...OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOO o oooooooooooooooooooooooooooooooooo o oooooooooooooooooooooooooooooooooooo o ooooooooooooooooooooooooooooo o o ooooooooooooooooooooooo o oooooooooooooooo o ooooooooooooooooo o ooooooooooooooooooo o oClinic, who is lead author of the report in the July 29, 2008 issue of the Journal of the American College of Cardiology. Most heart attacks occur in the day, generally between 6 A.M. and noon. Having one during the night, when the heart should be most at rest, means that something unusual happened. Somers and his colleagues have been working for a decade to show that sleep apnea is to blame. 1. If you take an aspirin or a baby aspirin once a day, take it at night. The reason: Aspirin has a 24-hour "half-life"; therefore, if most heart attacks happen in the wee hours of the morning, the Aspirin would be strongest in your system. 2. FYI, Aspirin lasts a really long time in your medicine chestClinic, who is lead author of the report in the July 29, 2008 issue of the Journal of the American College of Cardiology. Most heart attacks occur in the day, generally between 6 A.M. and noon. Having one during the night, when the heart should be most at rest, means that something unusual happened. Somers and his colleagues have been working for a decade to show that sleep apnea is to blame. 1. If you take an aspirin or a baby aspirin once a day, take it at night. The...
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...Community Health Needs Assessment Trinity Community Hospital AMT Task 2 Community Health Needs Assessment Trinity Community Hospital conducted a community health needs assessment (CHNA) to identify the needs of the local population. The assessment focused on oncology, orthopedic, and cardiovascular services. The following report will analyze the community health needs assessment by identifying the major risk factors in the community, and discussing if the needs defined in the evaluation are being addressed. The report will also outline recommendations for any outstanding community needs. Major Risk Factors Oncology Services The community health needs assessment identified that new cancer cases are expected to increase by 34% due to the aging population that will be over 65 within the next five years and a rise in expectation of men and women developing cancer. The assessment also identified that the current services are already stressed.; physician practices are at capacity, facilities and equipment are not keeping pace with the patient volume, services are fragmented, and there is little emphasis on prevention education and control. Orthopedic Services Another risk factor for the community is the sharp increase in the need for orthopedic services forecasted over the next five years. The need for orthopedic procedures in the next five years are expected to increase by 46%, inpatient joint and spine cases will increase by 30%, and outpatient spine and joint...
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...Running head: CARDIOLOGY PRACTICE Cardiology Practice HCM201-0903A-01 Toni Phillips-Wright Cardiology A Cardiologist is certified to treat problems of the cardiovascular system which includes the heart, arteries and veins of the body. Cardiologist treats: Angina – discomfort felt when a blockage in a coronary artery prevents enough oxygen rich blood from reaching part of the heart. Aortic Stenosis – A condition in which one of the valves in the heart (the aortic valve) has become sticky and does not open normally Aerial Fibrillation – An abnormality of the heart rhythm in which chambers of the heart no longer contract in an organized manner. Heart rate often becomes irregular and may be very fast. Congestive Heart Failure – A term used to describe any condition in which the heart is unable to adequately pump blood throughout the body. Endocarditic – A medical term that refers to infection of a heart valve. (Cardiochannel 2009) Systems of Systems of the Body The Circulatory System – the heart, the lungs, and the blood vessels work together to form the circle part of the articulator system. The Respiratory System – supplies the blood with oxygen in order for the blood to deliver oxygen to all parts of the body. (www.stronghealth.com) Common procedures performed Angioplasty – cardiac catheter based procedure Ventricular Arterial Device – Heart Assist Device Implantation Electrophysiology – an invasive diagnostic test CPT Codes 92980 – Transcatheter...
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...One of the reasons is the emergence of minimally invasive techniques like transcatheter aortic valve implantation (TAVI) and off-pump CABG (beating heart). http://bjcardio.co.uk/2011/02/impact-of-the-ageing-population-on-cardiac-surgery-in-the-uk/ The market potential for a device to provide treatment to heart valve sufferers in indicated in the Elsevier Business Intelligence article which reports that ‘15.6 million people worldwide suffer from rheumatic heart disease with approximately 282,000 new cases each year’ . (http://telavivmedtech.weebly.com/uploads/7/2/5/8/7258084/percutaneous_mitral_startup2012_2.pdf The problem is huge. Aortic stenosis is the most commonly diagnosed heart valve condition—annually roughly 300,000 patients worldwide, by conservative estimates, have been diagnosed with the disease. About one-third of them are not eligible for open-heart surgery due to age or other comorbidities. More than half of patients di-agnosed with the disease die within two years, according to FDA. http://www.mddionline.com/article/tavr-still-next-big-thing-cardiology 3. Patent Search Company Medtronic Edwards...
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...Independent Case Analysis Paper: Open Heart at Cabarrus NAME College Abstract In this activity, I will analyze The Case for Open Heart Surgery at Cabarrus Memorial Hospital by using the tools and skills previously learned in my Health Science curriculum. I will provide a brief summary of the case, discuss the major problems, use two case analysis tools and provide a detailed report with a decision. Independent Case Analysis Case Summary The board of trustees at Cabarrus Memorial (CMH) gathered in October for its monthly meeting. The meeting opened by stating the fact that (CMH) did not have an open heart surgery program. The Chairman mentions the fact that a quick decision is needed since Dr. Christy needs to make a decision regarding where he will be working. Dr. Christy was previously a staff member that left CMH to complete a fellowship in cardiovascular surgery and wants to return to work at CMH after his fellowship is complete. Dr. Christy needs to make a decision by the first of January. Should CMH add the open heart surgery program? SWOT The SWOT tool has been utilized to help determine the strengths, weaknesses, opportunities and threats of opening a heart surgery program at CMH. The use of this tool has identified several strengths. One of the strengths includes the fact that CMH and Duke have an affiliation. CMH had several educational affiliation programs and extensive in-service and continuing education programs, including a...
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...Adult Cardiology 11th Floor POB Adult Cardiology at RUMC • Treat a variety of congenital and chronic cardiac conditions – Range in acuity • Has 8 specialized programs that focus on disease and prevention • Ranked 21st in the nation by U.S. News and World Report Clinical Staff • 20 Cardiology M.D.s at Rush – 2 Cardiology M.D.s at Rush Oak Park Hospital • 1 Nurse Practitioner • 2 Check-In Clinic Coordinators • 3 Discharge Clinic Coordinators • 5 Certified Medical Assistants • 2 Call Center Coordinators • 3 Registered Nurses – Coumadin Clinic – Phone Triage Physician Education • Medical Degree or Doctor of Osteopathic Medicine • Residency in Internal Medicine – 3 years • Cardiology Fellowship Training – 3-4 years per ACGME guidelines 4 Outpatient Clinic Volumes • On average the clinic will see between 115-140 per day • Staffed with 5-7 Attending seeing patients per day • Roughly a patient volume of 29,000 outpatient visits per year – Monday-Thursday: 115-150 patients – Friday: 80 patients Outpatient Check-In Patients are greeted by two Clinic Coordinators • Verify patients appointment by asking for their name and date of birth • Scan a copy of patients insurance card • If the patient has not verified their insurance with hospital Registration prior to appointment, they would do so at this time • Patient is called to their clinic room by Medical Assistant Check-Out Cardiology utilizes 3-4 Clinic Coordinators who check out patients following...
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...Chief Complaint: “I am having chest pain.” Question One: Please describe your chest pain in terms of it being a new or prior symptom, onset, duration, radiation, quality, what makes it worse or better, and describe the location(s) felt. Rationale: Understanding the patient’s pain gives a perspective of potentially what or where the underlying etiology could be, or where to start as a focal point for the assessment. Priest (2012) assert that there is a multiplicity of conditions that could cause chest pain, which includes an acute myocardial infarct, pulmonary embolus, thoracic-aortic aneurysm or dissection, gastroesophageal-reflux disease, chest-wall pain, a muscle pull, inflammation in the lining of the lung from a viral infection, and gallbladder or pancreas problems. Dodaro (2015) states that the experience of chest discomfort lasting longer than a couple of minutes or chest discomfort that comes and goes might signal an emergent condition and the clinician should test for the most urgent causes first. Diagnostic testing should be the focus of ruling out the potential differential diagnosis associated with the highest morbidity and mortality is the nature of the chest pain is unknown, which is AMI, PE and aortic dissection. Associated potential normal and abnormal findings: • Coronary angiograms will indicate an abnormal finding of a blockage in one or more of the coronary arteries. • Women's heart attack symptoms, signs, and treatment differ from men's, international...
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...In Section 4, you will proofread the Progress Report listed below. Next, you will identify the 15 mistakes that are listed in the report. The mistakes could be misspellings, incorrect abbreviations or misuse of a medical term. Please list them in the chart below under the heading “Medical Terminology Error.” After you have listed the errors, you will need to identify the correct term or abbreviation. Please list them in the chart below under the heading “Correct Term.” • PROGRESS NOTE • CHIEF COMPLAINT: Severe pain between the shoulder blades, shortness of breathe, nausea for the past 3 hours. • • PRESENT ILLNESS: Darelen Denton is a 62-year-old woman who presented to the emergency department via ambulance. In transport, patient received O2 at 4 liters via nasal cannula, baseline EKG, Normal Saline IV started in left hand, 325 mg aspirin by mouth (po). Patient complained she was short of breath and experiencing severe pain between her shoulder blades. She stated that she has been feeling nasuseated for the past 3 hours. She states she has a history of stable angina and is currently taking medication as needed. She states she did not take the nitroglycerin because she was not experiencing chest pain, just back pain. She states that her last check-up with the Pulmonologist showed that her EKG did not show any changes since her last visit. She denies episodes of syncope. The patient does report that she tripped over something on the floor, which resulted in her falling...
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...The aim of this essay is to explore an acute deterioration in the health of an adult I have encountered during a clinical placement, in an acute care setting. The essay will begin with a definition of acute care, followed by the introduction of my patient and predisposing factors. This essay will include an explanation of the significant pathophysiological changes and related clinical manifestations and a critical analysis of the nursing interventions implemented during the acute episode of care, focusing on holistic care, rationale and evidence base. It will then describe the actual deterioration in the patient’s condition, and discuss the nurse’s role in the recognition and assessment of the actual deteriorating condition following the trusts policies. Assessment tools, monitoring, detecting and reporting will be considered. Finally this essay will include a discussion of the importance of multidisciplinary team collaboration in the diagnosis and provision of care during the acute episode, and a discussion on whether the deterioration could have been prevented by identifying any areas of practice which could change in relation to evidence based practice. For the purposes of privacy and confidentiality, in accordance with NMC (2008) code of conduct, the name of the patient will be changed to Peter and the placement area will remain as an acute care setting. According to McFerran (2008) the term “acute” is described as a disease of rapid onset, severe symptoms, and brief duration...
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...Congestive Heart Failure Armi Gonzales Western Governors University Congestive Heart Failure A. Investigated Disease Process Congestive Heart Failure is a condition in which the heart is unable to pump a sufficient amount of blood for the body to function. If the heart’s ability to pump blood decreases, blood and fluids may start to pool into the lungs and accumulate in the legs, ankles, and feet causing an edema, shortness of breath, and fatigue. (Heart Failure, 2015, para. 2) The American Heart Association and American College of Cardiology defines heart failure as “a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricles to fill with or eject blood” (King, Kingery, & Casey, 2012, p. 1). Heart failure can be seen as a widespread disease, affecting around five million Americans. (Titler et al. n.d.) It is a chronic condition that is disabling and costly and common to our aging population. With the advancement in therapy and early diagnosis, survival increases from previously fatal acute cardiac events to patients feeling better and living longer. Millions of Americans living with heart failure are 65 years of age or older. (Roger et al, 2004) A1. Pathophysiology The Circulatory system focuses on the heart, a muscular organ that pumps blood through a complex network of blood vessels throughout the body. Blood that is pumped from the heart carries oxygen and nutrients that fuel...
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...A Hybrid Operating Suite at Community Medical Center Russell F Stahl, M.D., Carmen Sciandria, CCP, Cassandra Cuesta, BA The Evolution of Treatment of Cardiovascular Disease Surgery for coronary artery disease (CABG), valve repair and replacement, and the treatment of aortic disease, all have a remarkable history of success and evolution. Just as with computer technology, the trend in surgery has been to become smaller, faster and better. The treatment of cardiovascular disease (CVD) is moving towards less invasive and, in many cases, catheter based technologies. First interventional radiologists, then cardiologists, and now cardiac and vascular surgeons have embraced this trend. Clinicians are encouraged by outcomes that appear to be at least as good, albeit with trade-offs, and a high level of patient acceptance. Hybrid operating rooms - rooms combining operating room sterility and functionality with fixed angiography and echocardiographic imaging- are rapidly growing in prevalence and gaining increased interest from hospital administrators. These rooms are used by cardiac surgeons, vascular surgeons, interventional cardiologists, and neuro-interventionalists, and are suited for both open and closed procedures, as well as collaborative “hybrid” procedures. Given the dynamic nature of this room, these investments require thoughtful preparation operationally and logistically, especially when planning for physician and support staff that will work and cover call in this...
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...Read the attached article regarding new techniques for treating heart attack victims and identify the problem statement for a study among residents in the Minn. area where this new technique is being practiced. This study is to learn how the residents feel about the new technique being used. You might want to include survivors of this technique to learn of their assessment of the technique vs. the more commonly used techinque of clot busting. |PAGE ONE | | | | | | | | | | | |[pic] | |[pic] ...
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...time.” When she awoke this morning, her toes were purple in color, and she was unable to touch them secondary to the immense pain. Her husband drove her to the hospital immediately. Her weight is 65.0 kg. Other findings include normal heart tones, clear lung sounds, positive bowel sounds and clear yellow urine from a urinary catheter inserted in the emergency department. Her medical history consists of hypertension, partial lumpectomy of the right breast seven years ago, alcohol abuse and hyperlipidemia. She is allergic to angiotensin converting enzymes inhibitors and angiotensin receptor blockers. She takes metoprolol 25mg twice per day at home for hypertension management. She has been married for 25 years and has two adult children. She reports that she smokes one pack of cigarettes per day and generally drinks two distilled alcoholic drinks per day. Blood work was drawn, but the results are not yet available. The emergency department team has transferred the client to the cardiac catheterization laboratory after inserting left jugular venous access and a urinary catheter. Healthcare Provider’s Orders: Cath Lab orders:...
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...A Complete Patient Assessment Susan Eisen RN Ramapo College of New Jersey A 63 y/o African American female presents to the emergency room complaining of shortness of breath worsening over the past week. Patient states she becomes severely short of breath while preforming everyday activities and has noticed that her legs have been “getting bigger”. Patient had been sleeping with 3-4 pillows a night for comfort and occasionally sleeping in a recliner. Patient states this evening she got up to use the restroom and had a sudden onset of severe shortness of breath. Felt as though she wasn’t moving any air. Patient called 911. The paramedics on scene established IV access and medicated patient with 40 of furosemide and Nitroglycerin sublingual 0.4 mg times 3 doses. Patient was placed on CPAP and brought to the ER. Upon arrival CPAP was continued, a nitroglycerin infusion was started at 20mcg/min. Additional IV access was established and labs were obtained. Stat EKG and Chest Xray were completed. Additional dose of furosemide 80mg was administered IV push and patient was provided with an indwelling foley catheter which is draining clear yellow urine. Past Medical History is significant for Hypertension, Diabetes, Congestive Heart failure, and Atrial Fibrillation with two unsuccessful cardioversions. Medications: Patient currently taking Furosemide, Lisinopril, Digoxin, ...
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...Heart Failure Christy Harding Western Governors University C155- Pathopharmacological Foundations for Advance Nursing Practice Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea, fatigue, dyspnea, cough with frothy sputum, peripheral edema, and decreased urinary output. Heart failure is caused by many conditions that damage the heart’s muscle. Any form of heart disease can lead to heart failure. A1. Pathophysiology Heart failure arises as a consequence of an abnormality in cardiac structure, conduction, rhythm, or function (Figueroa & Peters, 2006). Heart failure always begins with an index event. This event could be silent, as with the expression of a genetic mutation, or obvious, such as a myocardial infarction (Francis & Tang, 2003). Heart failure can be categorized into systolic ventricular dysfunction also known as systolic heart failure or diastolic ventricular dysfunction also known as diastolic heart failure...
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