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*NURSING > STUDY GUIDE > NURS6560 Week2 NURS 6560 Week 2 IHuman Completed for 2022/2023 (All)

NURS6560 Week2 NURS 6560 Week 2 IHuman Completed for 2022/2023

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NURS6560-WK2 I-Human Primary Diagnosis: Thoracic Aortic Dissection Status/Condition: Guarded/Critical Code Status: Full Code Allergies: No Known Allergies Admit to Unit: Cardiovascular ICU or Cor ... onary ICU Activity Level: Bedrest Diet: NPO IVF: 0.9% Saline at 75 ml/hr with close monitoring Critical Drips: Start Osmolol 2 g/100 mL IV to keep SBP between 110-120 mm Hg and HR between 60- 70 bpm Respiratory: Apply oxygen via nasal cannula to keep O2Sats >92% Medications: Morphine Sulphate 2-4 mg IV q30min PRN chest pain Discontinue Lisinopril Hold ASA and Lopressor Nursing Orders: Start 2 large bore peripheral IV’s Insert foley catheter for strict I&O’s Continuous HR, BP, and SPO2 monitoring Record vital signs per unit protocol Stat EKG with chest pain Strict bedrest Strict I&O’s Follow Up Lab tests: Troponin q3h X3, CBC, CMP, PT/PTT, type and cross, lactate Post-Admission Diagnostic testing: Chest CT or chest MRI, Echocardiogram, bedside cardiac ultrasound Consults: Stat cardiovascular consult for possible emergent surgery Patient Education and Health: Pamphlet explaining disease progression, pre- and post- surgery education and expectations Smoking cessation Cardiac rehabilitation Discharge planning and required follow-up care: Care management consult for discharge planning Discharge to home vs rehabilitation facilityReferences Black, J., Manning, W.J. (2019). Management of acute aortic dissection. Up-To-Date. Retrieved from https://www.uptodate.com/contents/management-of-acute-aortic-dissection Borloz, M. (2016). Thoracic aortic dissection. Clerkship Directors in Emergency Medicine. Retrieved from https://saem.org/cdem/education/online-education/m4-curriculum/group-m4- cardiovascular/thoracic-aortic-dissection Shono, Y., Akahoshi, T., Mezuki, S., Momii, K., Kaku, N., Maki, J., Tokuda, K., Ago, T., Kitazono, T., & Maehara, Y. (2017). Clinical characteristics of type A acute aortic dissection with CNS symptom. American Journal of Emergency Medicine, 35, 1836-1838. DOI: 10.1016/j.ajem.2017.06.011 Strayer, R.J., Shearer, P.L., & Hermann, L.K. (2012). Screening, evaluation, and early management of acute aortic dissection. US National Library of Medicine, National Institutes of Health, 8(2), 152-157. DOI: 10.2174/157340312801784970 [Show More]

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