By Janice Jones PhD RN CNS, Brenda Fix MS RN NP

This pocket-sized, quickly reference is your go-to consultant for the scientific info you must deal with grownup sufferers properly and successfully.

thoroughly revised and up to date, the 2d variation deals much more of what you would like at a moment’s detect, together with insurance of rebreathing mask, cardiac surgical procedures, annoying mind and head accidents, MRSA prevention and therapy directions, and lots more and plenty more!

Write-on, wipe-off, reusable pages make it effortless to take notes in any atmosphere.

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Extra resources for Critical Care Notes: Clinical Pocket Guide

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Consider sildenafil (Viagra) in select instances. ■ Administer morphine for pain. ■ Avoid NSAIDs and calcium channel blockers as they can exacerbate HF. Many antiarrhythmics are also contraindicated in HF. ■ Prepare patient for biventricular pacemaker or AICD. ■ Other procedures that may be necessary include: ■ Ultrafiltration for patients who have significant volume overload unresponsive to diuretics ■ Coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) ■ Valvular surgery on the aortic or mitral valve ■ Cardiac resynchronization therapy (CRT) ■ Ventricular restoration procedures ■ Extracorporeal membrane oxygenator (ECMO) ■ Ventricular assist device (VAD) ■ Heart transplant CV 4223_Tab02_045-106 29/08/14 10:00 AM Page 56 CV Ventricular Assist Devices (VADs) ■ VADs are used in the treatment of acute or chronic heart failure refractory to standard treatment and a failing heart.

Pain can be described as pressure, tightness, heaviness, burning, or a squeezing or crushing sensation, located typically in the central chest or epigastrium; it may radiate to the arms, shoulders, neck, jaw, or back. 48 4223_Tab02_045-106 29/08/14 10:00 AM Page 49 49 Discomfort may be accompanied by weakness, dyspnea, diaphoresis, or anxiety; not relieved by NTG. Women may experience atypical discomfort, SOB, or fatigue. Diabetic patients may not display classic signs and symptoms of AMI. Elderly patients may experience SOB, pulmonary edema, dizziness, altered mental status.

Unstable Angina Unstable angina is the sudden onset of chest pain, pressure, or tightness resulting from insufficient blood flow through coronary arteries. Pathophysiology Atherosclerosis → obstruction of coronary arteries → decrease blood flow through coronary arteries → decrease oxygen supply to myocardial demand for O2 during exertion or emotional stress → angina. 46 4223_Tab02_045-106 29/08/14 10:00 AM Page 47 47 Clinical Presentation Chest pain manifests as follows: substernal pain, tightness, dullness, fullness, heaviness, or pressure; dyspnea; syncope; and pain radiating to arms, epigastrium, shoulder, neck, or jaw.

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