Cardiac Arrhythmia - The Pathophysiology of Acute Pulmonary Oedema - Nursing Assignment Help

Assignment Task:

Case Study One: Mr Curtis 

You are caring for Mr Curtis, a 69-year-old man who has been admitted for a routine laparoscopic cholecystectomy. He has a medical history of hypertension and angina over the last year that has previously responded to treatment with GTN spray. 

Question 1: Cardiac Arrhythmia 

When performing your observations after Mr Curtis returned from theatre 6 hours ago, you find that Mr Curtis has an irregular heart rate (HR). You take an Electrocardiogram (ECG) and see the following cardiac rhythm and manually record a pulse rate of 135 bpm. 

a) Interpret and explain the above cardiac rhythm 

b) Discuss three (3) potential reasons for this cardiac rhythm to occur 

c) Discuss three (3) treatment options for a patient in this cardiac rhythm 

Question 2: Pathophysiology and treatment 

You notice that Mr Curtis is coughing and short of breath. His respiratory rate (RR) is 26, his SaO2 is 91% on RA and Blood Pressure (BP) is 170/80. The met call team has requested a chest X-Ray and an Arterial Blood Gas, suspecting Acute Pulmonary Oedema (APO). The results are as follows: 

ABG Normal Range 

pH 7.33 7.35 - 7.45 

PaO2 68 80 – 100 mmHg 

PaCO2 58 35 – 45 mmHg 

HCO3- 25 22 – 28 mmol/L 

SaO2 91% 95 – 100% 

a) Provide a basic interpretation of the above ABG results and explain if these results support the diagnosis of Acute Pulmonary Oedema 

b) Discuss the pathophysiology of Acute Pulmonary Oedema 

c) Discuss the medical and nursing interventions generally for a patient in APO and specifically for Mr Curtis, taking into account the ABG and vital signs stated above. 

Question 3: Patient Assessment with a respiratory focus 

You are providing a handover to the RN on the night shift. 

a) Describe and outline each component of a secondary survey assessment 

b) Discuss three (3) respiratory signs and symptoms of APO and why they occur including the assessment and monitoring techniques that can be used for Mr Curtis throughout the night shift 

Case Study Two: Mrs Graham 

You are caring for Mrs Graham, a 78-year-old woman who has been on the ward for two days following an anterior resection for bowel CA. She has a history of COPD. 

Question 1: Cardiac Arrhythmia 

Mrs Graham tells you that she is having intermittent chest palpitations. You take an Electrocardiogram (ECG) and see the following cardiac rhythm: 

a) Interpret and explain the above cardiac rhythm strip 

b) Discuss three (3) potential reasons for this cardiac rhythm to occur 

c) Discuss three (3) treatment options for a patient in this cardiac rhythm

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