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1. Cardiac Arrhythmia a. Interpret and explain cardiac rhythm · Heart rate- tachycardia · Heart rhythm- irregularly irregular (atrial fibrillation) detected by the r-r interval measurement · Axis ·...

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1. Cardiac A
a. Interpret and explain cardiac rhythm
· Heart rate- tachycardia
· Heart rhythm- i
egularly i
egular (atrial fi
illation) detected by the r-r interval measurement
· Axis
· Hypertrophy
· Intervals
· P wave- p wave was unidentifiable in the given ECG
· QRS complex
· ST segment- T wave
· PR interval- should be XXXXXXXXXXms XXXXXXXXXXsec) that equals to 3-5 small ECG squares
. Potential reasons for this cardiac rhythm
c. Three treatment options
2. Pathology and treatment
a. Interpretation of the ABG findings
· Lower saturation- lower gas exchange, APO (acute pulmonary oedema)
· Low pH level means more acidic
· ROME (respiratory opposite and metabolic equal) acronym. In this case study, blood results show pH 7.33 that was less than normal. It also shows PaCO2 level was 58mmHg that was higher than the normal PaCO2 level. From these findings it can be indicated that patient was having respiratory acidosis as the pH and PaCO2 a
ows move in opposite directions.
. Pathophysiology of acute pulmonary oedema
c. Medical and nursing interventions for the patient with APO, with ABG and vital signs listed in case study
· Positioning
· Aspirin
· 12 lead ECG
3. Systematic Patient Assessment (handover)
a. Secondary survey
· History- medical history of hypertension and angina treated and well responded to GTN. Nil known past surgical and family history
· Body system assessment-
· Central nervous system,
· Cardiovascular system- tachycardia and blood pressure 170/80
· Respiratory assessment findings indicate the presence of shortness of
eath, coughing, tachypnoea (26
eaths/min) and 91% oxygen saturation on room air. Skin integrity
· Gastro-intestinal system- cholecystectomy,
· metabolic system,
· Renal,
· musculoskeletal system,
· Integumentary
· Nil known medication allergies
· Social history
· Mental health
· Advance care plan
. 3 Respiratory sign and symptoms of APO, assessment and monitoring techniques to be used by the night shift staff
Impaired gas exchange manifested by the O2 saturation, higher respiration rate of 26
eaths/min, shortness of
eath, coughing.
Appropriate positioning throughout the night shift.
Assessing the O2 levels
Articles- Medical and nursing management in af management articles
(Szymański, Lip, & Filipiak, 2016).
Management of apo with GTN (Hsieh, Lee, Kao, Hsu, & Chong, 2018).
APO (Powell, Graham, O'Reilly, & Punton, 2016)
Managing acute pulmonary oedema (Purvey & Allen, 2017)
Af and ecg(Jonas et al., 2018)

Hsieh, Y.-T., Lee, T.-Y., Kao, J.-S., Hsu, H.-L., & Chong, C.-F XXXXXXXXXXTreating acute hypertensive cardiogenic pulmonary edema with high-dose nitroglycerin. Turkish Journal of Emergency Medicine, 18(1), XXXXXXXXXXdoi:10.1016/j.tjem XXXXXXXXXX
Jonas, D. E., Kahwati, L. C., Yun, J. D. Y., Middleton, J. C., Coker-Schwimmer, M., & Asher, G. N XXXXXXXXXXScreening for Atrial Fi
illation With Electrocardiography: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA, 320(5), XXXXXXXXXXdoi:10.1001/jama XXXXXXXXXX
Powell, J., Graham, D., O'Reilly, S., & Punton, G XXXXXXXXXXAcute pulmonary oedema. Nursing standard (Royal College of Nursing (Great Britain) : 1987), 30(23), 51. doi:10.7748/ns XXXXXXXXXXs47
Purvey, M., & Allen, G XXXXXXXXXXManaging acute pulmonary oedema. Australian prescriber, 40(2), 59. doi: XXXXXXXXXX/austprescr XXXXXXXXXX
Szymański, F. M., Lip, G. Y. H., & Filipiak, K. J XXXXXXXXXXManagement of atrial fi
illation in specific patient populations. Kardiologia polska, 74(1), 1. doi:10.5603/KP.a XXXXXXXXXX
Amandeep Kaur Sandhu    Student ID XXXXXXXXXX    Assignment 1: Case Study
Answered Same Day Aug 17, 2021


Popi answered on Aug 18 2021
128 Votes
Health care        1
Health care
1.    Cardiac A
hythmia    3
a.    Interpret and explain cardiac rhythm    3
.    Potential reasons for this cardiac rhythm    4
c.    Three treatment options    5
2.    Pathology and treatment    6
d.    Interpretation of the ABG findings    6
e.    Pathophysiology of acute pulmonary oedema    6
f.    Medical and nursing interventions for the patient with APO, with ABG and vital signs listed in the case study    8
3.    Systematic Patient Assessment (handover)    8
g.    Secondary survey    9
h.    Three respiratory sign and symptoms of APO, assessment and monitoring techniques to be used by the night shift staff    10
4.    References    11
Cardiac A
Interpret and explain cardiac rhythm
The proper interpretation of the cardiac rhythm is one of the most important parts of the emergency medical services. The four-chambered heart is generally made up of two receiving chambers named atria and two pumping chambers they are called ventricles. The cardiac rhythm is generally counted as the number of electrical impulses that are generally represented by PQRST (Jonas, Kahwati, Yun, Middleton, Coker-Schwimmer, & Asher, 2018). The number of P waves generally indicates the atrial rate and the QRS complex acts as an indicator of ventricular rate. Various methods are available in case of determining the cardiac rhythm. A
ief explanation is being given below to describe the cardiac rhythm
· Heart rate tachycardia
· Heart rhythm i
egularly, i
egular (atrial fi
illation) directed by the r-r interval measurements
· Axis
· Hypertrophy
· Intervals
· P wave - p wave was unidentifiable in the given ECG
· QRS complex
· ST-segment- T wave
· PR interval should be 120-200 ms (0.12-0.20 sec) that equals to 3-5 small ECG squares
ECG tracking generally explains the condition of the heart. The rate of heart as well as the regulatory or regulatory face of the rhythm can also be detected by this process. From the above interpretation, the general overview for both the atrial and ventricular rates can be calculated. Generally, both the atrial and ventricular rates remain the same. the normal heart rate in most of the cases falls between 60-100 beats/ min. In abnormal cases, the heart rates generally deflect from the normal range. The R-R intervals and the P-P intervals remain regular in the normal cases and there should be one P for every QRS (Petty 2016). All the P waves are needed to be pointed in the same direction and they should be upside and rounded in the normal cases. All QRS complexes are needed to be in equal duration and the R-R interval between each QRS is needed to be regular.
Potential reasons for this cardiac rhythm
· High blood pressure
· Valve disorders
· Cardiomyopathy ( changes in the heart muscle)
· Severe injury due to a heart attack
· Coronary artery disease
· Imbalances of electrolyte in the blood (sodium, potassium)
If the coordinator of electrical impulses of the heart gets disrupted, the heart a
hythmias occu
ed. The i
egular heartbeat such as a very fast or very slow rate can be observed. The cardiac a
hythmia can be considered as a life-threatening severe condition and is needed to be taken care of properly. An increasing rate of heartbeat such as greater than 100 beats/ min refers to tachycardia. On the other hand, the slow heart rate is less than 60 Beats/min is termed as
adycardia. Atrial fi
illation is also a stage of rapid heart rate. This is generally caused by chaotic electrical impulses in the atria. These chaotic electrical signals generally create pressure on AV notes. This results in i
egular and rapid rhythm in the ventricles. There is another type of i
egular heart condition that can be seen, called atrial flutter. This is also caused due to more rhythmic electrical impulses and leads to severe complications such as stroke. Supraventricular tachycardia is also a severe form of cardiac a
hythmia. This supraventricular tachycardia acts on the AV nodes and many times it causes sudden episodes of palpitations.
Three treatment options
· Cardioversion - in the case of treatment of the various types of a
hythmia such as atrial fi
illation, most of the cases use of cardioversion can be observed. By adopting proper medications and precaution this process can be performed. In this case, a shock is being delivered through paddles on the chest of the patients. This cu
ent may affect the electrical impulses of the heart and also most of the time can restore the normal rhythm.
· Vagal maneuvers- in this case, supraventricular...

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