Critical patient scenarios - page 2

I took a quiz yesterday in which our instructor was just assessing our overall 'critical thinking'. She said she wasn't concerned with us knowing specifically which interventions to use for these... Read More

  1. Visit  pinkkitty11 profile page
    0
    Thank you to all of you who replied to my post! It was really helpful to see that I did have a lot of this all written down.. and then the things I didn't know off hand were just a result of my inexperience.
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  3. Visit  RNextraordinare profile page
    0
    Quote from mcleanl
    A heart rate of 130 in this situation would never be treated with a beta blocker....this heart rate is most likely compensatory and NEEDED. If the patient is truly bleeding his blood pressure will come down all on its own....and it won't be pretty. Again, you would never beta block a fresh post-op patient that you suspect is bleeding.
    Agreed. Consider volume and let the team know to see this patient. Stat ECHO could show tamponade or if theres not time for that a quick trip to the OR for exploration
  4. Visit  CCL RN profile page
    0
    Quote from mcleanl
    A heart rate of 130 in this situation would never be treated with a beta blocker....this heart rate is most likely compensatory and NEEDED. If the patient is truly bleeding his blood pressure will come down all on its own....and it won't be pretty. Again, you would never beta block a fresh post-op patient that you suspect is bleeding.
    Jenni isn't a working nurse. Herin lies the problem on message boards-anyone can give you advice with the implication that they are nurses. Even terrible advice like giving metoprolol to a compensating tachycardia.

    The the OP, please reasearch. It's good to get advice, and there has been good advice given here, but also take it with a grain of salt. Anybody can be anybody here...
    Last edit by CCL RN on Mar 20, '11
  5. Visit  mcleanl profile page
    1
    Quote from CCL RN
    Jenni isn't a working nurse. Herin lies the problem on message boards-anyone can give you advice with the implication that they are nurses. Even terrible advice like giving metoprolol to a compensating tachycardia.

    The the OP, please reasearch. It's good to get advice, and there has been good advice given here, but also take it with a grain of salt. Anybody can be anybody here...

    CCL......I think these types of discussions are great. Hopefully there are enough experienced nurses on the forum to counter-act the inaccurate advice. So now a whole bunch of readers are clear on the fact that when a patient has a compensatory heart rate a beta blocker should never be given......and guess what I have seen doctors order it! So I think these discussions are huge....and I am not sorry that Jenni threw it out there....it gave us a chance to correct her thinking.
    CCL RN likes this.
  6. Visit  CCL RN profile page
    0
    Quote from mcleanl
    CCL......I think these types of discussions are great. Hopefully there are enough experienced nurses on the forum to counter-act the inaccurate advice. So now a whole bunch of readers are clear on the fact that when a patient has a compensatory heart rate a beta blocker should never be given......and guess what I have seen doctors order it! So I think these discussions are huge....and I am not sorry that Jenni threw it out there....it gave us a chance to correct her thinking.
    That's a great point!
  7. Visit  Do-over profile page
    0
    Was just thinking in scenario #1 - I would also assess the incision / dressing

    #2 call RRT

    #3 MONA, ekg, trops/cardiac enzymes, call doc, verify that ordered meds given appropriately (plavix)


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