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NUR 302 Nursing

Published : 07-Oct,2021  |  Views : 10

Question:

Write about the Peer evaluation.

Write about Student SM-MI and Catheterization Interventions.

Answer:

Peer evaluation

Student SM-MI and Catheterization Interventions

The case is based on a seventy eight years old patient, who had been admitted to the hospital with a diagnosis of acute myocardial infarction. He was also taken to the laboratory for heart catheterization.

The case study reveals that the patient was having high blood pressure. The other vital signs of the patients were considered to be a bit abnormal than the normal limits.

There are certain risks of cardiac catheterizations such as bruising, bleeding, stroke, arterial damage where the catheter was introduced, arrhythmias and anaphylactic reactions against the drugs.

A nurse should be able to record the vital signs of the patient daily.  The punctured site should be monitored for 4 hours until ambulation. Manual compression should be necessarily applied to prevent excess bleeding. In case of profuse bleeding it is advisable to stop the heparin treatment (Ackley et al., 2016). The nursing interventions regarding the issue provided in the paper was appropriate.

Seizures in older patient may bring up extra complications in older patients. To prevent seizures it is advisable to put up the side rails of the bed. Neurovascular assessments should be conducted in patients to prevent brain strokes and seizures. Prolonged bed rest may affect the skin and develop sores. Therefore it is necessary to provide proper padding and medications to prevent pressure injuries (Ackley et al., 2016). The case study shows that the patient did not suffer from any skin injury, which proves that the nursing interventions taken were effective. All the nursing interventions and the discharge plans that were taken in the paper were appropriate.

Student HM-DVT Clinical Analysis

This case study is about a patient of eighty years old, who was suffering from deep vein thrombosis (DVT). DVT is a common complication after a coronary stent placement. For the prevention of Deep vein thrombosis, patient care should involve graduated compression stockings and the use of pneumatic compression device along with the application of appropriate doses of anticoagulation agent (Goldhaber & Bounameaux 2012). A properly monitored post operative therapy along with physical interventions can prevent the formation of the deep vein thrombosis. The nurse did a commendable job to practice an evidence based method and find that the blood clot might have reached the heart leading to pulmonary embolism. The vital signs of the patient were monitored efficiently and shifts were found form the normal limits. Since the patient was suffering from acute respiratory distress, it is important that he should be provided with some respiratory aids. In this case the use of the nasal canulla has been appropriate (Goldhaber & Bounameaux 2012).

Medications like unfractionated heparin, low molecular weight heparin (LMWH), Warfarin and Fondaparinux can be given to treat DVT. Mechanical DVT prophylaxis can be appropriate if there is bleeding. The case study reveals that the nurse educated the patient regarding the signs of bleeding. A PPT lab value of 97.5 indicates that the patient's blood was taking longer time to clot. In such a case it is advisable to lower the doses of Heparin (Anthony, 2013).

Throughout the stay of the patient, a nurse should be alert about some of the signs like bleeding, shortness of breath, bloody sputum and rapid pulse. The diagnosis should be confirmed by doing a CT scan, pulmonary angiography and ventilation- perfusion lung scan (Anthony ,2013).

A patient should be kept under a continuous follow up. They should be imparted education regarding the intake of medications. They should be explained that certain foods reacts with Warfarin and can decrease the anticoagulant effect (Anthony, 2013)

Thus it can be said that imparting education to the patients and families assists in ensuring a complete discharge plans. In this case study the nursing diagnosis provided by the nurses was appropriate for the patient.

References

Ackley, B. J., Ladwig, G. B., & Makic, M. B. F. (2016). Nursing Diagnosis Handbook-E-Book: An Evidence-Based Guide to Planning Care. Elsevier Health Sciences.

Anthony, M. (2013). Nursing assessment of deep vein thrombosis. Medsurg Nursing, 22(2), 95.

Goldhaber, S. Z., & Bounameaux, H. (2012). Pulmonary embolism and deep vein thrombosis. The Lancet, 379(9828), 1835-1846.

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