CCS - Complete Heart Block (trauma) Flashcards
1
Q
PRESENTATION
Common Features of Complete Heart Block
A
Symptoms:
- Chest Pain
- Dyspnea
- Fatigue
- Confusion
- Dizziness
- Syncope
Vital Signs:
- Bradycardia
- Hypotension
- Tachypnea
2
Q
PHYSICAL EXAMS
Physical Exams for Complete Heart Block
A
- General Appearance - Appears confused, well developed
- Lungs - Chest wall with Bruising on the Sternum (trauma), Rales, breath sounds bilaterally
- Heart - Bradycardia; heart sounds normal. No murmurs. Bilateral central and peripheral weak pulses. Mild JVD.
3
Q
DIAGNOSIS
Orders for Complete Heart Block
A
-
Physical Exam :
- General Appearance, Lungs, Heart
-
ECG (12-lead):
- Atria and Ventricles beat independently of one another.
- Regular and constant Atrial rate (constant P - P)
- Slower but constant Ventricle rate (constant R - R)
4
Q
TREATMENT
Therapy for Lung Cancer
A
- Advise patient, Cancer Diagnosis
- Consult Heme/Onc
- Antibiotics (if pneumonia)
- Advise patient, fluid restriction (if SIADH)
- Demeclocycline (if SIADH)
5
Q
MONITORING
Monitoring for Lung Cancer
A
Not important for lung cancer case
6
Q
SEQUENCING
CCS Order Sequence for Lung Cancer
A
- Physical Exams - General Appearance, Skin, HEENT, LNs, Lungs, Heart, Abdomen, Extremities/Spine, Neuro
- Orders - Pulse Oximetry & CXR (PA/Lat)
- Clock - advance to CXR results (Lung infiltrate, COPD signs)
- Location - Inpatient unit
- Orders - Sputum tests, Chest CT w/ contrast, Bronchoscopy, Antibiotics, Acetaminophen, Advise no smoking, Advise medication side effects, Counsel patient
- Clock - advance to results of Bronchoscopy or Sputum Cytology
- Orders - Advise cancer diagnosis, Abdominal CT w// contrast, CBC, BMP, LFT, Consult Heme/Onc, Consult Radiation therapy, Consult Thoracic surgery, Reassure patient
- Clock - advance to additional results and case end. Treat SIADH and Hyponatremia if present
- End Orders - Advise Advance Directives
