100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
Nur255 – Acute Care Cardiac Case Study $8.99   Add to cart

Exam (elaborations)

Nur255 – Acute Care Cardiac Case Study

 15 views  0 purchase

Total Points: 25 Scenario Your patient, 58-year-old K.Z., has a significant cardiac history. He has long-standing coronary artery disease (CAD) with occasional episodes of heart failure (HF). One year ago, he had an anterior wall myocardial infarction (MI). In addition, he has chronic anemia, hype...

[Show more]

Preview 2 out of 5  pages

  • January 30, 2024
  • 5
  • 2021/2022
  • Exam (elaborations)
  • Questions & answers
All documents for this subject (3)
avatar-seller
22skinnynurse7404
Nur255 – Acute Care
Cardiac Case Study
This study source was downloaded by 100000808565474 from CourseHero.com on 06-26-2021 10:31:52 GMT -05:00
https://www.coursehero.com/file/36776916/NUR255-CaseStudy-CADCABG-studentprintdocx/Total Points: 25 Scenario
Your patient, 58-year-old K.Z., has a significant cardiac history. He has long-standing coronary artery disease (CAD) with occasional episodes of heart failure (HF). One year ago, he had an anterior wall myocardial infarction (MI). In addition, he has chronic anemia, hypertension, chronic renal insufficiency, and a recently diagnosed 4-cm suprarenal abdominal aortic aneurysm. Because of his severe CAD, he had to retire from his job as a railroad engineer about 6 months ago. This morning, he is being admitted to your telemetry unit for a same-day cardiac catheterization. As you take his health history, you note that his wife died a year ago (at about the same time that he had his MI) and he does not have any children. He is a current cigarette smoker with a 50–pack-year smoking history. His vital signs (VS) are 158/94, 88, 20, and 97.2 ° F (36.2 ° C). As you talk with him, you realize that he has only a minimal understanding of the catheterization procedure.
1.Before he leaves for the catheterization laboratory, you briefly teach him the
important things he needs to know before having the procedure. List five priority
topics you will address. 5 points
I would teach him that after the procedure he will need to remain in bed with his extremity flat for the first 12 to 24 hours with the HOB elevated at 30 degrees. That we will be placing an IV and giving his heparin and give teaching on antiplatelet med. They may use radial access but can possibly use the femoral access to get the job done. I would tell him that the doctor will be inserting a catheter that has a balloon like device to the blockage(s) and if the needed the doctor may place a stent. Advised the patient that he will have a pressure dressing in place that is to remain there and is not to be touched. The health care team will be monitoring him before during and after the procedure to ensure his wellbeing and safety by checking for pluses, bleeding, procedure complications, ECG monitoring and all vital signs.
2.Look at his past history. What other factors are present that could contribute to his risk for cardiac ischemia? 1 point.
The past history of previous MI, HTN, being a male over the age of 45 y.o. and being a smoker, having increased stress trying to cope with the passing of his wife, having increased lipids / CAD, having a poor diet / lifestyle for his diseases and having chronic anemia as well as renal issues. Nur255 – Acute Care
Cardiac Case Study
This study source was downloaded by 100000808565474 from CourseHero.com on 06-26-2021 10:31:52 GMT -05:00
https://www.coursehero.com/file/36776916/NUR255-CaseStudy-CADCABG-studentprintdocx/Case Study Progress
Several hours later, K.Z. returns from his catheterization. The catheterization report shows 90% occlusion of the proximal left anterior descending (LAD) coronary artery, 90% occlusion of the distal LAD, 70% to 80% occlusion of the distal right coronary artery (RCA), an old apical infarct, and an ejection fraction (EF) of 37%. About an hour after the procedure is finished, you perform a brief physical assessment and note a grade III/VI systolic ejection murmur at the cardiac apex, crackles bilaterally in the lung bases, and trace pitting edema of his feet and ankles.
Except for the soft systolic murmur, these findings were not present before the catheterization.
3.What is your evaluation of the catheterization results? 1 point
He could now be having acute pulmonary edema, or he may be having fluid volume overload. Another possible issue could be that he is going into total heart failure since he is having crackles and edema that where not noted before.
4.Explain the significance of having an EF of 37%. 1 point
The patient is only pumping out 37% of his blood in the heart. The normal level for EF is 55% (+) so the patient has a very low EF. This means that the patient’s heart failure damage is causing his ventricle to not pump as well as it should be normally.
5.What problems do the changes in assessment findings suggest to you? What led you to your conclusion? 1 point
The assessment findings suggest that the patient is showing signs of heart failure because his heart is not contracting effectively and having both left sided heart failure because she is having lung crackles and decrease EF and congestion. He is also showing signs of right sided heart failure due to having edema and that he is having issues with management of his CAD since he has multiple blockages and decreased blood flow.

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller 22skinnynurse7404. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $8.99. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

79650 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 14 years now

Start selling
$8.99
  • (0)
  Add to cart