Reference no: EM133818560
Case: You are the nurse assigned to R. J., a 52-year- old male who had been admitted yesterday due to a syncope episode at his home. The client has a medical history of hypertension, dyslipidemia, and coronary artery disease. At 0710, you enter his room to introduce yourself and begin your assessment and notice the client is alert and oriented and appears uncomfortable; he has pale and diaphoretic skin and was grasping at his sternum and moaning. Respirations and pulse were normal; a faint carotid pulse was palpated; jugular venous distention was not visible.
You call the rapid response team (RRT). | The RRT physician orders cardiac monitoring which revealed a sinus rate of 56 beats per minute, without ectopy. Nausea and vomiting developed. Additional orders included providing supplemental oxygen administered through a nonrebreather face mask at a rate of 15 liters per minute, and intravenous catheters (18 gauge) were inserted into the antecubital vein in the right arm and a vein in the left forearm. At 0750, you retake his vital signs and the blood pressure was 110/90 mm Hg, the pulse 51 beats per minute, the respiratory rate 18 breaths per minute, and the oxygen saturation 98%, with the patient reporting chest pain rated at 7 on a scale of O to 10, with 10 indicating the most severe pain. A 12-lead ECG showed sinus rhythm at 60 | beats. Three minutes later, the patient vomited, became increasingly pale and diaphoretic, and was unresponsive to voice. Normal saline (a 500-ml bolus) ' was administered. The client's pulse decreased to 36 beats per minute and the width of the QRS complexes on the cardiac monitor inlreased. External : pacing was attempted, without mechanical capture. Seizure activity occurred briefly, and runs of ventricular tachycardia with wide ventricular complexes | were seen; the blood pressure and carotid pulses could not be obtained, and the patient was unresponsive. Do You Need Help?
The cardiac monitor revealed ventricular | fibrillation, cardiopulmonary resuscitation (CPR) was begun, and the patient was moved to a resuscitation bay.
Outline what additional orders you believe the RRT physician lead will order including for airway, fluids, and drugs during the code management to support