Discussion 9.1 – Case
Study One

A 72 year old woman is transported to the ED with a
diagnosis of chest pain to rule out myocardial infarction MI. During the
initial assessment the nurse notes the cardiac rhythm changes from sinus
tachycardia to ventricular tachycardia VT with a pulse. Her vital signs are 84/40,
pulse 154 and respirations 30.

What is the initial treatment for this patient at this time?

What drugs should you anticipate administering to this
patient? Why are they indicated?

What evidence-based precautions must be taken to promote
safety for both the patient and the ACLS team?

If this rhythm deteriorates to ventricular fibrillation or
VT without a pulse, what steps should you take? Why?

Discussion 9.2 – Case
Study Two

At a recent staff meeting, the medical-surgical nurse
manager reports that the rate of repeated hospitalizations for patients with
chronic heart failure has increased 50% in the past 3 months. As a staff nurse
you agree to be part of the unit quality improvement team to examine the causes
of the increase and make evidence-based recommendations for improving the
outcomes for this patient population. Specific patient data and summaries are
available for the team to review as needed.

Where will your team begin with this process during the
first meeting of the team?

What internet sites will your team use to determine best
practices for decreasing repeated hospital stays and why?

How will you know if the plan of action to improve care was
effective?

See Chapter 5 for assistance for answering above questions.