Week 2 EKG Week 2: 12-lead EKG Interpretation and Diagnostic Evaluation of

Week 2 EKG
Week 2: 12-lead EKG Interpretation and Diagnostic Evaluation of Arrhythmias
Much like problems with a home’s heating and cooling system, arrhythmias begin with symptoms that often require expertise to diagnose. The symptoms of arrhythmias are routinely among the leading reasons for emergency room visits. Palpitations, racing hearts, anxiety, irregular heartbeats, and chest pain often alert sufferers to the potential for bigger problems. This puts cardiology squarely in the spotlight as the branch of medicine responsible for addressing not only arrythmias but the many cardiac and circulatory disorders that afflict so many each year.
As an advanced practice nurse, you must be prepared to effectively recognize, respond, diagnose, and treat these symptoms. Hence, it is important for nurses at every level of care to demonstrate expertise in heart arrhythmias as a component of cardiovascular care.
This week, you examine issues pertinent to arrhythmias. You examine diagnosis and management approaches to heart rhythm issues and the health problems that may trigger them. You also examine the tools used to help recognize and respond to these issues.
Learning Objectives
Students will:
Interpret 12-lead EKGs 
Discern arrhythmias within 12-lead EKGs 
Develop appropriate treatment plans, including diagnostics and laboratory orders for patients with identified arrhythmias 
Assignment: Branching Exercise: Cardiac Case 1
For this Assignment, you will review the interactive media piece/branching exercise provided in the Learning Resources. As you examine the patient case, consider how you might assess and treat patients with the symptoms and conditions presented.
Photo Credit: [IMAGEMORE Co., Ltd.]/[none]/Getty Images
To prepare:
Review the interactive media piece/branching exercise provided in the Learning Resources.
https://mym.cdn.laureate-media.com/2dett4d/Walden/NRNP/6566/SC01/index.html
answer 1- Atrial Fibrillation with Rapid Ventricular response
answer 2- I would order 12 leads EKG, TSH, CBC, CMP
answer3- I would administer a beta blocker medication such as Metoprolol for rhythm control.
Reflect on the patient’s symptoms and aspects of disorders that may be present in the interactive media piece/branching exercise. My answer this patient is suffer from Atrial Fibrillation
Consider how you might assess, perform diagnostic tests, and recommend medications to treat patients presenting with the symptoms in the interactive media piece/branching exercise. Start this patient on medication for rate control , then for rhythm control to convert A-fib to a normal sinus rhythm such as metoprolol, cardizen IV then amiodarone IV drip for 24 hours then switch to PO , labs 2 D echo of the heart, blood test CBC, TSH, CMP
You will be asked to develop a set of admission orders based on the patient in the branching exercise. ( Google how to treat Atrial- Fibrillation)
The Assignment
Using the Required Admission Orders Template, write a full set of admission orders for the patient in the branching exercise.
Be sure to address each aspect of the order template
Write the orders as you would in the patient’s chart
Make sure the order is complete and applicable to the patient
Any rationale you feel the need to supply should be done at the end of the order set – not included with the order
Please do not write per protocol. We do not know what your protocol is and you need to demonstrate what is appropriate standard of care for this patient.
A minimum of three current, evidenced based references are required.
By Day 7 of Week 2
Learning Resources
Required Readings 
Barkley, T. W., Jr., & Myers, C. M. (2020). Practice considerations for the adult-gerontology acute care nurse practitioner (3rd ed.). Barkley & Associates.
Chapter 21, “Arrhythmias” (pp. 263–290)
Document: Admission Orders Template (Word document) SEE other attachment
Required Media
 



https://mym.cdn.laureate-media.com/2dett4d/Walden/NRNP/6566/SC01/index.html
MedCram. (2019, June 9). ECG interpretation explained clearly and succinctly – arrhythmias, blocks, hypertrophy [Video file]. Retrieved from https://www.youtube.com/watch?v=Rv6l0ViRJDQ
MedCram. (2018, July 15). ST elevation – EKG/ECG interpretation case 12 (STEMI, MI, ACS) [Video file]. Retrieved from https://www.youtube.com/watch?v=8ajWCLqz3VQ
MedCram. (2017, July 23). EKG/ECG practice strip interpretation explained clearly – case 10 [Video file]. Retrieved from https://www.youtube.com/watch?v=zA1Dpwnzrxg
Walden University (Producer). (2019a). Branching exercise: Cardiac case 1 [Interactive media file]. Minneapolis, MN: Author.
Rubric Detail Check for grading
 
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Name: NRNP_6566_Module2_Assignment1_Rubric
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Excellent
Point range: 90–100
Using the Admission Orders Template, write a full set of admission orders for the patient in the branching exercise. Be sure to address the following:· Identify the Correct Diagnosis.
5 (5%) – 5 (5%)
The order set includes an accurate and correct diagnosis.
· Identify the ‘Status/Condition’, ‘Code Status’, ‘Admit to Unit’for the patient in the presenting case.
5 (5%) – 5 (5%)
The order set includes an accurate description / plan for condition, code status, and admission location.
· Describe the “Allergies’, ‘Activity Level’ and “Diet” for the patient in the presenting case.
5 (5%) – 5 (5%)
The order set includes an accurate description / plan for allergies, activity level, and diet.
· Identify any ‘IV Fluids’ needed for the patient in the presenting case.
9 (9%) – 10 (10%)
The order set clearly and accurately identifies a complete order for IV fluid type, flow rate, and administration parameters for the patient in the presenting case.
· Identify any ‘Respiratory’ needs for the patient in the presenting case. Be specific about oxygen (if ordered, include type and rate), pulmonary toilet needs, and ventilator settings.
5 (5%) – 5 (5%)
The order set clearly and accurately identifies a complete order for respiratory care, delivery method, treatments and parameters for the patient in the presenting case.
· Describe the ‘Medications’ including any IV drips for the patient in the presenting case.
Be specific about medications related to the reason for admission and any chronic medications the patient may be taking (ALL, tx of primary condition, underlying conditions, pain, comfort needs, etc.). Be sure to include name, dose, route of administration, and frequency of each medication.
13 (13%) – 15 (15%)
The order set clearly and accurately identifies a complete set of medication orders for the patient in the presenting case. Orders are complete, account for all conditions, and are appropriate to treat the patient.
· Explain any ‘Nursing Orders’ for the patient in the presenting case. Be specific about vital signs, skin care, toileting, and ambulation.
9 (9%) – 10 (10%)
The order set includes a full set of nursing orders that provide essential direction to provide care, monitor, assess, ensure safety, prevent complications and promote healing.
· Explain the ‘Follow-Up Lab’ tests for the patient in the presenting case. Be specific about diagnostic testing (e.g., CXR, US, 2D Echo, etc.).
9 (9%) – 10 (10%)
The order set includes complete laboratory and diagnostic testing to adequately monitor and assess the presenting patient.
· Explain the ‘Consults’ for the patient in the presenting case. Be specific about how you, as an ACNP, would manage the patient’s acute needs for at least a 24-hour period. Include indication for consult (e.g., “Cardiology consult for evaluation of new-onset atrial fibrillation,” “Nutrition consult for TPN recommendations”).
5 (5%) – 5 (5%)
The order set includes clear, accurate, and essential consults for the patient in the presenting case including complete rationale for the consult.
· Explain the ‘Patient Education and Health Promotion’ for the patient in the presenting case. Be sure to address age-appropriate patient education, if applicable.
9 (9%) – 10 (10%)
The order set provides clear, accurate, and complete patient education and health promotion recommendations for the patient in the presenting case.
· Explain the ‘Discharge Planning and Required Follow-Up Care’ for the patient in the presenting case.
5 (5%) – 5 (5%)
The order set provides clear, accurate, and complete discharge planning and necessary follow up care for the patient in the presenting case.
· Identify a minimum of three ‘References.’ Be sure that they are timely and support the admission order in following current standards of care.
9 (9%) – 10 (10%)
The order set includes a minimum of three professional level references that are timely and clearly support the admission orders following current standards of care. References are formatted in APA format.
Written orders include all elements, address all the needs of the patient, are complete, logical, and meets the complete needs of the patient.
5 (5%) – 5 (5%)
Written order set is complete, addresses all the needs of the patient, and are based on current literature.
Total Points: 100
Name: NRNP_6566_Module2_Assignment1_Rubric