The purpose of this paper is to describe what are the indication for a bedside open chest procedure. Define what a cardiac tamponade is and the causes along with why there is a need for a bedside open chest procedure. Describe the signs and symptoms of a cardiac tamponade along with what equipment is needed for measurement. A scenario will be created in order to allow for answering of questions that will challenge the nurse to perform critical thinking. Five questions will be addressed along with the appropriate answers and the rationales for the answers. Anyone can memorize signs and symptoms and rattle them off, but the true art of critical thinking is the application and interpretation of the data that is observed in the patient during Signs and Symptoms of a Cardiac Tamponade Signs and symptoms that the patient will be different for every person. Common symptoms are “anxiety, restlessness, chest pain, difficulty breathing, pale, gray or blue skin” (Health Guide, 2017), low blood pressure and decreased urine output. These sign and symptoms can be associated with other disease processes. But following open heart surgery a combination of these with the inclusion of physical findings will give rise to the conclusion of a cardiac tamponade. Diminished heart sounds, increased jugular vein distention along with low blood pressure are referred to as Beck triad signs (Yarlagadda, 2016). How do these signs and symptoms along with Beck triad apply to a patient? Equipment needed following open heart surgery Initially the patient will be recovered in the post anesthesia area. They are orally intubated for a few hours or more. Blood pressure will be measured via an arterial line to their radial, brachial or femoral artery, depending on their vascular issues. An invasive line called a Swan Ganz catheter measures “pressures inside your heart and in the artery to
Respiratory assessment is a significant aspect of nursing practice. According to the National Institute for Health and Care Excellence, respiratory rate is the best indicator of an ill patient and it is the first observation that will demonstrate a problem or deterioration in condition (Philip, Richardson, & Cohen, 2013). When a respiratory assessment performed effectively on a patient, it can result in upholding patient’s comfort and independence in progress of symptom management. Studies have acknowledged that in spite of the importance of the respiratory rate (RR) it is documented rarely than the other vital signs in the hospital settings (Parkes, 2011). This essay will highlight the importance of respiratory assessment and discuss why nurses
Mary returned to the ward around three hours after the operation and at the time, had a blood pressure of 105/85. Blood pressure was relatively stable until 11.30am the following morning when she was
When patients finally seek help, they will usually present with a combination of symptoms such as worsening dyspnea, chronic coughing with sputum production which may or may not include acute chest pain and wheezing (Zab. M. 2014)
October 9th, 2016, after being discharged just three days prior, a 44-year-old African American female presented in the emergency department with complaints of shortness of breath with minimal activity and chest pain that radiates to the back and shoulders. Vitals signs were taken and reveled a heart rate of 134, blood pressure of 219/147 and a respiratory rate 28. Observation of the patient showed that she was slightly diaphoretic and anxious. Lab work was ordered to be drawn as well as an ECG and the admission process began. Admitting diagnosis recorded was tachycardia, elevated troponin, acute exacerbation of congestive heart failure, acute chronic congestive heart failure, chest pain and pleuritic chest pain.
Background: While in the SICU, I was involved in the care of a patient that presented with pericardial tamponade. He subsequently underwent a pericardiocentesis and a pericardial window. I was interested in the specific causes of pericardial effusions/tamponade as well as the incidence of each cause. Furthermore, I was interested in the treatment of cardiac tamponade. Specifically deciding between pericardiocentesis versus pericardial window.
Bedside emergency chest reopen should be done by the surgeon or a trained healthcare provider when a patient undergone a post cardiac surgery suffer a cardiac arrest for example temponade , as the impact on performing this procedure can delay death. Dunning J and Nandi J (200...
The factors presented indicate that the 57-year-old woman is affected by myocardial ischemia. Myocardial ischemia takes place when blood flow to the heart is reduced, preventing it from accepting sufficient oxygen. The diagnostic tests expected for this condition are: electrocardiogram, echocardiogram, nuclear scan, coronary angiography, cardiac CT scan, and a stress test.
There are some symptoms which can helps in order to identify and can be found in people who are affected. Symptoms such as smoking, physical inactivity change in amount of urine passed in a period of time and pain in kidney areas, high blood pressure, diabetes and glomerulonephritis.
759. Mr. Miller is likely presenting with an acute myocardial infarction. Based on his past medical history of hypertension, hyperlipidemia, obesity, and diabetes, along with his current symptoms of chest pain, shortness of breath, pale skin with beads of sweat on the forehead, as well as elevated lab 's Troponin, CK, and CK-MB, he is most likely presenting with an acute myocardial infarction.
These patients can quickly have a change of status and the nurses are there to provide immediate care and assess patients. The nurse will evaluate the patients’ conditions and if they need to go back to surgery for change of status that requires intervention from the surgeon. They also have a crucial responsibility of making sure the patient has a patent airway. The RN will monitor the incisions and observe for signs and symptoms of an infection and will administered pain medications and assess the comfort of
Signs and symptoms come along with any disease, some symptoms may be noticeable but sometimes there's just no symptoms at all. The common symptom for Coronary Heart Disease is chest pain and/or discomfort. This happens when the heart is not getting oxygen and blood. How strong the chest pains are varies from patient to patient. The chest pains my feel like the heart is being squeezed. The pain may be felt below the sternum but also in the neck, arms, stomach, and upper back. The chest pain usually occurs when the patient is doing activities or is in motion but it goes away with rest or a medicine called Nitroglycerin. Other symptoms are sho...
In the case scenario 2, the patient’s oxygen saturation dropped to 88% on room air, respiratory rate increased to 30 per minute. The nurse then tried to apply the oxygen mask to the patient. The patient’s daughter was worried about the patient, and kept asking the nurse about the rationale for each intervention. Reflect on the scenario, the nurse did not acknowledge patient’s daughter’s distress, did not provide clear explanations and reassurance to her. This is the reason why the daughter seemed to be anxious and kept asking questions. The nurse should initiate communication with both the patient and her daughter from the beginning, inform the daughter about patient’s condition timely, and articulate rationale for each intervention. Study conducted byMitchell and Chaboyer (2010) highlighted that the challenges issues for nurses during crisis time not only include the multifaceted patient care issue but also the complexity that the patient’s family can add to the
Blood circulates around the body due to the force exerted on it by the heart. During this process, it pushes through the blood vessels. The force which the blood exerts against the walls of the arties during this process is referred to as the blood pressure. It’s never constant, it varies depending on the body demands. Thus, it’s vital to monitor blood pressure on regular basis. It is measured using a sphygmomanometer. This procedure should be done when the patient is in relaxed. The measurement is usually recorded as 2 numbers, that is to say, 120/80. The lager number represents the systolic blood pressure (pressure in arteries), while the smaller number represents the diastolic blood pressure (as the heart relaxes).
During clinical this week, the student nurse got the opportunity of an observational experience in a Specialty Care Unit. The student was directed to the Surgical Intensive Care Unit (SICU) to observe a patient that was critically ill and receiving extensive treatment. The student observed a nurse caring for a patient while administering therapeutic hypothermia after cardiac arrest.
The treatment priorities of the registered nurse upon admission to the emergency department are as follows; within the first 10 minutes of Mr. Bronson’s arrival to the emergency department begin a 12 lead ECG. Assess Mr. Bronson’s vitals heart rate, blood pressure, respiratory rate, oxygen saturation, and administer oxygen 2-4 liters via nasal cannula (Sen, B., McNab, A., & Burdess, C., 2009, p. 19). Assess any pre hospital medications, and if he has done cocaine in the last 24 hours. At this time, the nurse should assess Mr. Bronson’s pain quality, location, duration, radiation, and intensity. Timing of onset of current episode that brought him to the emergency room, any precipitating factors, and what relieves his chest pain.