Reference no: EM133593486

Case Study: You are asked to assess a 47-year-old female who is brought into the urgent care center, having "fainted" in her living room. She reports feeling like her heart was racing and felt light-headed just before falling to the ground, unconscious. She has had the sensation of rapid heartbeats in the past, but her primary care physician was unable to find any abnormality. She is otherwise healthy, with no previous medical concerns or surgeries. She is anxious in appearance but in no obvious distress. Vitals: HR 260 bpm; RR 20; BP 110/75; Temp 36.9°C (98.5°F). Carotid and peripheral pulses are thready and irregular. Heart sounds are irregular but normal and without murmurs. The remainder of the examination is unremarkable. Her ECG rhythm is as follows:

Questions:

1. Recognize cues (Priority Assessment findings)

a. What information is relevant/irrelevant?

b. What information is MOST important?

c. What information is of immediate concern?

2. Analyze Cues

a. What client conditions are consistent with the cues? Are there cues that support or contraindicate a particular condition?

b. why is a particular cue or subset of cues of concern?

c. What other information would help establish the significance of a cue or set of cues?

3. Prioritize Hypotheses

a. Which explanations are most/least likely?

b. Which possible explanations are the most serious?

4. Generate Solutions (Planning care)

a. What are the desirable outcomes?

b. What interventions can achieve those outcomes?

c. What should be avoided?

5. Take Action (Priority Interventions)

a. Which intervention or combination of interventions is most appropriate?

b. How should the interventions be accomplished? (this includes ACTION, communication, administration, interdisciplinary collaboration, etc.)

6. Evaluate outcomes

a. What signs would point to improving/declining/unchanged status?

b. How would you determine if interventions were effective?

c. If interventions were ineffective, what would be the next steps?