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Question-1- (a) The above-mentioned ECG strip represents atrial fibrillation. It is a common form of observed cardiac arrhythmia, which is represented by a loss of “P-wave” in the ECG strip. It is marked by an irregular and rapid heartbeat or heart rate (Freedman, 2016). This condition can increase the chances of development of stroke in an individual and can also cause further heart-related complications. The cardiac arrhythmia in atrial fibrillation is found to be caused by irregularity in the flow of atriums or upper chambers of the heart. These chambers do not attain pumping action in sync with the lower chambers or ventricles of the heart and thus, creating an emergent situation for the patient. Missed or rapid conduction in the upper chambers of the heart, brings about an added pressure on the heart vessels and thus, repetition of this phenomenon can cause life-threatening condition for the patient as well (Staerk, 2017). If atrial fibrillation goes untreated, it can lead to clot formation in the upper chambers of heart, which is well-connected with some of the major arteries in the body. This can cause blood flow obstruction and ischemia in various organs of the body.
(b) There are multiple reasons for development of atrial fibrillation. Three of the main attributing reasons can be as enlisted below:
(c) The treatment options of atrial fibrillation can be in multiple forms. Some of the commonly used methods are as mentioned-below:
Question-2 (a) The arterial blood gas analysis of the patient indicates respiratory acidosis. Respiratory acidosis is marked by respiratory insufficiency in the patient. This insufficiency brings about a hampered potential of the patient to evacuate out carbon dioxide from the lings. The increase in the value of partial level of carbon dioxide in blood and low pH indicates an acidic nature of blood developing in the body. The pH of the blood is supposed to be maintained at a neutral value so that proper gaseous exchange can be executed by the lungs and thus, maintaining a normal inspiration and expiration ratio. Acidosis in blood in indicated in blood with a pH value below 7.35. Respiratory acidosis can lead to the patient developing a ventilatory failure (González, 2018). Due to increased value of carbon dioxide, they can get mixed in the lungs through ventilation process and not get adequately flushed out of the system, leading to carbon dioxide toxicity. Pulmonary edema in the lungs is marked by fluid filled in air passages of lungs due to gaseous exchange abnormality. This condition can be both acute and chronic. The condition of pulmonary edema can be directly associated with respiratory acidosis as there is a major imbalance in the gaseous exchange. With respiratory failure occurring in respiratory acidosis, the patient can develop acute pulmonary edema as well (Belenguer, 2017).
(b) Acute pulmonary edema in the lungs can be marked by a rapid fluid buildup in the lungs. This fluid is generally filled in lower passages such as alveoli and interstitium. This further hampers with the pulmonary circulation in the lungs (Bhattacharya, 2016). With the slow progressive building up of fluid the air passages further constrict and thus, decreasing the lungs’ capacity for adequate gaseous exchange and reduced lung compliance as well. This can also accumulate in the patient causing symptoms such as hypoxia and dyspnoea. Acute pulmonary edema can be cardiogenic in nature or non-cardiogenic. Cardiogenic acute pulmonary edema can be reflected in the patient in terms of reduced cardiac output, whereas, non-cardiogenic acute pulmonary edema can be reflected as the patient having reduced vascular permeability.
(c) The treatment of patient having acute pulmonary edema can be as follow:
Nursing interventions- The nurses can cater to the medical needs of this patient in the following ways:
Question-3 (a) A secondary survey of the patient is generally conducted when all potential life-threatening conditions are avoided. A composite assessment of the patient is carried out in this method. The various aspects that are covered in this condition include the following:
(b) The three common respiratory signs that can be observed in the patient in the given case scenario include:
The patient in the given case study should be monitored on an hourly basis for vitals such as heart rate, respiratory rate, blood pressure, blood oxygen saturation etc. The lab test of arterial blood gas analysis should also be done, to keep a close vigil on the gaseous abnormality (Fanari, 2019). This will be helpful in altering the dose of medication and oxygen supplement to be provided to the patient. Blood pressure readings are to be monitored specifically to this case, as the readings will be helpful in altering the dosage of diuretics in the patient, used for managing acute pulmonary edema.
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