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 hypertension indicates a need for additional teaching?
1. "All of the medications have lots of side effects"
2. "Exercise helps to control the disease"
3. "I need to eat meals that have less salt and fat"
4. "My blood pressure is lower when I'm at home"
2) A patient is admitted to the emergency department for chest pain. His ECG findings show ST elevations indicating acute myocardial infarction. The ER doctor orders standard cardiac therapy including aspirin and metoprolol and then asks you to complete a bleeding history and contact the patient's primary-care physician. The primary physician gives you standard orders for oxygen therapy, nitroglycerine and heparin. He then asks that the patient's labs to be called to him for further orders. Before hanging up the phone, you should say:
1. "Considering the positive ECG, don't you want to order a thrombolytic?"
2. "He is quite uncomfortable, what would you like me to give him for pain?"
3. "Thank you, I will get back to you as soon as I have lab confirmation"
4. "Would you like me to go ahead and arrange for transfer to the CCU?"
3) What heart sound is classic for congestive heart failure?
1. diastolic murmur
2. pericardial rub
3. S3 gallop
4. S4 gallop
4) The nurse finds the client to be in ventricular tachycardia and pulseless. What is the nurse's best first action?
1. Administer an anti-dysrhythmic medication
2. Administer oxygen
3. Initiate CPR
4. Instruct the client to take deep breaths and cough
Specializes in Geriatrics, Pediatrics, Home Health.
If a person is tamponading. There would be so much fluid around the heart, the heart would not be able to fill enough to pump out an adequate stroke volume. So it beats faster and faster to pump out what little it can. Largely decreased or next to no stroke volume = no pulse.
What good would 02 do if the patient's not breathing?
Think Basic Life Support.
A= Airway
B= Breathing
C= circulation
Make sure they have a patent airway, Bag them with O2 then start CPR.
I watched a code about 3 weeks ago, and this is how they did it. The Resp therapist was bagging long before anyone started CPR and there were 3 doctors in the room. The doc in charge gave the resp. therapist the ok to intubate, before the doc used any IC meds.
Remember, the brain can only go 3-5 min without O2. If we can get O2 into the b l o o d then do CPR the b l o o d being pumped from the heart is O2 saturated and may prevent brain damage .
At least that is the way I understand it. Am I wrong? Please advise.
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.
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).
#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
kwagner_51
592 Posts
A= Airway
B= Breathing
C= circulation
Make sure they have a patent airway, Bag them with O2 then start CPR.
I watched a code about 3 weeks ago, and this is how they did it. The Resp therapist was bagging long before anyone started CPR and there were 3 doctors in the room. The doc in charge gave the resp. therapist the ok to intubate, before the doc used any IC meds.
Remember, the brain can only go 3-5 min without O2. If we can get O2 into the b l o o d then do CPR the b l o o d being pumped from the heart is O2 saturated and may prevent brain damage .
At least that is the way I understand it. Am I wrong? Please advise.
Thanks!!
__________________________________________________
In His Grace,
Karen
Failure is NOT an option!!