Question-1- (a) The above shown ECG strip reflects on supraventricular tachycardia of the patient. Supraventricular tachycardia is a type of abnormal heart rhythm, which is mainly created due to abnormality in the upper chambers of the heart, also commonly known as atria (Page, 2016). Supraventricular tachycardia is generally represented with an absence of “P-wave” in the ECG strip and a prolonged “QRS-complex”. These cardiac arrhythmias are mainly observed to be in four types as follow:
The conduction mainly starts at atria and increases rapidly. As the heart rate increases abnormally, there is a reduced contraction of the atria, leading to the missing “P-wave” formation in the ECG strip. This is a direct reflection of abnormality in the atria chambers of the heart (Al-Zaiti, 2020). The patient might experience the symptoms like chest palpitations, feeling of faintness, shortness of breath, sweating and so on.
(b) There are multiple reasons for development of supraventricular tachycardia. Three of the main attributing reasons can be as enlisted below:
(c) The treatment options of supraventricular tachycardia depend on the severity of the symptoms. The treatment can be as follow:
Question-2 (a) The ABG of the patient with given readings indicate respiratory acidosis. Respiratory acidosis is a condition where the lungs are not efficient enough to remove excess carbon dioxide from the body. This increase in the levels of carbon dioxide brings about a decrease in the level of pH and other body fluids as well, making them acidic in nature (Pompey, 2019). Acidosis is generally observed when the pH .value in arterial blood gas analysis is reflected at a value below the reading of 7.35. Respiratory acidosis is an underlying condition which is mainly manifested in the patient due to severe respiratory failure or ventilator failure. Normally the lungs help in the ventilation process by taking in the oxygen and exhaling our carbon dioxide. Oxygen is circulated through the lungs in the blood, whereas, carbon dioxide passes from the blood to the lungs. Due to respiratory insufficiency, the lungs are not able to filter out enough carbon dioxide from the lungs (Pompey, 2019). This can also be caused due to decreased movement of air with in the lung passage, due to other underlying factors such as age, physiological changes and so on.
(b) Chronic Obstructive Pulmonary Disease (COPD) is characterized by the feature of poor and irreversible airflow obstruction. It is brought about by an abnormal inflammatory response in the lungs. Long term exposure to pollutants and genetic abnormalities can also result in the development of COPD in the patients (Anzueto, 2017). Due to increase mucous production and its hypersecretion, there is constant tissue damage in the lungs. The destruction starts from smaller passages of the lung spaces known as bronchioles and extending further into the further branches of lungs spaces. This progressive deformation and inflammation of the lung passages lead a patient to develop Chronic Obstructive Pulmonary Disease.
(c) The treatment of patient having COPD history and having respiratory acidosis can be divided into surgical management and medical management. The medical management of these patients can be done in the following manner:
The surgical management of the condition can be done in the following ways:
Question-3 (a) Before getting a secondary assessment survey done for the patient, it is generally considered that any life-threatening condition which was observed in the patient, was dully detected and corrected as on time. The main focus of this assessment method is to identify a specific condition the patient may be having. For this assessment purpose, a full set of vital signs, giving comfort and history of the patient from head to toe is taken, including the inspection of the posterior part of the body as well. The components of secondary survey are as follow:
(b) The three common respiratory signs that are observed in patients of COPD are as follow:
The patient can be monitored for these abnormal signs through physical examination as well as vital and lab monitoring. The patient can be assessed through the means of periodic auscultation to evaluate for the air flow entry. Vitals such as respiratory rate, heart rate, saturation and blood pressure can be monitored for the any deviation. Arterial blood gas analysis can also be helpful in keeping a track on the percentage of oxygen and carbon dioxide saturation in blood.
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