Posted: March 4th, 2016

You are the RN working in the HDU and accept Daisy into your care. Discuss your nursing management for Daisy on her admission to the unit.

Part A
You are the RN working in the HDU and accept Daisy into your care. Discuss your nursing management for Daisy on her admission to the unit. Your response should be evidence-based demonstrated by an engagement with the literature and any relevant guidelines. In your discussion, include:
• The assessments you would do to gather data regarding her cardiovascular status

• The interventions that you would anticipate to investigate and treat atrial fibrillation with a focus on your role and responsibilities as an RN.

(Word guide 500 – 600 words)

Your Response

On your next shift you have been allocated two HDU patients to care for, one of them is Daisy. Over the preceding 24 hours, Daisy has required several IV fluid boluses to maintain her mean arterial pressure above 65 mmHg. She has had an arterial line inserted to allow continuous blood pressure monitoring and blood samples to be taken. On your initial assessment of Daisy you notice that her respiratory rate is 28 bpm and her SpO2 is reading 92% despite being on a Hudson mask at 6L/min. Discuss your immediate interventions, including:

• Further assessments that could gather data regarding her respiratory status.

• Interventions that you would anticipate to manage and treat pulmonary oedema. (Word guide 500 – 600 words)
Your Response

Part B
Two weeks later Daisy has recovered from her surgery and has had no further complications. She has spent ten days on the surgical ward and is coping with caring for her colostomy. During her recovery, Daisy was informed that she may have had a small myocardial infarction post-operatively and that she should have a coronary angiogram in a few weeks.
You are the nurse caring for Daisy over her last couple of days in hospital. Discuss her discharge plan including a focus on:

• Education on what a percutaneous cardiac intervention (PCI) involves

• Daisy’s cardiovascular disease risk factors

• A chest pain action plan. (Word guide 1000-1200 words) Your Response