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Mr Pepper is an inpatient at the local hospital and is walking back in after going out for a cigarette. You notice he is a pale/grey colour, slightly diaphoretic, is holding the side rail to balance himself, he states he has chest pain.
Mr Pepper requires a comprehensive cardiac assessment
- Explain what the top 6 priorities are for Mr Pepper at this point in time. (easy and simple)
- vital signs
- PQRST pain assessment
- Bloods (troponin)
- ECG
- MRI
- Listen for heart and lung sounds
- signs of bruising and bloods
- auscultation
- palpation
- physical: looking at patients colour
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- Mr Pepper is an inpatient at the local hospital and is walking back in after going out for a cigarette. You notice he is a pale/grey colour, slightly diaphoretic, is holding the side rail to balance himself, he states he has chest pain. Mr Pepper requires a comprehensive cardiac assessment Explain what the top 6 priorities are for Mr Pepper at this point in time.Mr Jones is a 59-year-old man who was admitted 4 days ago following a motorcycle accident. He sustained a fractured R tibia and fibula. He underwent external fixation of the fracture 3 days ago. This morning he was complaining of some shortness of breath and chest pain. A 12 lead ECG showed non-specific ST segment and T wave changes, vital signs were Pulse: 110, B/P: 100/60, resp: 24, SaO2: 92. V/Q scan indicated pulmonary embolism. Past medical history: type 2 diabetes, peripheral vascular disease and impaired renal function GFR 60ml/min. He smokes 1 pack per day, but says he is going to give it up. Normally does little exercise and weighs 89kg. He has been commenced on Dalteparin 200 U/kg/day. Discuss the rationale for commencing Dalteparin and outline the mechanism of action and nursing care required while on this drugBen, 59 is an employee who works in a post office. He is 5ft. Tall and weighs 150 pounds. His vital signs are the following : T 36.3°C; HR 94;BP 135/85; pain level 0. At the clinic, he presents himself with a major complaint of "just not feeling well" Dusting ascultation, you hear a heart murmur. How would you identify Ben's heart murmur?
- A nurse is assessing a 3-year-old child who has aortic stenosis. Which of the following findings should the nurse expect? (Select all that apply.) Hypotension Bradycardia Clubbing of the nail beds Weak pulses Murmur OBaroreceptors: React to changes in blood pressure Are located in SA Node Are located in the carotid and aorta Respond to changes in EKGs React to changes in blood pressure Are located in SA Node Are located in the carotid and aorta ✓ [Choose ] False True [Choose ] [Choose ] [Choose ]Mr Rupinder Patel is a 70 year old retired businessman. You have previously met Mr Patel in the Intensive 1 Workshop workbook. Please review all information you have already received. He has a medical history of Heart Failure. This developed after he experienced a two myocardial infarctions 8 years ago. Both ventricles were affected. Previous chest radiography showed left ventricular hypertrophy. The death of his wife 2 years ago has led to Rupinder experiencing several episodes of depression which has been exacerbated by his sons both moving to Western Australia for work. The loneliness and sadness makes it difficult for him to be concordant with his Heart Failure management and sustain the necessary lifestyle adjustments required to prevent exacerbations. This has resulted in several admissions to hospital for management and review of his Heart Failure. For this current admission, Mr Patel was referred to hospital by his Nurse Practitioner, after recently rapidly gaining weight…
- Mr Rupinder Patel is a 70 year old retired businessman. You have previously met Mr Patel in the Intensive 1 Workshop workbook. Please review all information you have already received. He has a medical history of Heart Failure. This developed after he experienced a two myocardial infarctions 8 years ago. Both ventricles were affected. Previous chest radiography showed left ventricular hypertrophy. The death of his wife 2 years ago has led to Rupinder experiencing several episodes of depression which has been exacerbated by his sons both moving to Western Australia for work. The loneliness and sadness makes it difficult for him to be concordant with his Heart Failure management and sustain the necessary lifestyle adjustments required to prevent exacerbations. This has resulted in several admissions to hospital for management and review of his Heart Failure. For this current admission, Mr Patel was referred to hospital by his Nurse Practitioner, after recently rapidly gaining weight…You are a nursing student who is assigned to a busy medical-surgical unit that specializes in the care of patients with various cardiac related disorders. One of your patients for the day is Mr. Stein, a 66 year old male with a primary diagnosis of a myocardial infarction. You enter the room to conduct your morning assessment and you find that Mr. Stein does not appear to be in a positive mood. As you begin your assessment, Mr. Stein criticizes your technique and berates you for anything you seem to do. Should you continue with your assessment? If so, could you say or do anything different to help improve the situation? How do you think receiving criticism and negative feedback may affect your job performance, if at all? Prior to beginning your assessment, could you have said or done anything that may have prevented or reduced Mr. Stein's hostility towards you?Jon, a 51-year-old successful businessman, was rushed to the hospital by ambulance after experiencing crushing substernal chest pain that radiated down his left arm. He also complained of dizziness and nausea.On presentation, Jon is diaphoretic, shortness of breath and nauseous.Vital signs: Blood Pressure 165/100 mmHg, Heart Rate 120 bpm, Respiratory Rate 26 bpmMedical history:Chronic, stable angina and hypertensionBorderline diabeticOverweight (BMI 29 kg/m2)Diagnostic studies:ECG shows occasional premature ventricular contractions and ST elevation in leads II, III, aVF, V5, V6Troponin I level 0.1 ug/L (N: 0.02to 0.08 ug/L)Cholesterol 9.1 mmol/L (N: <5.5 mmol/L)HbA1C 6.1% (N: 3.5 to 6%)Q1. Provide two (2) risk factors with rationales that were present in Jon’s life that contribute to coronary artery disease Q2. Based on the assessment data presented, identify two (2) priority nursing problems with one nursing intervention for each identified problem
- Cardiac arrest in pediatrics is most commonly caused by Exercise Injury Poor diet Respiratory problems When should cardiac pacing be administered to an individual with symptomatic bradycardia with a pulse? If the individual does not respond to CPR If the individual does not respond to CPR and pharmacological support None of the above If the bradycardia is the result of a complete heart block or an abnormal sinus node function Uninterrupted chest compressions are critical when treating individuals in cardiac arrest. You should only interrupt chest compressions to do the following: Evaluate cardiac rhythm and administer shocks. Place an endotracheal tube. Administer medications. Obtain central IV accessA nurse hears a low-pitched extra heart sound before what should be considered the first heart sound (S1) when auscultating a dient's heart sounds with the bell of a stethoscope. The nurse should document this finding as which of the following heart sounds? The fourth heart sound (54) A friction rub The third heart sound (53) A spit second heart sound 52 PAEVIOUSMr. Devin Anders is at his Cardiologist Dr. Winters office, he had a medical emergency was hospitalized for 4 days. He had an Acute Myocardial Infraction and needed a Coronary Bypass Surgery. The surgery was done by his Cardiologist. He doing well and his HTN is better controlled. He is having some Angina off an on, for which he is taking Nitro-Gylcerin tabs. His BS are still high and his insulin needed adjusting. He is instructed to f/u with his PCP in a few days. As a coder you may be asked to do the following: From the information given above, I would like you retrieve all possible diagnosis and E/M and CPT
