Please edit below. Please expand the critical thinking part. Make it informal. No introduction regarding arterial line and tranducer necessary. Need to focus the writing on the critical thinking part.
Please edit below. Please expand the critical thinking part. Make it informal. No introduction regarding arterial line and tranducer necessary. Need to focus the writing on the critical thinking part.
On my 4th week of orientation, I admitted a patient from OR post CABG, AVR and Aortic Root Replacement. It was my second admission since starting orientation. The anesthesiologist initially connected some cables to the ICU monitor then I took over. In the assessment portion on the nursing process in relation to admission, I noticed that while the MD was connecting the cables, he zeroed the transducer when it was not level to the patient right atrium (about 2 inches higher). Proper transducer levelling makes a difference in giving accurate BP reading. The pressure bag was also a little deflated and was not at 300mmHg. I understand that a pressure bag placed around the flush solution that’s maintained at 300 mm Hg of pressure delivers 3 to 5 mL of solution per hour through the catheter to prevent clotting and backflow of blood into the pressure monitoring system which is important in measuring the pressure accurately. At this point the BP on the monitor was reading 85/51mmHg. The NP told me to increase the epinephrine which was running. I had also noticed that the patient’s pulse was strong. I responded to the NP that I will not tirtrating the epinephrine yet as I need to inflate the pressure bag to 300mmHg, level and rezero the transducer first. The patient’s correct by then read 115/69 mmHg.
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