▪ change in condition make take priority over Priority questions...something to consider
ABCs (ex: post op bleeding is priority over
an O2 Sat% of 90%)
▪ pick the patient that is going to die first
You walk into your patient's room and they don't
have a pulse, what are you going to do?
CPR, press the code button
1/8
, 8/8/24, 2:23 AM
You walk into your patient's room and they are not
breathing but have a pulse, what are you going to
bag resuscitation, press the code button
do?
If you walk into a room with a patient that is in
ventricular fibrillation (v fib)
▪ unconscious, pulseless
▪ shock them with the AED!
▪ How will they present?
▪ What must we do to get them out of that state?
If you walk into a room and a patient is alert and
oriented, speaking to you, has a pulse, but their
▪ make them bear down (valsalva maneuver) cardiac monitor shows they are in ventricular
▪ make them cough (vagal maneuver) tachycardia
▪ What are you going to do?
Which cardiac rhythm requires the patient to take
adenosine?
Supraventricular Tachycardia (SVT)
What is our priority concern for a patient in atrial
▪ they may end up with a blood clot because fibrillation (a-fib)?
the blood is pooling in the atria
control RVR for patient: Nursing Interventions: A-fib RVR
▪ give anticoagulants
▪ beta blockers, digoxin, diltiazem
▪ if meds don't work...cardioversion
(synchronized shock to re-start the rhythm)
▪ if cardioversion doesn't work...ablation
▪ chest pain If you have a patient who comes into the ED and they are having an MI, what are the
▪ SOB signs/symptoms? lab values to confirm this?
▪ diaphoresis
▪ N/V
▪ hypertension
▪ tachycardia
▪ jaw pain, anxiety, indigestion (women)
▪ elevated troponin levels
▪ EKG changes - ST elevation
Oxygen - 1st Treatment: Myocardial Infarction
Nitro - given sublingual, 3 doses q 5 min
(home), drip (hospital), drops BP (vasodilator)
Aspirin - antiplatelet, stops clotting, 325 mg,
chew it
Morphine - calms the patient down, helps
pain
▪ CPK Name the cardiac enzymes
▪ troponin
▪ CK-MB
▪ BNP
2/8
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