Tricky homework questions - HELP! - page 2

Can someone please help me on these homework questions, I just don't know the answers and can't find them in my text book. 1) Which of the following statements by a client diagnosed with... Read More

  1. by   begalli
    Quote from kwagner_51
    A= Airway
    B= Breathing
    C= circulation

    Make sure they have a patent airway, Bag them with O2 then start CPR.

    Remember, the brain can only go 3-5 min without O2. If we can get O2 into the then do CPR the being pumped from the heart is O2 saturated and may prevent brain .
    What was the patient's rhythm? Was it a perfusing rhythm?

    You're right:

    BLS =
    Check responsiveness
    not responsive?
    CALL FOR HELP/AED/CRASH CART
    Check for breathing
    not breathing?
    HEAD TILT/CHIN LIFT GIVE 2 BREATHS
    Check circulation
    no pulse?
    START CHEST COMPRESSIONS

    Ideally breaths and chest compressions should be taking place and according to AHA standards (two-person; 15:2 compressions to ventilations). Giving 02 to a person who doesn't have a pulse doesn't do much, actually doesn't do anything. You have to have a half-way decent beating heart to circulate the 02 to organs such as the brain.

    EVERY code situation is different. Perhaps your patient still had a blood pressure that was circulating the 02 the RT was bagging in. You can bet that if the patient had no pressure those docs would have been calling for compressions, but more likely shocks, if a defibrillator was in the room.
    Last edit by begalli on Mar 7, '05
  2. by   2rntish
    V Tach with a pulse is fairly common.
    Some patients are stable...good BP, no SOB...just a little fluttering in the chest.
    Some are unstable: chest pain, SOB, diaphoretic, hypotensive...
    Some are pulseless.

    You never have a pulse with V Fib...
  3. by   TiffyRN
    Maybe some current cardiac nurses can confirm, my ACLS is over 2 yrs old.

    There is such a thing as pulseless V-tach (I've seen it), and there is a separate path to take on the ACLS algorithm if v-tach is pulseless or with a pulse. The short of it is that pulseless v-tach is to be treated the same as v-fib, and shocking would be the appropriate first action. However since your question doesn't allow defib I would choose the CPR hoping they meant a defibrillator would come on the crash cart. Compressions and bagging won't hurt pulseless v-tach/v-fib (in the absence of defibrillator) but it won't really help except to buy a little time. That heart needs electricity.

    One more thing, I've never really heard it addressed but I'm pretty sure that a pulseless patient is not conscious. They don't have any pressure to perfuse the cerebral arteries. If you have a pulseless patient talking to you, check the patient's pulse again. Also defibrillating a conscious patient should not be done without sedation (though I'm sure it happens now and again).
  4. by   MorganO
    My answers

    #1 is 1 Knowledge is vague

    #2 is 1 "Time is muscle" the quicker the doc will consider thrombolytics, the more benefit the patient will have from the med. Pain can be managed with NTG if VS stabke

    #3 Not sure

    #4 CPR althought I would rather Defibrillate a pulseless VF Vtach patient I will do CPR until the patient can be defibrillated

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