Mr. Theodore Jeffers is a 73-year-old admitted to the progressive coronary care unit with a diagnosis of atypical chest

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Mr. Theodore Jeffers is a 73-year-old admitted to the
progressive coronary care unit with a diagnosis of atypical chest
pain and congestive heart failure. He has a history of acute
myocardial infarction, deep vein thrombosis, hypertension, diabetes
mellitus, and gouty arthritis. He reports “spasm-like” chest pain
over his breastbone and difficulty “catching my breath.” His
admission data includes the following:
• Chest pain rated as a 4 on a scale of 1 to 10; states,“It
feels like my heart is clenching like a fist—I am notsure I can
call it pain.”
• BP: 172/100 – 102 – 30
• Temperature: 99.2°F
• O2 saturation: 90% on room air
• Lungs: fine crackles throughout all lung field
s• Heart sounds with S3 present
• 4+ pitting edema, decreased peripheral pulses bilaterally,feet
cool to touch
• Height: 72 inches; Weight: 231#; BMI: 31.3
1. Mr. Jeffers is placed on continuous cardiac monitoring. As
the primary nurse, what are your responsibilities in the care of a
patient requiring this type of monitoring?
2. For the patient with cardiac dysrhythmias, what is the
nursing diagnosis that drives the prioritization of care? Is this
the correct diagnosis for this patient? Why or why not?
3. The NOC outcome that is determined for Mr. Jeffers is cardiac
pump effectiveness. Based on Mr. Jeffers’s status, write four
individualized expected outcomes that will demonstrate resolution
of the diagnosis.
4. Mr. Jeffers tells you during the morning assessment, “I know
I have had this happen before but I think I just might die this
time around.” How should you respond to this statement?314 Unit 4 |
Supporting Physiological Functioning.
5. As the day progresses, Mr. Jeffers becomes confused. Based on
your understanding of oxygenation and perfusion, what is the
probable etiology of this change in status?
6. Mr. Jeffers is a “full code.” If he should need
resuscitation, can you legally and ethically delegate basic
cardiopulmonary resuscitation (CPR) to unlicensed assistive
personnel within the hospital setting? Give a rationale for your
response.