Case Study: Cardiogenic Shock and Anterior Wall Myocardial Infarction 1. What is the clinical presentation of a client having an acute myocardial infarction (AMI)? Identify Mrs. Sutton’s clinical presentation in the ED. Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back, Nausea, indigestion, heartburn or abdominal pain, Shortness of breath, Cold sweat, Fatigue, and Lightheadedness or sudden dizziness. Q waves and ST elevation.
Print. This article talks about the variability in the sedation-analgesia and neuromuscular blockade protocols in therapeutic hypothermia in comatose survivors of cardiac arrest. The patient may have renal or hepatic involvement and the medications that can be used are susceptible to complications with the use of these drugs. Metabolism and elimination of these drugs are delayed for an unpredictable amount of time. Hypothermia produces delay in metabolism
Case Study 1c NURN 453 Fall 2013 Mr Walters presents at the triage desk of a community hospital. He is diaphoretic, nauseated, and states the reason he came today is that he has discomfort in his chest that extends down his left arm. 1. What information does the nurse need to gather and what interventions should be started within the first 10 minutes of care? (10 points) The nurse should: Assess Mr. Walter's pain and obtain a brief history Obtain a 12 lead ECG, Cardiac monitor, IV access Assess vital signs and apply oxygen as needed.
Nurse can use isotonic crystalloid solution such as 0.9% sodium chloride or lactated ringers solution, are used during the early stage of burn recovery. Colloid solution, such as albumin or synthetic plasma expanders ( Hespan), may be used after the first 24 hr of burn recovery. Nurse need to remember to check for urine output of 1 to 2 ml/kg/ hr if the child weights less than 30 kg (66 lb). If the child weights more than 30 kg (66 lb) nurse should assess for urine output of 30 ml/ hr. (Prater, D.
Monitor for signs of digitalis intoxication when used (e.g.,reports of nausea/vomiting, blurred vision; increasingatrial dysrhythmias and heart block Rationale:Magnesium deficit may precipitate digitalis toxicit 3. Assess level of consciousness and neuromuscular status,e.g., movement, strength, reflexes/tone; note presence of Chvostek’s/Trousseau’s signs Rationale:Assess level of consciousness and neuromuscular status,e.g., movement, strength, reflexes/tone; note presence of Chvostek’s/Trousseau’s signs 4. Monitor status of airway and swallowing Rationale: Laryngeal stridor and dysphagia can occur whendepletion is moderate to severe. 5. Take seizure/safety precautions, e.g., padded side rails, bed in low position, frequent observation as indicated.
-Measure Oxygen Saturation In assessing Josh’s breath sounds the nurse should ask him to perform which action? -Breathe deeply through the mouth To measure capillary refill the nurse must perform which action? -Compress Josh’s nailbed The nurse plan’s to measure Josh’s oxygen saturation with a spring-tension finger clip. While the nurse is explaining the procedure Josh asks if it will hurt. Which response is best for the nurse to provide?
Meet the Patient: Jeff Dickson Traumatic Brain Injury Jeff Dickson is a 17-year-old admitted to the Emergency Department via ambulance following a motor vehicle accident (MVA). He is accompanied by his parents and two of the three friends who were in the vehicle with him. Another friend, who was driving the vehicle, was transported to a different hospital by LifeCare Helicopter. A basilar skull fracture is a linear skull fracture that extends over the base of the frontal and temporal lobes. The nurse knows that this particular type of fracture can cause damage to the nerve pathways, cranial nerves, or vital centers.
Mr Jones is bought into the emergency department by ambulance after a motor bike accident. His left femur bone is obviously fractured mid-shaft and the broken bone fragment is visible externally. The Ambulance officer estimated a 1 litre blood loss from the fracture site. On examination the doctor notes that he also has a distended abdomen. 1) The emergency nurse records the vital signs on his chart.
She complains of back pain. She has a history of Type II Diabetes, and hypertension. Her admitting doctor has asked that she has mid--stream urine test, a full blood count, electrolyte blood test, and blood cultures. You are on a morning shift. The consultant has been informed of Mrs Jones’ admission.
Then position and drape patient as needed, adjust bed to proper height, and orient patient to call light/bed control system. Simultaneously adjust side rails. Explain to patient that the nurse will conduct hourly rounds to reassess for fall risks, provide toileting needs, and attend to symptom management. Also provide clear instructions to patient and family regarding mobility restrictions and ambulation and transfer techniques. Briefly explain to patient the specific safety measures to prevent falls (e.g., wear well-fitting, flat footwear with nonskid soles; dangle feet for a few minutes before standing; walk slowly; ask for help if dizzy or weak).