Personal Narrative: Blood Pressure

Pulling off the ramp, we turned onto Church Hill Road responding on a priority one for the cardiac arrest. I tried to review my field guide en-route to the call, but all I could see were flashing lights reflecting off the guide’s pages and crowds of cars moving over for our wailing sirens. Within three minutes we had arrived on-scene and it was clear that our patient was not in cardiac arrest; however, his 12-Lead EKG and oxygen saturation were marginally reassuring and pointed to an active heart attack. At this point in my EMS training I was a BLS provider, but had adequate knowledge to assist Kathy. Instinctively, I went right to work and loved every second of it. The concept of formulating a differential diagnosis in the field and testing that theory is one of the principle factors that kept drawing my back to EMS. In addition, I developed an unparalleled appetite for knowledge, stemming from my desire to get every differential diagnoses right. Coming to this realization early in my EMS career, we [healthcare providers] frequently forget that patients often lack the medical knowledge provided to us through years of training. Behind CT Scans and MRIs are patients with questions. Having the ability to provide compassion, sympathy and reassurance to a patient is a central part to their recovery and survival; therefore, we [healthcare providers] need to be able to care for our patients on a holistic level, focusing less on the disease and more on the

An evaluation of Mrs Smith circulation was the next step carried out by the nurse, as in the breathing assessment Mrs Smith pallor was noted as being flushed and the patient appeared confused this could be associated with poor cardiac output. The nurse recorded the patient’s blood pressure using a dinamap it was measured at 88/50, it was then rechecked manually to ensure accuracy. The pulse was checked manually for rate and rhythm it was recorded as 98 beats per minute. Capillary refill was checked, was found to be normal.

When we walked into the emergency room, they paid attention to me right away due to the warning indicators I reported. An EKG was performed. Complete laboratory work up was accomplished during my stay as well. In the meantime, I was given Ativan to relieve my anxiety. I felt somehow better thereafter. Laboratory results came and were negative. Yet I was diagnosed with paroxysmal supraventricular tachycardia (PSVT). Nevertheless, I went home relieved, but that harrowing experience has truly made a mark to this date.

Ms. Sunshine immediately was placed on oxygen, sitting upright, an IV infusing, had blood work sent for numerous labs, including cardiac markers, had a chest x-ray and an electrocardiogram (EKG) performed. A clinical nurse leader is able to teach patients and patients regarding health promotion, disease prevention, or disease management (American Association of Colleges of Nursing, 2011). It is important to understand the pathophysiology behind disease processes in order to help facilitate better outcomes for Ms. Sunshine.

You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M, a man who has been coming to the clinic for several years for management of CAD and HTN. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a CXR showed cardiomegaly and a 12-lead ECG showed sinus tachycardia with left bundle branch block. You review his morning blood work and initial assessment.

One night in the Emergency Department (ER) I was able to use all four patterns when caring for a patient. Mr. XYZ had come in for feeling “not him self”, weak, overall fatigued, and having minimal chest pain. Based on his symptoms we immediately begin a cardiac work up. Mr. XYZ was stable for the first hour or so he was there. I was in another room when my charge nurse came to get me and said I was needed in Mr. XYZ’s room. I immediately when in there to find him sitting up in bed, awake, with his heart rate on the monitor reading asystole. I locate his pulse and feel a very faint, but palpable pulse. As I am assessing him my

On arrival at the ED, the physician auscultates muffled heart tones, no breath sounds on the right, and faint sounds on the left. A.W. is

Why? Well, I personally have a heart condition. I was born with left Valve Stenosis witch means my heart has to work harder to pump blood though the valve and my body can suffer with less oxogen. With having this condition I do have chest pains, more then anyone has. The wild part is I can not take birth control because there is a lot of effects within the heart. I’ve had an inhaler many times to help with my breathing and multiple open heart surgeries. With my condition there are many things in this world I am not able to do, such as I have to be a certain weight. As for me I can’t weaigh over 120 pounds, I can’t go on roller costers, I can’t have too much salt, and I’m very limited on working out and I can’t skip meals and being stress is not great for my heart.

Parker included collecting cues in 12-lead ECG, blood pressure, potassium level, sodium level, the warmth of hands and feet and pain score (Corrales-Medina et al., 2012). Also, the process involved identifying the risk factors associated with the patient's condition. From the immediate assessment, it included weight, smoking history, history of depression and family history of cardiac conditions (Corrales-Medina et al., 2012). One evening, Mr. Parker slumped on the bed; I monitored the continuous cardiac monitor to determine his heart rhythm. Based on current information, the T wave on the ECG indicated that the ventricles are repolarising (Levett-Jones et al., 2010).

This paper briefly touches on a case study by a nursing assistant student who is assisting with an anesthesiologist that she is shadowing. The student was asked to monitor vitals during a knee surgery. The patient was given Halothane and the surgery began. After two hours in surgery, the patient, who was a young athletic female named Sharon Riley, began to show signs of distress. This patient’s temperature elevated to 105 °F and pulse began to rise up to 120 bpm, and her blood pressure began to drop down to 60/56 mmHg. This triggers the monitors alarm because normal vitals for this patient were a temperature of 98.6 °F, 75 bpm pulse and blood pressure of 105/60 mmHg. This causes the doctors to react quickly and begin to assess what is wrong

The patient is a 72-year-old black female who presented to the ED with complaints of low blood sugar. Her son found the patient at home in bed unresponsive. The son states he checked the patient's blood sugar it was 47. The patient is on NovoLog 3 times a day and Lantus one time a day. The patient had similar symptoms in the past. The patient has a medical history of dementia. She also is known to be hypertensive, insulin-dependent diabetes and has no surgical history. It is to be noted on presentation her BP was 128/95 with a pulse of 52, respirations of 15, hypothermic with a temp of 93 and oxygenating 94% on room air. She also showed significant bradycardia. EKG at 48 beats per minute, T waves were inverted in leads 4, 5 and 6 but

Everyone is exhausted and I know someone will come help”. I reviewed the chart. This patient condition seems eerily familiar; a young lady with Postural Orthostatic Tachycardia Syndrome (POTS). This particular female patient came to our clinic for IV hydration to treat her POTS. POTS is a condition in which a change from the supine position to an upright positin causes an abnormally large increase in heart rate (tachycardia) along with lightheadedness, fainting and a host of other unpleasant symptoms. I’m familiar with this condition because my oldest daughter was diagnosed with this condition at the Mayo Clinic when she was a teenager. This diagnosis was only the beginning of a long journey through the healthcare

life or death. Knowing the chances and the odds is important so we can become aware and

Like a perfect automaton, the nurse proceeds to measure vital signs and note her findings with as little human interaction with you as is possible. After the nurse has completed her tasks, you must wait until the doctor pops his head in, nurse's records in hand. The doctor then proceeds to ask you some variation of the stock doctor question: "What seems to be the problem today?"

As the lady had a pre-existing heart condition an echocardiogram was performed. An echocardiogram is a non-invasive ultrasound test that shows an image of the inside of the heart (Klein et al 2011). Routine pre anaesthetic assessment and a physical examination were carried out prior to ECT to ensure the treatment was still viable. Informed consent was also obtained.