Many cardiac disorders such as myocardial infarctions are a common problem in the acute care setting. Thus it is essential for you, as the advanced practice nurse caring for acute patients, to identify potential signs and symptoms of complications. Although some cardiac disorders require outpatient treatment and management, other procedures such as CABGs or valve replacements are more common and frequently require major interventions. In your role with acute cardiac patients, you must evaluate symptoms and determine how to treat patients. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies.
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Liz is a 79-year-old female with a history of aortic stenosis and hypertension. The patient underwent elective aortic valve replacement yesterday. This AM during rounds, the patient is sitting up in the chair. Vital signs: 99.4-54-20-85/50. Pa 29/13, CVP10. Urine output 20 ml/hr for the last 3 hours. Cardiac output 3.9, cardiac index 1.8. Patient’s preop ef was 50%. Labs are as follows:
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- K 4.0
- Cr 1.5
- BUN 42
- Hgb 9.8
- Hct 29.1
- Plt 138
- Postoperative chest X-ray normal
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Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the cardiac disorder.
SAMPLE SOLUTION
Differential Diagnosis The possible differential diagnosis includes hypovolemia, hemorrhage, cardiogenic shock, acute kidney injury/acute tubular necrosis (ATN), or low cardiac output secondary to bradycardia, with the most likely diagnosis being low cardiac index secondary to | PLACE YOUR ORDER NOW AT writtask.com | fact that the patient has…
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