Circulatory Case Studies

• The radiotracer will be injected through the IV tube. You may feel a cold sensation in your arm.

no further medication changes. K.N. is instructed to fi nish the remaining 2 days of

Any incident in which a line designated for oxygen or other gas to be delivered to a patient contains the wrong gas or is contaminated with toxic substances.

24) A patient who is on Aldactone and Lasix ask the nurse why he is receiving two medications together, the nurse explains that this combination:

Septic shock results from bacteria that multiply in the blood and then releases toxins that decrease blood pressure, thus, impairing blood flow to cells, tissues and organs. It is an acute infection, usually systemic, that overwhelms the body (toxic shock syndrome) (Huether & Mccance, 2012). This

The clinician demonstrated evidence based practice in his care. By informing the patient about the procedure and waiting for a clear approval. He demonstrated great communication skills as well as keeping the client’s values and circumstance at the core of his care throughout. In addition, the five moments of hand hygiene, aseptic technique and the rights of medication administration of current best practice were utilised. Furthermore, clinical expertise were demonstrated the clinician completed the task in a timely manner with good dexterity highlighting that he has been administering IV therapy for quite some time and is experienced in the way he handled the

After a suitable vein has been visualized and the venipuncture site thoroughly cleansed, the needle is then placed into the patient’s vein for blood collection. Difficulties can arise if a needle is not fully inserted or if it went entirely through the vein and a hematoma will be the result. (Morgan, 2005) Hematomas are bruises due to the collection of blood from veins or arteries in the surrounding tissues. (Garza, 2010) Sticking a fragile vein, excessive probing of the needle if the vein is initially missed, and failure to remove the tourniquet before removing the needle are some other ways a hematoma can develop during a venipuncture procedure. (Garza, 2010) When needles are incorrectly inserted into a vein, blood is allowed to escape, forming a bruise. (Garza, 2010) If at any time this should happen, the phlebotomist should immediately end the procedure by first removing the tourniquet, then the needle, and apply firm pressure to cease the blood flow. (Morgan, 2005) Improper needle placement can also cause neurological damage. With deep insertion of a needle, hitting the nerve behind the vein is likely. (Garza, 2010) Radiating or shooting pain and sometimes numbness has been reported by patients in these situations. (Garza, 2010) Phlebotomist should always insert needles with care to avoid any injury to the

DVTs usually occur within the deep veins of the lower leg. The DVTs that remain in the lower leg and calf tend to be asymptomatic and do not become clinically significant. A DVT is most likely to present symptoms when the proximal leg veins are involved and also when the DVT obstructs venous outflow resulting in inflammation of the vein wall (Bonner and Johnson, 2014). Warmth, redness, pain and swelling in the affected limb are common symptoms of a DVT. If a patient presents with these symptoms, a physical examination of the whole limb should be undertaken by a nurse or physician to observe for signs suggestive of a DVT. Suggestive symptoms of DVTs include superficial venous dilation, tenderness along the course of the vein, unilateral leg oedema, cyanosis, warmth and erythema (Bonner and Johnson, 2014). On examination of the limb, these are the symptoms that the nurse or physician should be looking out for, however, diagnosis on clinical presentation alone is extremely difficult as these symptoms are not specific to DVT and can be present in numerous other conditions. To improve accuracy when determining the probability of a DVT, nurses are advised to use the two level DVT Wells score. Each clinical feature is accompanied with a score. If a patient presents with a score that is two points or higher, it is likely that a DVT is present and

The patient reports being sick with the flu for the past 8 days. She has been vomiting several times a day and has been using more than the recommended dose of antacids in an attempt to calm the nausea. She has become severely dehydrated. After fainting at home she was taken to the hospital. An arterial blood gas sample was drawn and then an IV was placed to help rehydrate her.

can have adverse effect on the functionality of the patient. It is also a threat to the health of the

Deep vein thrombosis (DVT) happens when a blood clot forms in one or more of the deep veins in your body, it usually takes place in your legs. Deep vein thrombosis can cause swelling or leg pains, and you may not get any symptoms at all. Deep vein thrombosis can arise if you have certain medical conditions that affect how your blood clots. Deep vein thrombosis can also happen if you don't move for a long time. I can happen sitting in a car for too long, after surgery, following an accident, or when you are confined to a hospital or nursing home bed. DVT is a serious condition because blood clots in your veins can break loose, travel through your bloodstream and lodge in your lungs. It can block the blood flow and cause a pulmonary embolism.

a normal manner and it may take longer to clot. If prescribed this medication they will attend a Anticoaglant

• Bed rest and fluids given through an IV tube inserted into one of your veins. Sometimes, this is all that is needed for the obstruction to improve.

In some cases, they may become ill and feel nauseous or vomit. Patients may also experience fever, chills or a fast heart rate as a result of CLASBIs. Additionally, these types of infections may cause redness, swelling or tenderness in the area around where the catheter is inserted. There may also be drainage from the catheter site.

Scrub the site of the puncture with a alcohol pad. Use a circular scrubbing motion, from inside to outside only. Cover a wide area around the selected site, 3 to 4 inches. This may have to be repeated depending on the cleanliness of the patient. Cleansing the site prevents chemical or microbial contamination of specimen and patient. Do not touch this area again. Let the area air dry. Do not blow on or fan the area. The alcohol should be allowed to dry to avoid hemolysis and/or burning sensation when the venipuncture is performed. It is better to use syringes if veins are small. butterfly collection sets are also available and useful if multiple tubes are needed. If a syringe is used, move the plunger up and down in the barrel once or