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Question: Physiological Monitoring: Case 1: Jean
Jean (Blood Pressure and Heart Rate)
Jean is a 79 year old lady who lives alone and was found on the floor of her home by her home help who had not seen her since the previous day. She was taken to hospital and three hours later was admitted to the Stroke unit. She tells you that her left arm and leg feel weak and she is unable to raise her left arm off the bed.

Which two of the following are most accurate for measuring heart rate?
a) Counting the heart rate using a stethoscope
b) Monitoring heart rate with ECG electrodes


Physiological Monitoring: Case 2: Bob
Bob (Blood Glucose)
Bob, a 59 year old man weighing 28 stone, was in the fish and chip shop when he developed sudden vertigo.
He was driven straight to A&E where it was noted that he had a nystagmus and ataxia (lack of coordination). A diagnosis of posterior circulation stroke was confirmed on a CT brain scan.


Physiological Monitoring: Case 3: Archie
Archie (Temperature, Respiratory Rate and OArchie (Temperature, Respiratory Rate and Oxygen Level)
Archie is a 69-year-old retired accountant who was admitted to hospital after waking from sleep with loss of speech and weakness down his right side. The exact time of onset was unclear and he was admitted to the stroke unit five hours after wakening. A number of observations were carried out on admission to the stroke unit, which are shown in the chart.xygen Level)

Answer: Physiological Monitoring: Case 1: Jean - Counting the radial pulse is usually accurate however there can be problems with a patient who has an irregular pulse or Low BP. Measuring the HR using either pulse oximetry or radial pulse has the following limitations:
1) Weak pulses can be difficult to feel and count
2) Fast or irregular pulses can be difficult to count accurately
3) The pulse may not accurately reflect the actual heart rate because a weak heart beat may not always produce a pulse that can be detected at the wrist
Counting the heart rate using a stethoscope should be measured for a full 60 seconds.

Common implications of not recognising abnormal HR or rhythm include;
• Progressive deterioration in stability of the cardiovascular system
• Potential to lead to changes in blood pressure
• Low blood pressure leading to poor perfusion of important organs e.g. bra...(short extract)

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  • Subject: Nursing
  • Course: Nursing
  • Level: Degree
  • Year: 1st
  • Mark: Not available
  • Words: 1751
  • Date submitted: May 19, 2017
  • Date written: Not available
  • References: No
  • Document type: Essay*
  • Essay ID: 7986

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