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In: Nursing

Which eight interventions should you be prepared to initiate?

L.V. is a 68-year-old male admitted to the coronary care unit 24 hours ago with an anteroseptal myocardial infarction (MI). His past medical history includes two other MIs within the last 5 years, obesity, hypertension, hyperlipidemia, and sleep apnea. L.V. had chest pain at home for 12 hours before seeking medical treatment. Lab results note troponin I at 5.2 mcg/L. L.V. is currently pain free with stable VS. The heart monitor shows sinus rhythm with occasional, unifocal premature ventricular contractions and a heart rate (HR) in the 90s. His blood pressure (BP) is 130/70, respiratory rate (RR) is 24 breaths/minute and O2 saturation is 93% on O2 via nasal cannula at 2 L/min. He has a heparin drip infusing at 1200 U/hr and IV nitroglycerin infusing at 20 mcg/min. You are assigned to care for L.V. as part of a two-patient assignment. Question 4: Unfortunately, L.V. quickly begins to deteriorate and displays symptoms of progressive cardiogenic shock. His BP is 84/50, HR 132, RR 30, temperature 36° C, and oxygen saturation 89% in spite of supplemental oxygen. As his health care provider is notified,

Which eight interventions should you be prepared to initiate?

Solutions

Expert Solution

The emergency management focuse don life saving methods.

  1. Oxygen is needed,by ventilator support.
  2. Fluid and plasma resuscitation.
  3. Ionotropic agents.
  4. Aspirin
  5. Thrombolytics.
  6. Norepinephrine
  7. Dopamine support.

The management mainly focused on

  • Oxygen administration to avoid tissue necrosis.
  • Angioplasty and stenting
  • Ballot pump.
  • Pain control
  • Hemodynamoc monitoring.
  • Fluid therapy.
  1. Assess the vital signs of the patient.
  2. Assess the fluid level of the patient, ventricles fail to eject the blood during systolic leads to accumulate fluid in the lungs.
  3. Prevent recurrence - Identify the risk cases
  4. Hemodynamic management - Arterial line must be maintained,cardiac monitoring must be continued.Assess breath sounds.
  5. Fluid management
  6. Intra aorta Ballon counter pulsation.
  7. Arterial blood gas analysis.

Nightingale answered 2 years ago
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