Robin Gilbert – PESI – Cardiac and Respiratory Complexities: Quickly Differentiate to Take Rapid Action

Description

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Robin Gilbert – PESI – Cardiac and Respiratory Complexities: Quickly Differentiate to Take Rapid Action

You are assessing the patient who just returned from endoscopy following a foreign body removal. The patient is complaining of his throat itching. On assessment, his vital signs are normal, but he appears anxious. Is this normal following the procedure? Do you put him on a cardiac monitor? Should you call a rapid response?

We have all been faced with the clinical dilemma when our patient has rapidly progressing dyspnea, tachypnea, fever, cough, and chest pain. What is happening? Distinguishing between heart failure, pneumonia, and ARDS can be difficult. Did you know that COPD could mask a pulmonary embolism? When your patient is wheezing, do you make the assumption it is asthma? Or could the presentation be caused by heart failure or an allergic reaction?

This recording will provide you with the confidence to recognize early and identify appropriate interventions to prevent further deterioration. We will discuss when non-invasive ventilation devices should – and should not – be used. If you are still struggling with blood gases, don’t let blood gases intimidate you! Learn quick and easy ways to interpret ABG results. You will learn from actual patient stories to illustrate the complexities and co-morbidities of cardiac and respiratory diagnoses!

Speaker
Robin Gilbert, MSN, RN, CEN, CPEN, has over 25 years of experience in emergency nursing. She is both a certified emergency nurse and a certified pediatric emergency nurse. Robin has extensive experience working in the emergency department, progressive care, intermediate care, transitional care, step-down and, currently, as the regional manager for staff development at Central Maine Medical Center. Robin draws on her expertise to teach her own hospital staff and experienced healthcare audiences throughout the country on a variety of critical care and emergency nursing topics.

She has been an item writer for the Board Certification of Emergency Nursing (BCEN), a former Chairperson of BCEN, and most recently a contributing writer for the current CEN Review Manual. Robin is an active member of the Emergency Nurses Association, the American Nurses Association, Society of Critical Care Medicine, Association for Nursing Professional Development, and is a reviewer for the ANCC’s Pathway to Excellence.

Speaker Disclosures:
Financial: Robin Gilbert has employment relationships with EBSCO, Central Maine Medical Center, Rumford Hospital, Pathway to Excellence, and Kaplan University. She receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Robin Gilbert is a member of the Society of Critical Care Medicine, the American Association of Cardiovascular and Pulmonary Rehabilitation, and the Emergency Nurses Association.

Objectives

1. Review the nursing assessment for patients with airway or ventilatory problems.
2. Describe the pathophysiologic changes that occur causing the signs and symptoms associated with airway or ventilatory problems.
3. Select appropriate interventions for airway or ventilatory problems.
4. Differentiate between ventilator modes and the use of NPPV.
5. Evaluate appropriate treatment strategies for high-risk ECG findings.
6. Plan for emerging treatments in heart failure.
7. Analyze management options for acute coronary syndromes.
8. Describe the diagnosis, evaluation, and management of inflammatory cardiac disease.

Outline

Hemodynamics

• Do you need a Swan-Ganz?
• Preload/Afterload
• Contractility
• Cardiac output
• Cardiac index
• Mean arterial pressure

Respiratory Diagnoses

• Will the real cause of SOB please stand up: Complicating the respiratory diagnosis
• Clinical presentation, signs/symptoms, interventions, management of:
  Pneumonia
  Asthma
  COPD
  Acute Respiratory Distress Syndrome
  Pulmonary embolism (Air, Fat, Amniotic)
• Anaphylaxis
• Acute Respiratory Failure
• Pleural effusions
• Pneumothorax
• Foreign body aspiration

Respiratory Interventions and Medications

• Pharmacology
• ABGs: Simplifying the numbers
• Chest Tubes: Indications, set-up, troubleshooting
• Capnography: Interpreting what it tells us
• Ventilation and NPPV basics: Modes of ventilation and appropriate uses

Cardiac Diagnoses

• Bradycardic & tachycardic rhythms: Essentials that you need to know
• Is This Patient Having an MI?
  Pericarditis
  Myocarditis
  Endocarditis
  Etiology, Clinical Presentation, ECG changes, Treatment
• Aortic Stenosis
• Heart Failure
• Current best practice recommendations
• Long-term prognosis

Acute Coronary Syndrome

• Unstable Angina
• STEMI
• Non-STEMI
• Differentiating the Three

Cardiac Interventions and Medications

• Pharmacology
  Vasopressors vs. Inotropes
  Ace Inhibitors, Beta blockers
  Anticoagulants
• Stabilization & Treatment procedures
  Stents, CABG, LVADS
• What’s Trending?
  Current trending technology
• Case Presentations & Identify Probable Diagnosis

Target Audience

• Nurses
• Nurse Practitioners
• Clinical Nurse Specialists

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