Perfusion

Cardiovascular System and Dysrhythmias

Rapid Reasoning

Virtual Simulation

Mr. Schmidt is a 62-year-old man who had 3 vessel CABG 2 days ago. He was transferred to the cardiac telemetry floor yesterday and is currently progressing per his plan of care for discharge tomorrow. He had his chest tubes removed yesterday and his pain is controlled 3/10 with Norco 325mg/5mg. He was last reported to be in NSR pulse in the 80’s and vitals stable for this patient. Assessment is WNL except for diminished breath sounds bilaterally and 2+ pitting edema to bilateral lower extremities up to the mid-calf area. His weight is up 4.8kg from surgery.

You enter his room to teach him about the medications he will continue at discharge such as a loop diuretic, a statin, and an ace-inhibitor and inform him of the necessity to participate in phase 1 cardiac rehabilitation. He is up in the chair upon entering room when he states his “chest feels jumpy”, he complains of being lightheaded and dizzy and his heart is racing. You notice that he is pale, anxious compared to last seen and slightly diaphoretic.

*Students will complete the Rapid Reasoning Activity Sheet

*Students will revise the current plan of care based on Mr. Schmidts current status.

*Create 3 priority nursing diagnoses

*Each diagnosis will have 2 goals

* Student will identify 6 interventions for each goal identified (3 assessments & 3 teachable points.