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Kendra Brown
25:705:460:03 Nursing Elective
Cardiac Arrest Case Study
April 24, 2023
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Cardiac arrest is a medical emergency that occurs when your heart starts beating. It’s important
for healthcare professionals to take action when this occurs. In this case study, there were many
key problems. Patient D has a history of smoking. Smoking is one of the risk factors for cardiac
arrest. This is something to be mindful of when taking care of patients with this history. When the
patient was transferred to the PACU, the nurse was aware of the signs and symptoms of respiratory
distress and the patient’s vital signs at the time. One thing I noticed during this part was that there
was no indication of an assessment being done. This is another key problem. The nurse did not
check the patient’s incisions, if there were wound vacs, how the patient’s skin feels and looks, the
heart sounds, lung sounds, etc. A full assessment was not completed. Another key problem in this
study was the nurse’s judgment when giving the narcotic.
In the study, Patient D was noted to be dozing but still mentioned being in pain. The nurse
should’ve assessed the patient’s pain on a scale from 0-10 and then spoke with surgeon or provider
at the time. This is important because the patient has already received previous medications and
sedatives. Opioids and sedatives combined could increase side effects (American College of
Surgeons, 2020). Another key problem was the nurse making an assumption in regards the
patient’s oxygen saturation decreasing due to their smoking history. It’s important to never make
assumptions. These problems exist due to poor assessment, poor nursing judgment and making
assumptions. This can impact the organization because of possible lawsuits from family members,
possible increase in hospital errors or mortality rates, and possible misdiagnosis or wrong
treatments based on assumptions. Therefore, the nurse in the PACU is held responsible for Patient
D due to the problems mentioned above.
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As a scrub nurse in this case, I would set up the operating room for the patient and make
sure all tools are sterile and ready for the procedure (Western Governs University, 2020). I would
also assist the doctor during the entire procedure. As a circulating nurse in this case, I will meet
with the patient before the procedure. In this part, I would review the patient’s chart and history
and notice the risk factors. I will go over the consent form and witness the patient signing. I would
then answer questions if needed or have the doctor conduct the procedure to return if there are
questions, I can’t answer. I would also make sure to update the family members on the operation
status (Mathenge, 2020). As a PACU nurse, I will make sure the patient is stabilized, conduct a
physical assessment, take vital signs, update family members, and ensure the patient is
comfortable.
The best solution for this case is as follows: Make sure to review the patient’s chart and
past medical history to assess for risk factors. It’s important to assess if a patient has risk factors
so as healthcare professionals, we can work to prevent them. After surgery, it’s important to
conduct a physical assessment and take vitals to see what’s going on with your patient. The PACU
nurse has to document as well, so it's important to document the things you did and saw while
caring for the patient. If your patient appears to be sedated or not fully alert, it’s important to
reevaluate any medications that may put your patient at risk for respiratory distress or even cardiac
arrest. Obtain assistance if needed from the charge nurse. Communicate with your team. Never
make assumptions. Assumptions can lead to misdiagnosis, wrongful treatments, and medical
errors. As always, continue to monitor the patient until discharge or unless transferred to another
unit.
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Mathenge, C. (2020). The importance of the perioperative nurse. PubMed Central (PMC).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8115701/
Safe and Effective Pain Control After Surgery. (2020). American College of Surgeons.
https://www.facs.org/media/0zwpn2ao/safe_pain_control_women.pdf
Western Governors University. (2020). Surgical Nurse Job Description and Career Guide. Western
Governors University. https://www.wgu.edu/blog/surgical-nurse-job-description-careerguide2008.html#close