Interventions for Heart Attack Nursing Essay

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Nursing Concept Map for NURS 412/422Client Age and Gender: 62 F Weight: 105 kg Height/Length: n/a Allergies: morphine, percocetReason for Admission: Cardiac arrest with subsequent anoxic brain injuryPertinent History/Information: Refused last dialysis treatment, collapsed at dialysis facility, received CPR and AED shocks, given epinephrine en route, has had all COVID vaccines, on Zofran, Plavix, TrazodonePriority Concept #1: Airway/BreathingPriority Concept #2: Circulation/Hemodynamic StabilityPriority Concept #3: Neurological StatusOutcome: Patient will maintain a patent airway and adequate oxygenationPatient will demonstrate stable hemodynamics and adequate tissue perfusionPatient will maintain the highest possible level of consciousness and neurological functionSystem Specific Assessment:1. Respiratory rate and pattern2. Oxygen saturation levels3. Breath sounds4. Presence of any respiratory distressSystem Specific Assessment:1. Blood pressure2. Heart rate and rhythm3. Capillary refill4. Peripheral pulsesSystem Specific Assessment:1. Glasgow Coma Scale (GCS)2. Pupil size and reactivity3. Motor and sensory function4. Level of consciousnessInterventions: The nurse will…1. Monitor respiratory status every 2 hours2. Administer supplemental oxygen as ordered3. Position patient to optimize ventilation4. Prepare for emergency intubation if indicatedInterventions: The nurse will…1. Monitor vital signs every hour2. Administer IV fluids as ordered3. Administer vasoactive medications as ordered4. Assess for bleeding due to anticoagulation therapInterventions: The nurse will….1. Perform neurological checks every 2 hours2. Maintain elevated to decrease intracranial pressure3. Administer sedation as ordered to prevent agitation4. Protect patient from injury due to altered mental statusOutcome Criteria: The patient will….1. Demonstrate normal resp rate limits2. Maintain oxygen saturation >94%3. Exhibit clear breath sounds bilaterally4. Show no signs of respiratory distressOutcome Criteria: The patient will…1. Maintain blood pressure within parameters2. Have heart rate between 60-100 bpm3. Exhibit capillary refill of less than 2 seconds4. Have strong and equal peripheral pulsesOutcome Criteria: The patient will….1. Maintain GCS score as per baseline or improve2. Have pupils equal, round, and reactive to light3. Retain or regain baseline motor and sensory function4. Exhibit no unexplained decrease in level of consciousnessMedications R/T Concept Above:Zofran (for nausea prevention which can affect breathing comfort)Medications R/T Concept Above:Plavix (as part of the antiplatelet therapy)Medications R/T Concept Above:Trazodone (consider holding if patient is not fully conscious)Labs for Above Outcome:Arterial blood gases (ABGs), Complete blood count (CBC)Labs for Above Outcome:Troponin levelsElectrolytes (Potassium, Sodium, Calcium)Coagulation profile (if on anticoagulant)Labs for Above Outcome:Serum glucoseSerum ammonia…

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…to evaluate the cause of fluctuations in consciousness.

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Priority Lab/Procedures Results/Interpretations Nursing Indications (Pre & Post)· Arterial Blood Gases (ABGs) - Results indicated adequate oxygenation with current oxygen therapy. Assess the patient's respiratory status and oxygenation . pH 7.35, PaCO2 45 mmHg, PaO2 80 mmHg, HCO3- 24 mEq/L: These results suggest adequate ventilation and oxygenation at the current oxygen therapy settings.· Troponin Levels - Results were within normal limits, no indication of myocardial injury. Evaluate the patient for any signs of chest pain or discomfort. Troponin I

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