Cardiac Care Plan Marking Guide

To determine if the patient’s chest pain is related to injury, you would look for ST-segment elevation. Myocardial injury represents a worsening stage of ischemia. If ST-segment elevation is greater than or equal to 1mm above the isoelectric line, it is significant and treatment needs to be prompt and effective to try to restore oxygen to the myocardium, and to avoid or limit infarction. The absence of serum cardiac markers confirms that infarction has not

What findings would indicate that the patient is ready to have the chest tube removed?

He is to be on bed rest with low mobility due to need for elevation of extremities to prevent thrombus from developing into an embolus. Tell him to change positions periodically to

The physician was notified of the pain and discomfort related to the chest tube, which pain medication was given. Other notifications were the amount of drainage from both the chest tube and the JP. Both were under normal limits. SOB and fatigue with activities were also notified to the

3. Instruct the patient to reposition herself frequently and supply extra pillows for bony prominences like heels and elbows

In the evaluation of patients with chest pain, the preliminary ECG is a more clear-cut tool for early risk stratification with more recent recommendations indicating that ECG should be performed as early as possible, within 10 minutes of ED admittance. Early indicators associated with MI or ischemic complication such as ST segment elevation or depression allows rapid treatment aligning with the indicated complication. While the ECG may reveal significant indicators in certain situations, in other circumstances findings may be limited due to low diagnostic sensitivity

General treatment could include making sure the individual is comfortable and warm, keeping his or her legs elevated above their head, administering appropriate medications if given authorization, and providing oxygen to the patient (Quick and Dirty Guide to Shock). Prevention is the best type of treatment. This means keeping a healthy lifestyle, and obtaining as much self-knowledge as possible.

On admission to ICU, the patient should be positioned in fowler 's position, vital signs checked, oxygen is very important since her saturation is 82%. A non-rebreather mask is advisable at this time. Reassurance is very important to calm the patient and the plan of care explained to allay anxiety, calm the patient and ease breathing. Cardiac activities should be monitored continuously in every 10 to 15 minutes with pulse oxymeter, IV assess initiated, medications Beta blockers (Lopressor), Angiotensin-converting enzyme (ACE) inhibitors (Vasotec), diuretics (Lasix), and Morphine Sulphate giving. Laboratory work should be done such as levels of electrolyte, serum creatinine levels, weight and fluid balance. Other serum tests such as BNP, liver function, D-dimer, and CBC should also be done. Telemetry monitoring maintained continued for 24-48 hours after entrance into ICU. Signs and symptoms of congestion should also be monitored daily, intake and output, weight, if there is fluid restriction it should be adhered to, and diet should be according to dietician order such as 2g sodium and no added salt, turn and repositioned to avoid tissue breakdown, exercise according to patient tolerance.

ECG : ventricular rate 54 beats/min, HR varying from 39 to 60 during a 45 minute period of monitoring, infrequent PVCs, ST elevation in leads II, III and avF indicating inferior injury or ischemia secondary to acute MI.

The patient may experience dyspnea, caused by pulmonary congestion. They may report orthopnea as blood is redistributed from the legs to the central circulation when the patient lies down a night, paroxysmal nocturnal dyspnea due to reabsorption of interstitial fluid when lying down, and reduced sympathetic stimulation while sleeping. Pulmonary congestion may also cause a non-productive cough. Later clinical manifestations of left sided heart failure include crackles due to pulmonary congestion and hemoptysis resulting from bleeding veins in the bronchial system caused by venous distention. On physical exam the patient may have cool, pale skin resulting from peripheral vasoconstriction, and may be restless and confused due to reduced cardiac

194-195). The fourth nursing diagnosis that pertains to her is anxiety related her inability to breath adequately without support, the unknown outcome, her inability to speak from intubation, a change in the environment, a change in health status, and her not having insurance, and this is evidenced by restlessness, being unable to sedate her, and her uncooperative behavior(Gulanick & Myers, 2014, p. 416). The last nursing diagnosis for this patient is risk for decreased cardiac output related to her mechanical ventilation (Gulanick & Myers, 2014, p.

The patient arrived for his appointment on time. He was visibly short of breath although he was using portable O2 at 2 LPM via nasal cannula. The patients moblitly is slightly compromised, he seems depend on his walker unless for just simple tranfering.

Acute coronary syndrome encompasses patients diagnosed with unstable angina, non-ST elevation myocardial infarction, and ST-elevation myocardial infarction (Amsterdam et al., 2014). Per the American College of Cardiology (2014), a rapid evaluation to identify life-threatening cardiac conditions is imperative for patients presenting to emergency departments with symptoms of acute coronary syndrome and an electrocardiogram is an essential tool for diagnosis (Amsterdam et al., 2014). Patients with ST-elevation myocardial infarction have a 7.4% increase in risk of mortality with every half-hour that passes before implementing appropriate reperfusion therapy (Omar, Helal, Mangar,

In furtherance of a lifelong desire to become an advanced practice nurse, I herewith articulate my professional development plan (PDP) based on Walden University’s program of study (POS), in alignment with my personal and professional goals. I welcome this opportunity to begin the development of professional portfolio of evidence documenting my course of nursing practice. I am equally hopeful that this will be a springboard for recording my career progression as an electronic portfolio (e-portfolio). The e-portfolio gives added benefits of conciseness, confidentiality, portability, and ease of access over traditional paper portfolio. Also, it gives the benefit of career mapping to organizations intent on helping to shape and advance my professional career path (Thompson, T. 2011). I intend to leverage upon these benefits to showcase my competencies, professional attainment, and lifelong learning as I articulate my value to the healthcare industry.

This patient is not is need of oxygen at this time. As noted by Woo and Wynne (2012), administration of supplemental oxygen is done in the presence of hypoxemia to avoid organ damage (pg. 1016). This patient has reported shortness of breath, however the objective assessment reveals a respiratory rate of twenty and no use of accessory muscles or retractions.