Question

describe potential complication in patients with decreased cardiac output

identify cardiac code protocal, inclusive of medications

apply the framework for management of patient with inflammatory/infections of the heart

identify potential complication of CVADs and apply nursing process when providing care to client with a CVAD

Answer 1

Answer: A high afterload can be the cause of a low-cardiac-output state (eg, systemic hypertensive crisis or aortic stenosis). These patients can present with very high blood pressure or normal or low blood pressure, evidence of poor peripheral perfusion, and pulmonary edema. They need their afterload reduced.

Advanced cardiac life support or advanced cardiovascular life support (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.

Pericarditis is an inflammation of the lining surrounding the heart (the pericardial sac). Pericardial effusion is a collection of fluid in the pericardial sac. This fluid may be produced by inflammation. The cause of pericarditis in most individuals is unknown but is likely due to a viral infection.

The treatemnt for myocarditis are:

• corticosteroid therapy (to help reduce inflammation)
• cardiac medications, such as a beta-blocker, ACE inhibitor, or ARB.
• behavioral changes, such as rest, fluid restriction, and a low-salt diet.
• diuretic therapy to treat fluid overload.
• antibiotic therapy.

Central venous access devices are small, flexible tubes placed in large veins for people who require frequent access to the bloodstream. Central venous access devices are often referred to as venous access ports or catheters, because they allow frequent access to the veins without deep needle sticks. CVADs place patients at risk for local and systemic infectious complications, including local site infection because CVADs remain partially exogenous to the body, CVAD failure may also occur as a result of dislodgement and breakage. Breakage of a CVAD is most commonly due to the use of excessive force, causing a split in the structure of the device, as a result of drag from multiple heavy infusion tubes.

If bleeding, haematoma at insertion site occurs then apply pressure to vein insertion site until bleeding stops. If bleeding continues or is excessive, notify medical team. Consider investigating coagulopathy. Malposition is verify placement using X-ray, transducer waveform and/or blood gas. CVAD insertion site is assessed every shift for early signs of infection and this is documented. Check insertion sites visually when changing the dressing or by palpation through an intact dressing. If patients have tenderness at the insertion site, fever without obvious source, or other manifestations suggesting local or bloodstream infection, the dressing should be removed to allow thorough examination of the site.