The echocardiogram demonstated both RWMA and apical thrombus. Case Presentation A 61 – year – old male suffered an out of hospital cardiac arrest. The arrest was witnessed by his wife and basic life support was initiated in less than 6 minutes, with advanced life support being initiated with in 20 minutes. Epinephrine and amiodarone was given in route to the emergency department. An external defibrillator was used to shock the patient into sinus rhythm, a total of 10 shocks was administered and cooling measures were also started.
1. A patient with acute shortness of breath is admitted to the hospital. Which action should the nurse take during the initial assessment of the patient? A) Complete a full physical examination to determine the systemic effect of the respiratory distress. B) Obtain a comprehensive health history to determine the extent of any prior respiratory problems.
The nurse is caring for a middle-aged adult male client who is presenting to the emergency department with a severe headache, neck pain, and vomiting several hours after being involved in a motor-vehicle collision. The client is responding appropriately to verbal stimuli and is moving all extremities to command and contusions are noted around the cranium and left orbit. Questions: 1. Which assessments should the nurse perform at this time? List 3 assessments with rationales.
Check airway maintenance with C spine protection, a nurse must note the skin color, assess conscious level, and chest movement of the patient if the patient unconscious, the medical team should open the airway by using the jaw-thrust maneuver. 2. Check breathing and ventilation, a nurse I should note if the patient is not breathing, call a hospital emergency code and start CPR. (Trauma) 3. Circulation with hemorrhage, a nurse must assess the level of consciousness, such as the Glasgow coma score and AVPU which are “alert, voice, pain and unresponsive” to control hemorrhage, check the radial and carotid pulses, check for another external bleeding.
The physician orders a PPD, CBC and lymphocyte studies. He schedules a return visit to discuss his test results. Over the next few days M.G. develops a fever of 101 F, nonproductive cough and increasing dyspnea. Late one night he becomes extremely dyspneic, so his roommate takes him to the ED where he is admitted to the hospital with probable Pneumocystic jirovecii Pneumonia (formerly PCP).
Instructions prior to procedure: • Arrive 30 minutes early to fill out MRI screen form • Change into facility gown • Take medication, including Ativan, as prescribed by physician http://www.radiology.ucsf.edu/patient-care/prepare/mri What Patient Can Expect During MRI Brain Scan • Procedure will take 45 minutes to 1 hour • Patient is required to lie still during MR scanning • There is a fan, sufficient lighting, and a two way intercom system for communication between patient and technologist • Due the loud intermittent banging noise of the machine, patient will be provided with earplugs or head phones to minimizing the noise. • An alarm button is provided to alert the technologist of any discomfort during procedure
The treatment team gave him 3 nitroglycerin tablets spaced 5 minutes apart but his chest pain remained unrelieved. He was admitted to the hospital floor with a diagnosis of acute myocardial infarction. The patient was sent to the hospital telemetry floor so they can monitor his cardiac rhythms. His serums cardiac markers such as CKMB, myoglobin and troponin will be monitored as needed. While admitted, the health care team will monitor for complications such as heart failure, dysrthymias, , pericarditis and cardiogenic shock.
In February 2006, Emily Jerry, a two-year old child was at a Cleveland hospital to complete her last series of chemotherapy treatment. Her doctor ordered intravenous chemotherapy solution that was filled incorrectly by a pharmacy technician. The prescription called for 1% saline; however, a lethal amount of 23% saline was given instead, causing her to slip into a coma resulting in death. Eric Cropp, who was the supervising pharmacist signed off on the technician’s work despite her informing him that the mixture did not look right; nonetheless, he approved it. The pharmacy was so busy that day and short staffed, which led to a preventable fatal error that changed Eric’s whole life in a matter of seconds.
My client is a 55- year old male; I will call him Mr. A., to protect his confidentiality. He has been admitted to hospital due to respiratory failure and acquired immune deficiency syndrome (AIDS) related symptoms, as well as a stage 3 ulcer on his sacrum. He is also an illicit drug user and has Hepatitis C. He is homeless, currently staying in shelter. Mr. A is cognitive, alert, lacks knowledge of his condition. Verbally abusive and hostile.
Mr X needs investigations in hospital to find the cause of his increasing seizures. His past medical history includes admissions into hospital with epilepsy and urinary tract infections. As Mr X has been bedbound for the past four weeks he is starting to develop pressure sores on his sacrum due to his reduced mobility (Baillie 2005). Mr X has a temperature of 37.9 which is above average and is showing signs of infection. Since being admitted Mr X has lost 10lbs in weight.