Frank James is a 72 year old male who was admitted in the ward due to the exacerbation of his heart failure. His condition dramatically worsened, having developed pulmonary oedema as depicted by bat wings on his chest x-ray as well as signs and symptoms of cardiogenic shock. Vital assessment tools in identifying and prioritising the nursing care for Frank consist of the ABCDE of primary survey in conjunction with physical examination (inspection, palpation, percussion, and auscultation). This case study will explore relevant nursing assessments such as primary survey, physical examination, and the pathophysiology of cardiogenic shock and how it relates to Frank’s presenting signs and symptoms.
Primary survey which incorporates airway, breathing, …show more content…
al., 2012 p.119). Subsequently, Frank becomes hypoxic causing his breathing to be compromised. He continuously complains of shortness of breath despite being positioned upright. His respiratory rate escalated from 28 bpm in the morning to 36 bpm in the afternoon. His SaO2 is at 92% although he is on supplementary oxygen of 10 litres FiO2. Frank’s worsening breathing status is explained by Estes et. al. (2010, p.480), stating that his body tries to compensate his hypoxia by increasing his respiratory rate to meet his oxygen demand. Moreover, this stress response further stimulates the release of catecholamines, hence exacerbating his tachypnoea (Estes et. al. 2010, p.489). Another significant finding that requires close monitoring involves his circulation. His blood pressure plummeted from 140/100 mmHg mane to 96/50 mmHg in the afternoon while his heart rate falls between 124 to 130 bpm from admission to current findings. Linton (2016, p.304) stipulates that hypotension is the hallmark symptom of uncompensated phase in cardiogenic shock. His ECG monitoring also reveals some abnormalities implying ischemia. On the other hand, his urinary output is 20 ml/hr within the last 2 hours. Despite the lack of information to measure his
Primary survey which incorporates airway, breathing, …show more content…
al., 2012 p.119). Subsequently, Frank becomes hypoxic causing his breathing to be compromised. He continuously complains of shortness of breath despite being positioned upright. His respiratory rate escalated from 28 bpm in the morning to 36 bpm in the afternoon. His SaO2 is at 92% although he is on supplementary oxygen of 10 litres FiO2. Frank’s worsening breathing status is explained by Estes et. al. (2010, p.480), stating that his body tries to compensate his hypoxia by increasing his respiratory rate to meet his oxygen demand. Moreover, this stress response further stimulates the release of catecholamines, hence exacerbating his tachypnoea (Estes et. al. 2010, p.489). Another significant finding that requires close monitoring involves his circulation. His blood pressure plummeted from 140/100 mmHg mane to 96/50 mmHg in the afternoon while his heart rate falls between 124 to 130 bpm from admission to current findings. Linton (2016, p.304) stipulates that hypotension is the hallmark symptom of uncompensated phase in cardiogenic shock. His ECG monitoring also reveals some abnormalities implying ischemia. On the other hand, his urinary output is 20 ml/hr within the last 2 hours. Despite the lack of information to measure his