Mrs. Kelly’s s airway is patent. No signs of airway obstruction demonstrated by talking in full sentences. However, Maintaining airway by keeping the patient on an upright position will help eliminate the risk for potential risk of airway obstruction (Dao Le, L.K, 2016). It is a low priority nursing intervention in this case study.
Mrs. Kelly is Tachypneic as evidence of shortness of breathes due to lack of blood oxygen in the blood called hypoxemia. In which the body is trying to compensate by breathing more. Hypoxemia is taken from an artery to detect the oxygen level in the blood (arterial blood gas). Her ABG results showed a 75 mmHg (normal 80-100mHg). Hypoxemia has many reasons, most often related to respiratory disorders, as the blood is not providing enough oxygen to the body. Thus her oxygen saturation is low (Evers, Vaneker, & Biert, 2014).
Her X-ray showed a pulmonary vascular congestion and pulmonary oedema, wherein there is fluid accumulation in the lungs due to insufficient pumping of the heart, resulting to impaired gas exchanged in the alveoli that causing of her laboured breathing. And it’s also the reason why there is bilateral basal crackles and crepitation upon auscultation (Davis, Bluhm, Burke, Iqbal, Kim, Kokoszka, Larson, Puppala, Setterlund, Vuong, & Zwank, 2012).
The nursing strategy for this is to provide supplemental oxygen with appropriate delivering devices such as non-breathable mask to sustain and maintain the physiological amount of oxygen according to body’s needs recorded in Pulse oximeter or ABG analysis (Gupta, 2016). This is a high priority nursing intervention in this situation.
Her heart rate is fast indicates abnormal heart rhythm. Her heart is not pumpi...
... middle of paper ...
...diac output. This pulmonary oedema can lead to respiratory failure, cardiac arrest due to hypoxia that can lead to death (Morales, Prediletto, Rossi, Catapano, Lombardi, & Rovai, 2012).
The size of the heart is still normal because the cardiomediastinal contours are usually normal in the onset of myocardial infarction.
2. ARTERIAL BLOOD GAS (ABG)
It measures the acidity and the levels of oxygen and carbon dioxide in the blood from an artery. This analysis is used to detect how the oxygen from lungs move in the blood and how carbon dioxide removed from the blood.
Mrs Kelly is hypoxaemic with a slightly low PaO2 and SaO2 on 93% O2.
Her pH is <5-15bpm) hourly. Hooked the patient in cardiac monitor. Assess and palpate peripheral pulses of extremities throughout dobutamine administration. Notify immediately the doctor if there changes of vital (Skidmore-Roth, 2015).
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