Asthma exacerbation

An accurate history reduces risk. By Fidelindo Lim, DNP, CCRN, and Nick Deuz, BSN, RN Yi Rong Huang, a 55-year-old man who speaks only Chinese, comes to the emergency department (ED) for nonradiating substernal chest pain. His electrocardiogram (ECG) shows a sinus rhythm with no ST changes; his vital signs are blood pressure (BP) 160/92 mm Hg, heart rate (HR)…

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Atrial fibrillation

Patient history, new symptoms, and assessment findings prompt a call for the rapid response team Takeaways: Atrial fibrillation results from rapid electrical activity that arises from different ectopic foci. Definitive diagnosis of atrial fibrillation is made with a 12-lead ECG Pharmacologic treatment includes selective beta 1 adrenergic receptor blockers to decreases the automaticity of contractions.

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Supraventricular tachycardia

Quick action reverses SVT and prevents a disastrous outcome. Takeaways: Atrial fibrillation and atrial flutter are the most common subtypes of supraventricular tachycardia, which is relatively common in women. The treatment of choice for unstable patients is synchronized cardioversion. For stable patients, initial treatment is a vagal maneuver, such as the Valsalva maneuver or carotid massage. Pharmacologic treatment includes adenosine…

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Isopropyl alcohol poisoning

Quick action puts a patient on the path to recovery. Takeaways: Isopropyl alcohol poisoning is uncommon and resembles ethanol intoxication because both toxins affect the central nervous system. People ingest isopropyl alcohol to become intoxicated (when traditional alcohols aren’t available) or to harm themselves. The presence of an anion gap metabolic acidosis is used to differentiate etiology, assess severity, and…

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Abdominal aortic aneurysm

Recognize potential danger for a positive outcome. Takeaways:  Abdominal aortic aneurysm is a serious condition that requires prompt identification and effective interventions.  Early recognition of abdominal aortic aneurysm is key to effective management and prevention of fatal complications.  Nurse practitioners play a critical role in identifying abdominal aortic aneurysm. 

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