Percutaneous Coronary Intervention (ED)

Improved Essays
Mr. ABC came in to the emergency department (ED) with a chief complaint of left sided chest pain with giddiness and associated with diaphoresis the same morning. While in the ED, he developed a sudden episode of shortness of breath. Mr. ABC has nil past medical or surgical history and has an allergy to Enalapril.
His parameters taken are as follows:
Blood pressure: 112 /60 mmHg
• Pulse rate: 42 beats/min
• Temperature: 35.9°C
• Spo2: 97% on room air
• Respiration rate: 17 breaths/min
An echocardiogram (ECG) was ordered stat to view the electrical activities of the heart at different angle by heart muscle during a cardiac cycle and create a graphical representation of the electrical of the heart which used to assess abnormal cardiac rhythms,
…show more content…
During PCI, a deflated balloon or other device on a catheter is introduced from the inguinal femoral artery or radial artery until they reach the site of blockage in the heart under X-ray imaging guidance. At the blockage, the balloon is inflated to open the artery, allowing blood to flow. A stent is often placed at the site of blockage to permanently open the artery. (Kushner et al., 2009). The part of the heart muscle does not die immediately after occlusion of coronary artery. If blood supply is restored within a few hours, much of the affected area of the heart muscle will be saved from damaging (Deckers, …show more content…
XYZ was noted to be having CO2 retention. Besides, he was very restless and kept removing his face mask overnight, causing an increase in breathing effort with a chest X ray showing decreased expiratory effort bilaterally. Thus, the decision to put him on BIPAP PSV/ST mode, fio2 of 40%, IPAP at 12cmH20, EPAP at 5cmH20 with back up rate of 12 breaths/min. Fio2 of 40% acts as a supplementary oxygen to bring up the oxygen saturation. It decreases the hypoxic drive and thus attenuating the hyperventilatory response to a change in PaCO2. Inspiratory Positive Airway Pressure (IPAP) is a boost of pressure that helps in delivering comfortable sized breaths. On the other hand, it improves ventilation and decrease breathing workload. More importantly, it is applied to help blow off carbon dioxide. End Positive Airway Pressure (EPAP), similar to CPAP, is a continuous positive airway pressure during exhalation that helps keep patient’s air passages open so that the next breath comes in easier. A back up rate is pseudo-ventilation. This pressure support ventilation will be automatically delivered as soon as the Mr. XYZ breaths beyond the set respiration rate with the intention to trigger spontaneously breaths (Positive Airway Pressure Titration Task Force of the American Academy of Sleep Medicine,

Related Documents

  • Improved Essays

    Demonstrate the role of stents in Percutaneous Coronary Intervention (coronary angioplasty) Introduction The heart is a pump that circulates blood to the rest of the human body. It is positioned at the centre of the chest, just between the lungs. The network of blood vessels that branch over the surface of the heart are the coronary arteries.…

    • 1558 Words
    • 7 Pages
    Improved Essays
  • Improved Essays

    Bio 202 Unit 1 Case Study

    • 1549 Words
    • 7 Pages

    A day after admission N.K. ’s EKG shows R wave decreasing meaning AV nodes are not firing, Q wave shows AV nodes not filling ventricles, an ST is more elevated. Meaning N.K. is having a complete obstruction in coronary artery this is called myocardial infarction. 9) what minimally invasive procedure could be used to treat patient # 1’s coronary artery…

    • 1549 Words
    • 7 Pages
    Improved Essays
  • Improved Essays

    - The purpose of the Electrocardiogram test is to monitor and measure the quantity and quality of the electrical rhythm of the heart. Understanding the electrical rhythms of the heart is important because your heart's electrical system controls the timing of your heartbeat and you would have to understand how the electrical rhythm of the heart should be to know what problems may be occurring. There are three common variables that are encountered in an electrocardiogram which are the direction in which the signal is moving, the speed at which the signal is moving and the mass of the tissue through which the signal is moving. There are three different parts of an electrical signal which are P wave, QRS complex and T wave. P wave passes slowly…

    • 261 Words
    • 2 Pages
    Improved Essays
  • Improved Essays

    Split Night Case Summary

    • 306 Words
    • 2 Pages

    CPAP was discontinued at this time and the patient was placed on oxygen at 1 LPM via nasal cannula. The patient uses oxygen…

    • 306 Words
    • 2 Pages
    Improved Essays
  • Improved Essays

    Patient will participate in activities that reduce the workload of the heart. Monitor patient’s abnormal heart and lung sounds. Monitor patient’s blood pressure and pulse since patient has history of shortness of breath and hypertension. Assess patient’s mental status and level of consciousness since shortness of breath can lead to confusion, lethargy, and altered consciousness due to poor perfusion and oxygenation.…

    • 1735 Words
    • 7 Pages
    Improved Essays
  • Improved Essays

    Rg's Ischaemic Case Study

    • 528 Words
    • 3 Pages

    A patient named RG has ischaemic heart disease with two previous myocardial infarctions (MIs) is admitted to ICU after undergoing coronary artery bypass grafting. After surgery, his preoperative ejection fraction was 45%. He also has controlled hypertension and hypercholesterolaemia. He needs mechanical ventilation and pulmonary artery catheter in place. His blood pressure and urine output have fallen after one hour admission to the ICU.…

    • 528 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    James Petrovsky was at his usual state until 3/12/2017 evening, he refused to walk or stand. When staff assisted him to stand, he dropped to the floor. The nursing assessment was completed, he was afebrile and no distress was noted. On the morning of 3/13/2017, still he refused to walk or stand and nurse was notified. Up on nursing assessment, he had shortness of breath with wheezing and his SPO2 was around 84% on room air.…

    • 739 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Ekg Lab

    • 666 Words
    • 3 Pages

    Introduction The purpose of this lab was to determine the rate, function, and integrity of the heart during an exercise EKG. An electrocardiogram measures the electrical activity of the heart over time. In this lab a subject will exercise for about 15 minutes, not including rest times and the EKG will measure the heart’s activity.…

    • 666 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Patient Case Study Essay

    • 485 Words
    • 2 Pages

    The patient is a 56 year old Bangladesh male came by ambulance due to sudden onset of shortness of breath at 3 o’clock in the morning when he woke up to go to the washroom. The patient also has chest pain, nausea and vomiting, fever and worsening orthopnea The patient is having dementia, hypertension and ESRF stage 4. However, patient reused HD and was under nephro clinic, but planned for palliative management. The patient had been admitted to the hospital due to the same presenting complaint for several times.…

    • 485 Words
    • 2 Pages
    Improved Essays
  • Superior Essays

    Formal Case Studies

    • 1555 Words
    • 7 Pages

    Case Study Formal Write Up To ensure the privacy of our patient: his name is disclosed to the public Initial Impressions The middle- aged yr. old patient was experiencing moderate discomfort and substernal chest pressure. With this he had chest pain radiating down into his left arm that was accompanied by tingling sensations.…

    • 1555 Words
    • 7 Pages
    Superior Essays
  • Improved Essays

    Respiratory distress syndrome (RDS) commonly known as hyaline membrane syndrome occurs in many premature births. As the gestational age for a baby decreases subsequently the likelihood of them having this condition will increase because their lungs are severely underdeveloped. The problems that stem from RDS include lack of surfactant, smaller alveolar surface span, elevated compliance of the small airways, and occasionally the ductus arteriosis might be a factor if it doesn’t close shortly after birth. A clinician will notice upon arrival to stabilize the patient that the infant will be tachypneic, retracting (abdominal and/or sternal), have inconsistent respirations, grunting, and might also exhibit nasal flaring. The first test that should be ordered is a chest x-ray.…

    • 692 Words
    • 3 Pages
    Improved Essays
  • Decent Essays

    ECG is a graphical depiction of the electrical activity produced by the human heart over a period utilizing the electrodes placed on skin. These electrodes identify the small electrical variations on the skin that generate from the heart muscle’s pattern of depolarizing and repolarizing during each…

    • 47 Words
    • 1 Pages
    Decent Essays
  • Superior Essays

    Emily Barbic Cardiovascular disease is the leading cause of death among both men and women in the United States. Each year approximately 600,000 people die from these heart related diseases. Cardiovascular disease is something that can be acquired at birth or over a period of time due to genetics or lifestyle. There hundreds of different types of cardiovascular disease.…

    • 1861 Words
    • 8 Pages
    Superior Essays
  • Improved Essays

    Airway Case Study Nursing

    • 1310 Words
    • 6 Pages

    This is to provide immediate respiratory care if the patient’s airway is compromised (Higginson, Jones & Davies, 2011). This is a low priority. B. BREATHING – Respiration is altered due to left ventricular failure. The patient is tachypnoeic due to an increased pressure in the pulmonary veins that will lead to pulmonary congestion that lessens pulmonary compliance, which raises the respiratory rate.…

    • 1310 Words
    • 6 Pages
    Improved Essays
  • Improved Essays

    In modern American society the populous is experiencing both a longevity of life and in turn are faced with more chronic illnesses. In the Ohio-valley region of the United States there is a marked increase of chronic lung and heart issues exacerbated by coal mines, obesity, and tobacco use. Chronic obstructive Pulmonary disease is the third leading cause of death in the United States ("American Lung Association," 2013). B.H. was a 71-year-old male admitted to Hardin Memorial Hospital for shortness of air related to COPD and pulmonary edema. It was my assignment to gather his relevant medical history, assess his signs/symptoms for seeking healthcare, and provide a thorough physical and psychosocial assessment.…

    • 647 Words
    • 3 Pages
    Improved Essays