Question

Mr. Theodore Jeffers is a 73-year-old admitted to the progressive coronary care unit with a diagnosis of atypical chest pain and congestive heart failure. He has a history of acute myocardial infarction, deep vein thrombosis, hypertension, diabetes mellitus, and gouty arthritis. He reports "spasm-like" chest pain over his breastbone and difficulty "catching my breath." His admission data includes the following:
• Chest pain rated as a 4 on a scale of 1 to 10; states,"It feels like my heart is clenching like a fist—I am notsure I can call it pain."
• BP: 172/100 – 102 – 30
• Temperature: 99.2°F
• O2 saturation: 90% on room air
• Lungs: fine crackles throughout all lung field
s• Heart sounds with S3 present
• 4+ pitting edema, decreased peripheral pulses bilaterally,feet cool to touch
• Height: 72 inches; Weight: 231#; BMI: 31.3
1. a. Mr. Jeffers is placed on continuous cardiac monitoring. As the primary nurse, what are your responsibilities in the care of a patient requiring this type of monitoring?
b. For the patient with cardiac dysrhythmias, what is the nursing diagnosis that drives the prioritization of care? Is this the correct diagnosis for this patient? Why or why not?
c. The NOC outcome that is determined for Mr. Jeffers is cardiac pump effectiveness. Based on Mr. Jeffers’s status, write four individualized expected outcomes that will demonstrate resolution of the diagnosis.
d. Mr. Jeffers tells you during the morning assessment, "I know I have had this happen before but I think I just might die this time around." How should you respond to this statement?314 Unit 4 | Supporting Physiological Functioning.
e. As the day progresses, Mr. Jeffers becomes confused. Based on your understanding of oxygenation and perfusion, what is the probable etiology of this change in status?
f. Mr. Jeffers is a "full code." If he should need resuscitation, can you legally and ethically delegate basic cardiopulmonary resuscitation (CPR) to unlicensed assistive personnel within the hospital setting? Give a rationale for your response.