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Nursing situation  case study

 

Nursing Situation COVID-19 and Cardiac Events

Name: Ms. Corna Vee                        DOB: 03/26/1955        Ht: 158 cm                  Wt: 78 Kg

Ethnicity: African American               Religion: Christian               Marital status: Widowed

Allergies: NKA                                                                      Code status: Full code

Hospital: Lynn Simulation Hospital                           Unit: Medical-surgical/Telemetry

Admitting diagnosis: SARS-CoV-2 (COVOD-19)

PMH: Diabetes Mellitus (DM), Coronary Artery Disease (CAD), Hypertension (HTN), Sleep Apnea

PSH: Implantable Cardioverter Defibrillator (ICD), 2018

Chief complaint: Severe shortness of breath and fever with chills

HPI: Corna had new onset shortness of breath accompanied by fever and chills. She called 911 and was brought to the ED via ambulance. She was admitted to the ICU for 3 weeks. A nasopharyngeal swab returned positive for COVID-19. Her acute status improved resulting in her transfer to the medical-surgical/telemetry unit 3 days ago.

Labs: CBC: WBC 10.1; RBC 4.7; Hb 9.7; Hct 29; Plat 118

CMP: Na 130; K 3.2; Cl 94; BUN 9; Cr 0.9; CO2 ; Gluc 256; Mg 2.2; Phos 4.5; total protein ; Albumin ; AST ; Total bilirubin ; direct bilirubin .

Orders:

            Accu check AC & HS

Notify provider if blood glucose is greater than or equal to 400  

            Maintain standard, contact and airborne precautions including use of eye protection

            1800 Calorie ADA diet

            Continuous telemetry monitoring

Medications:

            Remdesivir 100 mg in 100 mL NS IVPB infuse over 60 minutes

Amiodarone 200 mg PO daily

Diltiazem 120 mg ER PO 2 times per day

Insulin glargine (U100) 8 units subcut at bedtime

Regular insulin per moderate dose sliding scale

Assessment: Subjective “palpitation”

Objective T 99.62 P 113 R 22 BP 132/90 O2Sat 91% Pain 2/10 [headache]

sliding scale for insulin.png

Rhythm strip.jpg

Please upload your response to the following (use the rubric as a guide).

  1. You are leading the interdisciplinary huddle this evening who will you invite (name other disciplines)? Why?
  2. Select the PPE to wear when entering Corna’s room
  3. What is the order for donning and doffing the PPE?
  4. There is a sudden change on Corna’s ECG rhythm on the continuous ECK monitor (see strip above). What will you record as the name of the rhythm?
  5. Write an SBAR to report to the provider (use chart data as necessary)
  6. Based on your knowledge of holistic nursing, what aspects of care might you want to include that are not necessarily on Corna’s orders. Identify at least 1 call for nursing and describe how to meet the client’s needs in the nursing situation using holistic nursing approaches.

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