1. Using the key below, place the

1. Using the key below, place the corresponding lead number to the appropriate location on Mr. T.’s chest where each lead would be placed. A. Red lead B. Black lead C. Brown lead D. White lead E. Green lead 2. Once the leads are attached, the monitor immediately begins alarming. You check the monitor and see the following rhythm. After reviewing the rhythm strip, provide the following information: Rate: Rhythm regularity: P waves present: QRS complexes present: T waves present: Wave intervals normal: P wave: QRS: T: P wave before every QRS: QRS after every P wave: 3. While analyzing the rhythm, you notice a sudden change. Ventricular fibrillation is quickly identified, you activate a code blue and defibrillation is performed successfully. Tissue plasminogen activator (TPA) is given and intravenous lidocaine 2mg/min, heparin at 1,200 units per hour, and dopamine at 4 mcg/kg/min are started. Blood work was obtained, and results were as follows. Interpret the results of the lab work. Evaluate the meaning for Mr. T. Lab Test Results (Cont’d) Na 145mEq/L K 3.6 mEq/L HCo₃ 19mEq/L BUN 9mg/dl Creatinine 0.8mg/dl WBC 14.r00/mm3 Hct 44.3% Hgb 14.5g/dl Laboratory Test Results Creatine Phosphokinase (CK) levels: 95 units/L On ED admission 1931 units/L 4 hours 4175 units/L 8 hours CK-MB isoenzymes: 5% On ED admission 79% 4 hours 216% 8 hours 160mg/dl LDL 11.9 sec PT 1.02 INR 29.6 sec aPPT (before Heparin) 2.2mg/dl Mg 3.3 mEq/L 4. How does tissue plasminogen activator work when used in a client like Mr. T.? 5. Are there are medications that Mr. T. is receiving that contraindicate using tissue plasminogen activator? If so, which ones? 6. Following a cardiac procedure, Mr. T. returns to the unit with a central line in place and pulmonary artery pressures are measured. The readings were as follows. 7. How would you interpret each of the readings? Readings CVP 8 mmHg Pulmonary Artery Systolic 28 mmHg Pulmonary Artery Diastolic 3 mmHg PAWP 17 mmHg Cardiac Output 4 L/min SV0â‚‚ 60% 8. What lifestyle changes would be highest in priority for Mr. T. to make? 9. Provide client handoff for Mr. T. using the SBAR mnemonic.

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