Aneurysm Case Studies

other intense tests can be done to make the diagnosis much clearer such as Doppler echocardiogram, this uses sound waves to show the function of the right ventricle to measure the blood flow through the heart valves, and then calculate the systolic pulmonary artery pressure. There is also an X-ray, this is done on the chest. This can show any increase or decrease in size of the right ventricle and arteries. A simpler test such as the 6-minute walk test, this controls exercise patience level and blood oxygen saturation level during exercise. There is also a Pulmonary function test, this seeks for other lung conditions such as chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis compared to others. Also there is a 'Polysomnogram or overnight oximetry', this monitors sleep apnea (results in low oxygen levels at night). Also a right heart catheterization, this measures various heart pressures ( inside the pulmonary arteries, coming from the left side of the heart), the rate at which the heart is able to pump blood, and finds any leaks between the right and left sides of the heart.

EX: The FCAT is a criterion- reference test because it is based on a set of standards.

|What criterion must be met |Consistency: Important when comparing data to make sure the data compared was prepared the correct way and done the same each time. |

Another follow up ABG at 0100 shows a small improvement on the Ph to 7.18, the Pco2 became more acidotic moved to 53, the Po2 improved to 77 which shows he is oxygenating better but still hypoxic, his Hco3 acidosis is improving at a change to 19.8, and sating 91% now. The Pt is now breathing at a rate has come down to 10 BPM on his own above and beyond the vent. After consulting with the physician we changed the Vt to 600 and the pressure support to 20 and Cpap to 15. The Pt continued on these settings till 0415. The physician then made the change to Bi-level with the settings of a rate of 14 pressure support of 25, and an H/L pressure of 35/15. The Pt at this time is pulling a Vt of 745 and a spontaneous rate of 17 and still at 100% Fio2 and sating 92%. This is the point when the Pt makes the turn. The Bi-level or APRV was the proper setting for this Pt. He continued to improve over the next several days with his peek pressure climbing to 40. The Pt continues these settings and slowly improves and eventually weaned from the ventilator till the Pt no longer needs support.

Step 2: During this second step, the characteristics of the comparison distribution is determined. In instances that the null theory is correct, the comparison distribution is compared to the score depending on the sample’s outcomes.

Mr. P’s vital signs and diagnostic studies are as follows: Blood glucose level 700mg/dL, Blood Pressure 90/60mm Hg, Heart Rate 128 beats/min, Respiratory Rate 34 breaths/min, Temperature 100.8 F, Serum pH 7.26, Serum HCO3 10 mEq/L, BUN 40 and Creatinine 3.5.

BP 166/73 | Pulse 69 | Temp 96.9 °F (oral) | Resp 14 | SpO2 99% on room air

Given that all the variables should be greater than zero, a lower limit is set for each variable tested.

For the collection of data, developed and verified NI surveillance was used. The NI surveillance was useful for measuring both the incidence and risk factors of VAP according to Katherason et al (2009). Demographical data, past medical history, medications, nutritional status, laboratory results, diagnosis, history of illness, etc were all included in the surveillance. The Acute Physiology and Chronic Health Evaluation III score measured the severity of the illness. The APCHE is comprised of the acute physiological score that entails the major physiological systems and the chronic health evaluation that incorporates the influence of co-morbid conditions on the patient’s current health (O'Keefe-McCarthy, Santiago, & Lau, 2008).

Here the test expression is first evaluated and then based on the result or value returned, (true or false), the program control is

Most use a number of clinical, laboratory and radiological parameters to predict severity. However some of the scores are cumbersome to calculate or use indices taken 48 hours after admission, limiting their clinical usefulness. The most popular scoring systems to determine the severity of AP include RANSON’s criteria, APACHE II and Bedside Index for Severity in AP (BISAP) criteria. APACHE II has the advantage of being used at the time of admission and thus has been preferred so far. The Ranson, Glasgow and APACHE II scores are widely employed clinical scores and have a predictive accuracy in the region of

An AAA (abdominal aortic aneurysm) is defined as enlargement of at least 3 cm of the abdominal aorta. The majority of abdominal aortic aneurysms begins below the renal arteries and ends above the iliac arteries. The exact cause of (AAAs) is unknown. However, it is thought to be due to a degenerative process of the abdominal aorta caused by atherosclerosis. Artherosclerosis represents a response to vessel wall injury caused by inflammation, genetically regulated defects in collagen and fibrillin, increased protease activity within the arterial wall, and mechanical factors (Stoelting p. 143).

When discussing risk factor modification for a 63-year-old patient who has a 5-cm abdominal aortic aneurysm, the nurse will focus discharge teaching on which patient risk factor?

Cary T, Pearce J. Aortic Stenosis: pathophysiology, diagnosis, and medical management of nonsurgical patients. Critical Care Nurse. April 2013;33(2):58-72. http://web.a.ebscohost.com.ezproxy.gannon.edu/ehost/pdfviewer/pdfviewer?sid=e6ada210-f338-49e3-9017-25e89c7004d9%40sessionmgr4002&vid=11&hid=4206. Accessed July 4, 2015.

When measuring the atherosclerotic aneurysm the transverse diameter is the most important measurement to obtain. Normal aortic diameter measures less than 3.0cm. They can be saccular, fusiform, or cylindrical. The location of the aneurysm is also of major importance, in particularly its position with respect to the kidneys. The most common location for abdominal aortic aneurysms is infrarenal. Ultrasound can also be used to assess the presence or absence of thrombi, their echostructural characteristics, and any signs of dissection. Ultrasound can also reveal aortic dissections and distinguish the true and false lumens.