Question

Write a response and submit your paper with your name on it in the Dropbox on D2L. 1) Review video link on CPR (10 points) • List one safety feature before starting CPR 2) Read Chapter one from ATI Fundamentals for Nursing Review Module on D2L, then read the case study about the 64-year-old-mam. • From the emergency department, what level of care should the patient be transferred to next? (20 points). • Review Maslow's hierarchy of needs and list two physiological needs for the 64-year-old man (20 points each). Case Study A 64-year-old man presented to the emergency department (ED) after sudden cardiac arrest. He lived in a suburb of a medium-sized midwestern city with his wife and worked as a branch manager for a bank. The nearest hospital was 7 miles away and emergency medical technicians (EMTs) were based at a fire station 4 miles from his home. Past medical history included hypertension, elevated total serum cholesterol, and osteoarthritis of the knees. At previous baseline, he could walk up to 4 blocks but felt short of breath with this degree of effort or when climbing 2 flights of stairs. This pattern had been stable for the past 6 months. He had never experienced chest pain. He had no history of palpitations, syncope, or presyncope. He attributed his shortness of breath to "deconditioning" but had not yet discussed this symptom with his internist. Medications included hydrochlorothiazide 12.5 mg orally once daily (a blood pressure medication), lisinopril 20 mg orally once daily (blood pressure and heart), atorvastatin 10 mg orally once daily (cholesterol lowering medication), and naproxen 375 mg orally twice daily as needed for pain. He had no known drug allergies. He had smoked 1 pack of cigarettes per day for 30 years, but stopped 5 years ago. He had required no previous surgeries. His wife had purchased a home defibrillator 2 months earlier after seeing a newspaper article about its availability. She requested a prescription for the device from her primary care physician. The patient had not discussed this purchase with his own physician.

Chain of Survival - Level of Care For adult patients who are in the hospital, cardiac arrest usually happens as a result of serious respiratory or circulatory conditions that get worse. Many of these arrests can be predicted and prevented by careful observation, prevention, and early treatment of prearrest conditions. Once a primary provider recognizes cardiac arrest, immediate activation of the resuscitation team, early high-quality CPR, and rapid defibrillation are essential. Patients depend on the smooth interaction of the institution’s various departments and services and on a multidisciplinary team of professional providers, including physicians, nurses, respiratory therapists, and others. After return of spontaneous circulation (ROSC), all cardiac arrest victims receive post-cardiac arrest care. This level of care is provided by a team of multidisciplinary specialists and may occur in the cardiac catheterization suite and/or ICU.

Answer 1

** Keep the attach automated external defibrillator (AED) ready at the site incase if the patient not responding to CPR..

** Emergency department always should be alert with all emergency equipment and medication with 24hours available doctors and nurses..

** There should be blue code alert team when patient present with cardiac arrest..

** Rehabilitation and resuscitation team should be available in ICU..

As per Maslow's hierarchy physiological needs for this patient with this condition

- he need cardiac pulmonary resuscitation with automated external defibrillator support..

- anti- arrhythmia drugs should be administer immediately..

- patient should be hospitalized immediately as he is living 7miles away from hospital..

- necessary oxygen should be administered immediately to meet the ventilation..

- connect cardiac monitor

- take ECG before and after the CPR.

- post CPR care should be given immediately to the patient..

- clear the airway in case any fluid accumulation.

- cardiac catheterization may needed as per the severity.

- all necessary action should be taken when providing CPR..team should be alert with required members.

- continue CPR till the patient condition stabilize.

- if you use defibrillator take measures before you apply it.

- make sure normal heart rhythm resume

- patient should be evaluated for further investigation once he stabilized..

- see the patient response after he recover from the condition

- maintain fluid level and monitor cardiac rhythm continuously..

- when providing defibrillator loosen the dress and avoid metal objects contact with patient..

- remove all the sharp objects from the patient..

- take precaution to protect the patient from burns..

- when providing defibrillator never touch anybody..

- keep catheterization room ready for immediate treatment..