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Case 1 Mr Cacciotti - Coggle Diagram
Case 1 Mr Cacciotti
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Why is intubation considered to be an important intervention strategy in the management of cardiac arrest?
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Review Mr. Cacciotti’s documented vital signs and neurological observations and relate these
to his medical history and clinical diagnosis.
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Patient has a history of COPD, increased risk of having a cardiac arrest
impaired elimination of CO2 (CO2 retainer), poor perfusion
BP dropping – likely due to weakened cardiac muscles, low cardiac output
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Discuss how each of the medications administered post resuscitation to Mr. Cacciotti may
have been helpful given his medical condition.
Adrenaline – stimulates sympathetic nervous system; increase HR, BP, contractility; vasoconstricts the peripheries
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Morphine – pain relief, slows HR to allow ventricles to fill; vasodilates around the heart
Dobutamine – B agonist, increases HR and contractility
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Given that Mr. Cacciotti has cerebral oedema secondary to hypoxia (or hypoxic ischaemic encephalopathy), summarise the nursing management that you would be implementing on him specifically to ensure maximum brain perfusion and oxygenation.
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Develop a plan of how you would manage Mr. Cacciotti following his arrival into ICU. Include
your nursing assessment and prioritised interventions.
Airway – assessing respiration, lung sounds, proper ventilation, pulse oximetry, suctioning, mouth care; ensuring tapes do not block venous return; checking how far the tube is in the airway to ensure it hasn’t moved; checking pressure of cuff (of ETT)
Breathing – ventilation rate (SIMV = synchronized intermittent mechanical ventilation vs CMV = continuous mechanical ventilation); Positive end-expiratory pressure (PEEP): keeps alveoli open to allow patient to take next breath, monitor SpO2, ABGs
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Disability – neuro and circ obs, monitor for seizures
Exposure – monitor temperature (slow metabolic rate →less energy expenditure→improve healing) for the first 48hrs, wound care, pressure care
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Review Mr. Cacciotti’s blood gas and biochemical results and relate any abnormal results to his medical history
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Mr. Cacciotti’s temperature began to rise > 38.8 C. What are the possible causes of this increased temperature? What measures would you undertake to manage his hyperthermia
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