Any topic (writer’s choice)

Choose 1 of the following Discussion Topics and provide your answers using appropriate medical terminology

1. A patient who is 48 hours post mitral valve replacement surgery has become progressively more hypotensive, tachycardic, tachypneic, and restless over the past several hours. You suspect that the patient is going into shock.

a. Since this patient is at high risk for both cardiogenic and septic shock, how would you go about determining what type of shock (if any) is present? Support your approach.
b. What special challenges are associated with trying to treat septic shock in a patient with cardiovascular disease?

2. You are the quality improvement coordinator in the nursing home where you work. The director of nursing asks you to investigate and resolve the problem of inaccurate and inconsistent blood pressure (BP) measurements by staff members who have been hired in the past several months. Because of budget constraints, only medium adult size BP cuffs are available.

a. How would using the medium-size BP cuff affect the accuracy of a blood pressure taken in a small adult?
b. How would using the medium-size BP cuff affect the accuracy of a blood pressure taken in a large or obese adult?
c. What causes of blood pressure measurement errors could be addressed through staff education and training? Explain.

3. A patient who is 4 days post coronary artery bypass surgery reports that she is having new chest pain that is different from my angina pain. The pains onset was 5 or 6 hours ago upon first waking up in the morning. The patient has a new pericardial friction rub and a low-grade fever of 100.5F. The patient is diagnosed with acute pericarditis.

a.Why was this patient at risk for developing pericarditis?
b. Why is this patient now at risk for cardiac tamponade?
c. What are the signs or symptoms that would be indicative of cardiac tamponade in this patient? What is the underlying pathophysiology of these signs and symptoms?

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