Nursing Case

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Ms. F. is a 45-year-old female who came into the emergency department with complaints of chest pain and a “racing heart.” She notes that she has lost 15 pounds in the past two months but eats constantly. On initial assessment, she is noted to have a heart rate of 170 beats per minute (QRS duration is 0.06 sec), blood pressure of 179/109 mm Hg, and an audible S3. The physician attempts vagal maneuvers, which are ineffective. She remains tachycardic. Because of her tachycardia, anxious behavior, and obvious bulging of her eyes, hyperthyroidism is suspected. A thyroid panel of laboratory tests is ordered. Ms. F’s cardiac troponin levels are elevated, and a cardiac catheterization is ordered.

Discussion:

Given the potential hyperthyroidism, which drugs might be used to control her cardiac rhythm, and which should be avoided?
What are the top priorities of care for this patient?
Should the nurse be concerned about the cardiac catheterization?
What complications might the nurse anticipate?

Sample Solution

ditional techniques for pre-usable sustenance are a consolation of short-term fasting. This model was remembered to forestall any gamble of goal while there is an endotracheal tube in the aviation route for breathing during intubation during surgery.5 There is likewise a worry that the food in the gastrointestinal plot may likewise turn into a gamble factor assuming their entrail is punctured during surgery.5 There is a disadvantage to this too like uneasiness from thirst, craving, cerebral pains, and tension for the patient as they can’t eat for a drawn out period.5 However, most recent examinations mirror that the admission of clear liquids taken up until two hours before sedation doesn’t expand the gastric volumes.3 As numerous surgeries are being modified to be finished as negligibly obtrusive and laparoscopically, the general mending time has expanded fundamentally in both conventional and ERAS careful procedures.6

Different parts of customary medical procedure are to increment pee yield, in this way, intravenous liquids are regulated generously to yield fifty milliliters an hour or more.7 Additional techniques for yield measures are the usage of catheters, seepage of the careful site, and a nasogastric cylinder to deplete any entrail contents. The adjustment of careful strategies from conventional to ERAS techniques, similar to the expulsion of catheters and diminished medicine organization, have been useful for those using 80% of ERAS practices or more. In any case, there is still loads of protection from change customary practices due to the overall obscure possible impacts of ERAS in careful subsets that poor person had ERAS preformed before.6

Medical procedure and Nutritional Status
Risk evaluations are involved upon confirmation for patients to survey the wholesome status. This is searching for the gamble of unhealthiness pre-operatively through two different appraisal screenings.

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