Heart Education Awareness Resource and Training through eLearning (HEARTe)
Frank’s cardiac care plan
Q. What do you think Frank’s care plan will consist of? Use the drag and drop to find out.
Investigations
Treatments
ECG (Y) – this will allow us to see what is Frank’s heart rhythm and whether he needs further investigations or consideration for device therapy.
CXR (Y) – This will show evidence of pulmonary oedema
Bloods (Y) – Obtaining blood samples will allow us to rule out other causes of Frank’s symptoms and allow us to keep on eye on his renal function.
urine volumes (Y) – Frank’s cardiac output is poor at present and we need to monitor his kidney function and ensure that he is diuresis well with the diuretics.
Echo (Y) – An echocardiogram wil give us a 2D image of what is happening within Frank’s heart. This can be carried out at the bedside
ETT (N) – Frank is not fit enough for undertaking an exercise tolerance test at the moment. This test allows us to assess patients fitness after a MI and is needed for certain driving licences.
CT Scan (N) – A CT scan will demonstrate cardiac anatomy but is not required in the acute setting of Frank’s illness
MRI (N) – A MRI scan will demonstrate cardiac anatomy but is not required in the acute setting of Frank’s illness
Oxygen: (Y), although sometimes the patients oxygen saturations are not low, the lack of oxygen to the body is due to the heart not pumping effectively.
Nitrates (Y) – IV nitrates will help reduce Frank’s preload and vasodilate his blood vessels putting less stress on his heart.
Diuretics – (Y) Frank needs IV diuretics to get rid of the fluid retention.
Morphine – (Y) this will help Frank relax and breath better. It will also reduce his anxiety levels.
Inotropes – (Y) Frank may require inotropes to help the pumping action of his heart and maintain adequate blood pressure.
CPAP – (Y), the Continuous Positive Airway Pressure (CPAP) will open up Frank’s airways and help him breathe.
IV Fluids (N) – Frank is already struggling with fluid overload therefore should not receive IV fluids.
calcium channel blocker (N) – Apart from Amilodipine, calcium channel blockers are contradicted in heart failure
