Assessment Of Cardiac Status
Esther Jackson is a 56-year-old black female who is 1-day post-op following a left radical mastectomy. During morning rounds, the off-going nurse shares with you during bedside report that the patient has been experiencing increased discomfort in her back throughout the night and has required frequent help with repositioning. She states that the patient was medicated for pain approximately 2 hours ago but is voicing little relief and states that you might want to mention that to the doctor when he rounds later this morning. With the patient appearing to be in no visible distress, you proceed on to the next patient’s room for report.
Approximately 1 hour later, you return to Ms. Jackson’s room with her morning pills and find her slumped over the bedside stand in tears. The patient states, “I don’t know what is wrong, I don’t feel right. My back hurts and I’m just so tired. What is wrong with me?” The patient refuses to take her medications at this time stating that she is starting to feel sick to her stomach.
Just then the nursing assistant comes into the patient’s room to record Ms. Jackson’s vital signs, you take this opportunity to quickly research the patient’s medication record to determine if she has a medication ordered for nausea. Upon return, the nursing assistant hands you the following vital signs: T 37, R 18, and BP 132/54, but states she couldn’t get the patient’s pulse because “it is all over the place.”
Please address the following questions related to the scenario.
- What do you suspect is the cause of the patient’s symptoms?
- Describe the course of action that you will take to confirm this suspicion and prevent further decline.
- What further assessments, lab values, and tests will likely be ordered for this patient and how often? If testing is to be completed more than once, please explain the rationale for doing so.
- While you are caring for this patient, how will you ensure that the needs of your other patients are being met
What entails assessment of Cardiac Status?
- Medical history: This includes information about the patient’s family history of heart disease, any past or current medical conditions, surgeries or hospitalizations, and medications.
- Physical examination: This involves listening to the heart sounds with a stethoscope, checking the pulse, blood pressure, and assessing the overall appearance of the patient.
- Electrocardiogram (ECG or EKG): This is a non-invasive test that measures the electrical activity of the heart, which can provide information about heart rhythm and any potential abnormalities.
- Echocardiogram: This is a non-invasive imaging test that uses sound waves to create pictures of the heart, which can help assess its structure and function.
- Stress test: This involves monitoring the heart’s response to exercise or medication-induced stress, which can help evaluate its ability to handle physical activity.
- Blood tests: These tests can provide information about cholesterol levels, blood sugar levels, and other factors that can impact cardiovascular health.
Depending on the results of these tests, additional assessments or referrals to specialists may be necessary. The goal of a cardiac assessment is to identify any potential issues early on so that they can be treated promptly to prevent further complications and promote better cardiovascular health.
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