Other labs and testing that would be important in this scenario would be monitoring lab data: ABGs, BUN, creatinine, electrolytes, coagulation studies (PT, aPTT, clotting times), and the rationale is to indicate the organ perfusion and function. Abnormalities in coagulation may occur as a result of therapeutic measures. Electrolyte imbalances can affect cardiac rhythm and contractility. Another lab would be cardiac enzymes, and the reason is that the enzymes monitor the resolution or extension of infarction. The presence of hypoxia indicates the need for supplemental oxygen. These labs would be checked regularly. Reviewing the serial EEGs will provide info regarding the progression or resolution of infarction, the status of ventricular function, electrolyte balance, and the effects of drug therapies. Reviewing chest x-ray may reflect pulmonary edema that could possibly be related to ventricular dysfunction. Measuring I&O’s every hour is important, noting a decrease in output and paying attention to appearance because decreased cardiac output results in impaired kidney perfusion, sodium/water retention, and reduced urine output. Weighing her daily because any sudden changes in weight may reflect fluid balances. Lastly, maintaining total fluid intake at 2,000 mL/24hr within cardiovascular tolerance. The reason we do this is so her body meets normal body fluid requirements but may require some adjusting or restricting in the presence of cardiac decompensation. All these testing would be done within 24-48 hours, and it depends on how long she will be hospitalized, say, the frequency.
While caring for Jackson, I would ensure my other patient’s needs are being met by communicating with my charge nurse about the situation. I will prioritize my other patients to see if anyone else is critical. Questions I would ask myself would be, what am I doing first and why? Which is most important at this moment? Besides Mrs. Jackson. Knowing that caring for each patient is important and quality care is crucial, communicating with my team is necessary for patient safety. If I need help, I would ask my charge nurse if there is anyone that could possibly take on one of the other patients or if she can just help me with them. I would tell her how I have prioritized them and help as much as I could still. Just as the body’s many components are needed to restore an equal balance, a work team can change its pace, reorganize care tasks, reconfigure itself, and redelegate responsibilities (Nelson, 2010).
Geiter, H.B. (2007). E-Z ECG Rhythm Interpretation. Philadelphia: F.A. Davis, pg. 168.
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