01 Jun A 72 year old woman is transported to the ED with a diagnosis of chest pai
Question
Discussion 9.1 – Case Study One
A 72 year old woman is transported to the ED with a diagnosis of chest pain to rule out myocardial infarction MI. During the initial assessment the nurse notes the cardiac rhythm changes from sinus tachycardia to ventricular tachycardia VT with a pulse. Her vital signs are 84/40, pulse 154 and respirations 30.
What is the initial treatment for this patient at this time?
What drugs should you anticipate administering to this patient? Why are they indicated?
What evidence-based precautions must be taken to promote safety for both the patient and the ACLS team?
If this rhythm deteriorates to ventricular fibrillation or VT without a pulse, what steps should you take? Why?
Discussion 9.2 – Case Study Two
At a recent staff meeting, the medical-surgical nurse manager reports that the rate of repeated hospitalizations for patients with chronic heart failure has increased 50% in the past 3 months. As a staff nurse you agree to be part of the unit quality improvement team to examine the causes of the increase and make evidence-based recommendations for improving the outcomes for this patient population. Specific patient data and summaries are available for the team to review as needed.
Where will your team begin with this process during the first meeting of the team?
What internet sites will your team use to determine best practices for decreasing repeated hospital stays and why?
How will you know if the plan of action to improve care was effective?
See Chapter 5 for assistance for answering above questions.
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