Scenario three I was working evenings in the emergency department of a seaside hospital. We admitted a 54-year-old man, whom I'll call Mr. Schmidt. He told me, "I just got here for vacation, and I'm not feeling so great. I had pneumonia at home, got treated, and thought I was better. Now my breathing feels lousy again." A check of his vital signs while he was sitting quietly revealed the following: T 99° C, P 138 beats/min, R 36 breaths per minute, BP 168/80 mm Hg. As I helped him to the stretcher, he became significantly more short of breath. I checked his lung sounds and heard a lot of congestion. I notified the doctor and voiced my concern that Mr. Schmidt seemed quite ill. The doctor examined him and ordered an electrocardiograph and chest x-ray study. During this time we got very busy. I was helping another patient when the doctor came to me and said, "I want you to give Mr. Schmidt 80 mg of furosemide (a diuretic) IV now and discharge him." I looked at him skeptically and said, "Discharge him?" He said, "Yes. I'm sure the diuretic will help him get rid of this fluid." Tactfully, I asked, "Can we give him some time to see how he responds?" The doctor said, "No. This place is wild. I'm sending him home. He's going to a private physician in the morning. He'll be fine once he gets rid of some fluid. Discharge him with instructions to call if he doesn't feel better." I gave Mr. Schmidt the furosemide, but still had trouble with the idea of sending this man home before knowing his response to the IV diuretic. Then I decided to use my own clout as a nurse: I had established a rapport with the Schmidts, and they trusted me. I said to them, "I realize the doctor has discharged you, but I'd be interested to see if there's any change in blood pressure after you get rid of some fluid. How would you feel about sitting in the waiting room, and I'll check your blood pressure in an hour?" The Schmidts thought this was a good idea and went off to the waiting room. Only 45 minutes had passed when there was a shout for help. I ran to the waiting room and found Mr. Schmidt on the floor having a grand mal seizure. He then stopped breathing. We were able to resuscitate him and he was admitted to the hospital, diagnosed with electrolyte imbalance and heart failure, and discharged a week later. b. Why do you think the nurse was so concerned about the assumption the physician made?

Scenario three I was working evenings in the emergency department of a seaside hospital. We admitted a 54-year-old man, whom I'll call Mr. Schmidt. He told me, "I just got here for vacation, and I'm not feeling so great. I had pneumonia at home, got treated, and thought I was better. Now my breathing feels lousy again." A check of his vital signs while he was sitting quietly revealed the following: T 99° C, P 138 beats/min, R 36 breaths per minute, BP 168/80 mm Hg. As I helped him to the stretcher, he became significantly more short of breath. I checked his lung sounds and heard a lot of congestion. I notified the doctor and voiced my concern that Mr. Schmidt seemed quite ill. The doctor examined him and ordered an electrocardiograph and chest x-ray study. During this time we got very busy. I was helping another patient when the doctor came to me and said, "I want you to give Mr. Schmidt 80 mg of furosemide (a diuretic) IV now and discharge him." I looked at him skeptically and said, "Discharge him?" He said, "Yes. I'm sure the diuretic will help him get rid of this fluid." Tactfully, I asked, "Can we give him some time to see how he responds?" The doctor said, "No. This place is wild. I'm sending him home. He's going to a private physician in the morning. He'll be fine once he gets rid of some fluid. Discharge him with instructions to call if he doesn't feel better." I gave Mr. Schmidt the furosemide, but still had trouble with the idea of sending this man home before knowing his response to the IV diuretic. Then I decided to use my own clout as a nurse: I had established a rapport with the Schmidts, and they trusted me. I said to them, "I realize the doctor has discharged you, but I'd be interested to see if there's any change in blood pressure after you get rid of some fluid. How would you feel about sitting in the waiting room, and I'll check your blood pressure in an hour?" The Schmidts thought this was a good idea and went off to the waiting room. Only 45 minutes had passed when there was a shout for help. I ran to the waiting room and found Mr. Schmidt on the floor having a grand mal seizure. He then stopped breathing. We were able to resuscitate him and he was admitted to the hospital, diagnosed with electrolyte imbalance and heart failure, and discharged a week later. b. Why do you think the nurse was so concerned about the assumption the physician made?

Biomedical Instrumentation Systems

1st Edition

ISBN:9781133478294

Author:Chatterjee

Publisher:Chatterjee

Chapter11: Instrumentation In Respiration

Section: Chapter Questions

Problem 1P

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