Monday, September 26, 2011

Post Ventricular Septal Rupture Repair

Immediate Post-Op

HR - 122/min
BP - 88/60 mmhg
Temp. - 35.8
PCWP - 13 mmhg
CVP - 12 mmhg
PAP - 42/14 mmhg
SVO2 - 42 mmhg
CI - 1.9
SVR - 2860
Vent settings:
VT - 600
AC - 16
FI02 - 90%


ABG
ph - 7.30
pCO2 - 40
HCO3 - 18
Base Excess - -4

Electrolytes
Na - 138
K - 3.0
Cl - 112
CO2 - 8

Hemoglobin 12
Hct - 32
WBC - 9800

IABP - 1:1 frequency
Aug - 80mmhg
MAP - 45 mmhg
Assisted Aoedp - 50
Unassisted Aoedp - 50
Assisted Systole - 80
Unassisted 81

Mediastinal tube - 60 ml
Pleural CT - no air leaks

Patient is intubated and sedated (on propofol)
Dopamine at 6 mcg/kg/min
Nipride is at 1 mcg/kg/min

Based on hemodynamic parameters, what is the most emergent situation the nurse has to do?

a. Cardiogenic Shock
b. Tension pneumothorax
c. Cardiac Tamponade
d. Septic Shock

The answer to this is cardiac tamponade because there is equalization of pressures between PAD, PCWP and CVP.

1 comment:

  1. The answer is Cardiac Tamponade. Do you all see the equalization ofpressures = PAD, PCWP and CVP all 3 within 1-3 mmhg.

    Of course, you can look at the hemodynamics which is showing cardiovascular collapse!!!

    By the way, you all can post anonymously if you don't want anyone to know your comment. Under comment there is a tab and you can click anonymous!!!

    ReplyDelete