70-year-oldfemale patient transported to the ED via EMS. Full code, past medical history:Angina,dyslipidemia, Diabetes type 2., NKA/NKDA. VS: Temp. 97, HR 150 and irregular/irregular, BP 80/60, O2 Sats. 80% on room air, now 90% on 6L HFNC.Husband with the patient.
You place 12 lead on the patient and note ST elevation and the patient complains of 8/10 left shoulder pain radiating down her arm. Immediately after you do a point of care blood glucose test (results 125) the patient goes into v. fib. and you call the code. CPR is commenced and the code lasts 15 minutes. The patient is defibrillated and regains a pulse. She is immediately transported to the cath. lab. You accompany the patient and observe insertion of cardiac stents.
Full Code02 HFNC titrate prnEKG STATPOCT BG STATDopamine 50mcg/kg/min. IVEpinephrine (1:1000) 1 mg IVP STAT, may repeat q 3-5 min x 2Amiodarone 300 mg IVP STATLisinopril 20mg PO dailyMetoprolol 100mg PO dailySpironolactone 100mg PO dailyLipitor 20mg PO dailyMetformin 500mg PO BIDAspirin 81mg PO dailyNitroglycerine spray 400mcg SL.May repeat q 5 minutes x 2Docusate 200mg PO BIDDiazepam/Valium 2mg PO qid prnMorphine 2mg IVP/IVPB q4h prnMidazolam 2.5mg IV pre-procedure, repeat q 5-15 minutes prn during procedureFentanyl 25mcg IV pre-procedure, then 25mcg q 5 prn during procedureWHAT TO DO
From the information provided in the case study for patient with MI, as a nurse handing over to the next nurse
write out a pre-shift report using the SBAR toolWrite out the discharge planning for this patientWrite out the teachings for this patient.
The post Clinical Scenario