Cardiovascular and Peripheral Vascular Systems

Esther Jackson is a 56-year-old black female who is 1-day post-op followin" rel="nofollow">ing a left radical mastectomy. Durin" rel="nofollow">ing mornin" rel="nofollow">ing rounds, the off-goin" rel="nofollow">ing nurse shares with you durin" rel="nofollow">ing bedside report that the patient has been experiencin" rel="nofollow">ing in" rel="nofollow">increased discomfort in" rel="nofollow">in her back throughout the night and has required frequent help with repositionin" rel="nofollow">ing. She states that the patient was medicated for pain" rel="nofollow">in approximately 2 hours ago but is voicin" rel="nofollow">ing little relief and states that you might want to mention that to the doctor when he rounds later this mornin" rel="nofollow">ing. With the patient appearin" rel="nofollow">ing to be in" rel="nofollow">in no visible distress, you proceed on to the next patient's room for report.Approximately 1 hour later, you return to Ms. Jackson's room with her mornin" rel="nofollow">ing pills and fin" rel="nofollow">ind her slumped over the bedside stand in" rel="nofollow">in tears. The patient states, "I don't know what is wrong, I don't feel right. My back hurts and I'm just so tired. What is wrong with me?" The patient refuses to take her medications at this time statin" rel="nofollow">ing that she is startin" rel="nofollow">ing to feel sick to her stomach. Just then the nursin" rel="nofollow">ing assistant comes in" rel="nofollow">into the patient's room to record Ms. Jackson's vital signs, you take this opportunity to quickly research the patient's medication record to determin" rel="nofollow">ine if she has a medication ordered for nausea. Upon return, the nursin" rel="nofollow">ing assistant hands you the followin" rel="nofollow">ing vital signs: T 37, R 18, and BP 132/54, but states she couldn't get the patient's pulse because "it is all over the place." Address the followin" rel="nofollow">ing questions related to the scenario. What do you suspect is the cause of the patient's symptoms? Describe the course of action that you will take to confirm this suspicion and prevent further declin" rel="nofollow">ine. What further assessments, lab values, and tests will likely be ordered for this patient and how often? If testin" rel="nofollow">ing is to be completed more than once, explain" rel="nofollow">in the rationale for doin" rel="nofollow">ing so. While you are carin" rel="nofollow">ing for this patient, how will you ensure that the needs of your other patients are bein" rel="nofollow">ing met?