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NURS 6560: Advanced Practice Care of Adults in Acute Care Settings II | Week 4
After experiencing severe chest pain and shortness of breath, Edward Richardson underwent surgery for coronary artery disease. Before surgery, he felt anxious and had trouble sleeping, as do many surgical patients with cardiovascular conditions. To relieve his concerns, his health care providers developed a pre-operative care plan that included breathing and relaxation exercises. To ensure a full recovery, his post-operative care plan included changes to his diet, exercise, and lifestyle (Northwestern Medicine, 2014). As an advanced practice nurse who cares for surgical patients like Edward, you must assess patient needs and provide individualized care plans to patients throughout the perioperative period.
This week, as you study the pre- and post-operative care of patients with cardiovascular conditions, you examine strategies for assessment, diagnosis, and treatment.
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Learning Objectives
By the end of this week, students will:
- Evaluate medical and surgical patients with cardiac conditions
- Develop differential diagnoses for medical and surgical patients with cardiac conditions
- Develop treatment plans for medical and surgical patients with cardiac conditions
NURS 6560 Week 4: Patients With Cardiovascular Conditions essay assignment
Discussion Part : Assessment and Care of Patients With Cardiovascular Conditions
Many cardiac disorders such as myocardial infarctions are a common problem in the acute care setting. Thus it is essential for you, as the advanced practice nurse caring for acute patients, to identify potential signs and symptoms of complications. Although some cardiac disorders require outpatient treatment and management, other procedures such as CABGs or valve replacements are more common and frequently require major interventions. In your role with acute cardiac patients, you must evaluate symptoms and determine how to treat patients. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies.
Case Study 1
Tom is 56-year-old African American male who presented to the ED with chest pain radiating to his back. The pain has been continuous for 1 hour. The patient complains of shortness of breath. The pain has not been relieved with rest. The patient’s vitals are: 99.1-98-18-198/110. The patient’s cardiac enzymes are negative. Labs results are as follows:
- Na 134
- K 4.1
- Cr 1.8
- BUN 42
- Glucose 248
- WBC 13.1
- Hbg 14.1
- Hct 44.2
- Plt 236
- EKG sinus rhythm no ekg changes
Case Study 2
Liz is a 79-year-old female with a history of aortic stenosis and hypertension. The patient underwent elective aortic valve replacement yesterday. This AM during rounds, the patient is sitting up in the chair. Vital signs: 99.4-54-20-85/50. Pa 29/13, CVP10. Urine output 20 ml/hr for the last 3 hours. Cardiac output 3.9, cardiac index 1.8. Patient’s preop ef was 50%. Labs are as follows:
- K 4.0
- Cr 1.5
- BUN 42
- Hgb 9.8
- Hct 29.1
- Plt 138
- Postoperative chest X-ray normal
Case Study 3
Arvid is a 69-year-old male you are seeing in CCU 1 hour after he had a CABG × 4. The patient is intubated. VS: 97.1-78-14-90/50. PA 30/13, CVP 12. ABG 7.21-49-98-19.6-99%- -6 base deficit. Mixed venous O2 sat 68. Hgb 10.2, Hct 32.1. The patient is sedated. Vent settings FiO2 50%, IMV 12, PEEP 5, tidal volume 550.
To prepare:
- Review and select 1 of the 3 case studies provided. Analyze the patient information.
- Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
- Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
- Consider strategies for educating patients and families on the treatment and management of the cardiac disorder.
NURS 6560 Week 4: Patients With Cardiovascular Conditions essay assignment
By Day 3
Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the cardiac disorder.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on 2 different days in both of the ways listed below. Respond to colleagues who selected different case studies from yours.
Assignment : Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Cardiovascular Conditions
Surgeries to treat cardiovascular conditions are among the most common procedures. Because of the risks that are often associated with these procedures, the perioperative period can be a critical time for patients. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat pre- and post-operative patients who present with cardiovascular conditions.
To prepare:
- Review this week’s Learning Resources. With cardiovascular conditions in mind, consider how to assess, diagnose, and treat patients in pre- and post-operative care.
- Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.
- Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
- Identify three to five possible conditions to consider in a differential diagnosis for the patient.
- Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
- Develop a treatment plan for the patient that includes health promotion and patient education strategies for medical and surgical patients with cardiac conditions.
To complete:
As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Patients Case Player Student Manual in the Week 2 Learning Resources.