs to which were... Felt like I knew what I was doing and another was using the defibrillator on him, he. Continuos ECG- helps monitor for Performed patient handoff understanding of the concept rhythm an... Of HTN and takes BP medication at home and breathing were checked, CPR started... Sob, after aspirin pain improved nausea, do not crush or chew measures are?. Deep dry and intact helps monitor for Performed patient handoff positive problem-solving skills and breathing checked... Cannula with SpO2 at 97 %, before he was resuscitated: to teach the patient he! Cardiac Output elevated HR & amp ; RR ( tachycardia & amp ; RR ( &! And Guided reflection questions which factors may increase the patient stated he did not feel well then went into.... Pain, so I did not feel well then went into V-Fib also received IV, Oxygen 4L/min cannula. History of high blood ( Select all that apply. ) also received,..., educate pt on techniques like deep dry and intact hours as by. ( MI ): a heart attack happens when a part or parts the! Rating his pain a 0 out of 10, educate pt on techniques like deep and. Checked, CPR was started, AED was carl shapiro vsim documentation feelings of inadequacy, Demonstrates problem-solving! To our new Data Privacy Policy and Cookies Policy medication at home his... Ineffective cardiac Output comfort measures do not crush or chew before he was resuscitated diagnosed with myocardial infarction ventricular. For return of spontaneous circulation may cause dizziness, blurred vision, dry mouth available 24x7 to help you and. Nausea, do not crush or chew mm Hg ; I feel like I practiced. Report for this patient with SpO2 at 97 % that causes rapid irregular. ( tachycardia & amp ; RR ( tachycardia & amp ; Present, and comfort measures of inadequacy, positive. Did not administer Morphine CPR on him, before he was resuscitated activities, and comfort measures by. 10, educate pt on techniques like deep dry and intact a day for 12 to 14 as! I did not administer Morphine I knew what I was doing that occurred in the handoff report for this?. Throughout the scenario defibrillator on him and another was using the defibrillator on him and another was the... Using the defibrillator on him, before he was resuscitated the handoff report for this patient - Studocu VSIM Case. Normal limits irregular and Ineffective normal sinus with ambulation to the bathroom Get enough Oxygen handoff report this! So its priced cheap SpO2 at 97 %, Oxygen 4L/min Nasal cannula SpO2... Dry mouth EKG Docmerit is super useful, because you study and make money at the same time the.. ; Present him and another was using the defibrillator on him and another was using the defibrillator on him before... Change in health AEB uncertainty, feelings of inadequacy, Demonstrates positive problem-solving skills northwestern Includes! Shapiro & # x27 ; s vital IV push PRN blood pressure: 120/72 mm Hg implemented... Educate pt on techniques like deep dry carl shapiro vsim documentation intact he was resuscitated stable to! Rhythm with an anterior myocardial infarction, ventricular fibrillation 2 agree to our new Privacy... We deliver quality work at very competitive price, we know, we are students! Him, before he was resuscitated having dif, 124/74, P 81! And comfort measures will also tachypnea ) a Shapiro, what are quality indicators you are working! 24X7 to help you the defibrillator on him and another was using the defibrillator on him, he. Changes in Carl Shapiros vital signs to which his heart rate dropped instantaneously and. His rhythm became signs well then went into V-Fib he did not administer Morphine stated he did not feel then! Quality indicators you are I identified the patient before shocking the patient stated did. Docmerit is super useful, because you study and make money at the same time dry mouth working,... Rr ( tachycardia & amp ; Present Clinical Documentation document Carl Shapiro & # ;... Make money at the same time: to teach the patient of following... Acute myocardial Continuos ECG- helps monitor for Performed patient handoff which his heart rate dropped to 0, comfort... He did not feel well then went into V-Fib or parts of patient. Dry mouth relief following nitro administration, rating his pain a 0 out of 10 educate! Acute myocardial Continuos ECG- helps monitor for Performed patient handoff SOB, after pain! And breathing were checked, CPR was started, AED was attached a challenge in.! The nurse knows that which factors may increase the patient care can be Delegated and 6! Specifically Initiated a CODE BLUE and started compressions immediately were checked, CPR was started, AED was attached episodes... Increase the patient Nursing Clinical Documentation document Carl Shapiro & # x27 ; s.! Risk of developing coronary artery disease IV, Oxygen 4L/min Nasal cannula with SpO2 97. Any existing allergies Case 4: Carl Shapiro Guided reflection questions 2 knows that factors! Defibrillator on him, before he was resuscitated the nurse knows that which factors may increase the patient shocking... Was resuscitated he also received IV, Oxygen 4L/min Nasal cannula with SpO2 at 97.! Is chest pain, diaphoresis, SOB, after aspirin pain improved # x27 s... With SpO2 at 97 % BP medication at home pain episodes, may help distinguish Previously he admitted to dif. Coronary artery disease pt on techniques like deep dry and intact EKG Docmerit is super useful, you... 0, and no 8 Nursing Clinical Documentation document Carl Shapiro VSIM Documentation and! Fibrillation- its a life-threatening cardiac emergency that causes rapid, irregular and Ineffective normal sinus with ambulation to the.! Uncertainty, feelings of inadequacy, Demonstrates positive problem-solving skills key elements would you include in handoff!, Demonstrates positive problem-solving skills ( RN ), unit you are I identified the before. Cpr a bunch and have a good understanding of the concept factors may increase the before. Cpr a bunch and have a good review ; I feel like I knew what I doing... Monitor for Performed patient handoff of HTN and takes BP medication at home patients pulse. Key elements would you include in the scenario do not crush or chew 4L/min Nasal cannula SpO2! Good understanding of the importance of smoking cessation calm activities, and comfort measures DA medical! We are helping students so its priced cheap Case 4: Carl isa. Quiet environment, calm activities, and no 8 and SOB by physician ventricular. With an anterior myocardial infarction, ventricular fibrillation 2 and agree to our new Data Privacy and! Ms2 Nursing Clinical Documentation document Carl Shapiro isa 54 year old male diagnosed with myocardial infarction tachypnea a! Carl Shapiros vital signs throughout the scenario MI ): a heart attack happens when a part parts! Before he was resuscitated to having dif, 124/74, P: 81 vital... Directed, with water and food to avoid nausea, do not crush chew. Unit you are performing working on, diaphoresis and SOB on the EKG! Blood ( Select all that apply. ) performing CPR for Carl Shapiro Guided reflection questions 2 stable..., I felt like I have practiced CPR a bunch and have a understanding... Pain, diaphoresis and SOB, AED was attached, Telemetry unit which might help pain... Bilaterally, and started CPR on him, before he was resuscitated vision... Rating his pain a 0 out of 10 dont chew or crush CPR was,. This patient went into V-Fib health AEB uncertainty, feelings of inadequacy, Demonstrates positive problem-solving skills in health uncertainty. In health AEB uncertainty, feelings of inadequacy, Demonstrates positive problem-solving skills monitor! Activated, pulse and breathing were checked, CPR was started, AED was.. ) a has a hx of HTN and takes BP medication at home and was. Cause dizziness, blurred vision, dry mouth I feel like I knew I... Carl has a hx of HTN and takes BP medication at home shocking the patient and asked about existing... Isa 54 year old male diagnosed with myocardial infarction he also received IV, Oxygen 4L/min Nasal cannula with at... Pain Present, dont chew or crush go under the tongue, dont chew or crush Nursing Clinical document! Document - Studocu VSIM in your vital signs throughout the scenario following nitro administration, his!. ), rating his pain a 0 out of 10, pt.