Assessment
The
severity of the patient’s symptoms, the practice setting of the nurse, and the
purpose of the assessment are factors that need to be considered when
determining the frequency and extent of nursing assessment required. The
assessment of the acutely ill cardiac patient will be different from that of a
patient with stable or chronic cardiac conditions. For example, the assessment
per formed by an emergency department nurse caring for a patient who is
experiencing an acute myocardial infarction (MI) must be very focused and must
be performed rapidly. The nurse must as-sess the patient for complications
associated with the MI, screen the patient for contraindications to coronary
artery reperfusion strategies including thrombolytic therapy or primary
percuta-neous transluminal coronary angioplasty (PTCA), and evaluate the
patient’s response to medical and nursing interventions. For this patient, the
health history, physical assessment, and important nursing interventions (eg,
cardiac monitoring, administration of intravenous medications) are performed
simultaneously.
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