Reference no: EM133921996
Questions
1. Nurse Cassandra is on her 7am- 3pm duty on the telemetry unit. She responds to the cardiac monitor alarm of Mang Justino , a 54-year-old patient recovering from a myocardial infarction. Upon entering the room, Nurse Cassandra notes that the rhythm on the monitor appears to be ventricular tachycardia.
a. What should be the priority action of Nurse Cassandra?
b. Upon assessment, Nurse Cassandra noted that the patient has no pulse, and told someone to get the code cart and another to call the hospital's code team. Upon arrival of the code cart, the nurse prepared the defibrillator for use. At what energy level should the nurse set the biphasic defibrillator for the first shock?
c. After defibrillation, the nurse assesses the patient, finds him pulseless, and initiates cardiopulmonary resuscitation. The code team has arrived, and epinephrine is administered. What is the rationale for this medication in the emergency situation?
2. Minda Flores (68 years old, single) is suffering from congestive heart failure. Having sustained three myocardial infarctions in the last 8 years, she has decreased left ventricular function. She takes the following drugs for the management of her disease Digoxin, Capoten, Coreg, and Lasix. Today she presents to the emergency department with fatigue, generalized weakness, and feelings of "skipping" heartbeats. Upon arrival, she is placed on the cardiac monitor, her vital signs are assessed, and an IV is inserted. She currently denies chest pain but is experiencing some shortness of breath. She is also placed on 2 L of oxygen via nasal cannula.
a. Which of her medications might be contributing to his symptoms of generalized weakness and heart irregularities?
b. For what clinical manifestations should you assess to correlate to his left-sided heart failure?