i have a patient who was in a motor vehicle accident.Her vital signs are normal except for the pulse rate which is 164. Patient was alert to name and care but is not a good historian. Oxygen sat is 93-94% in 1 Liter nasal prong. Patient complain of pain on the fractured ribs but not chest pain. She also complain of dizziness, when physio therapy got her sitting on the bed. She later complain of feeling nauseated but she was previously complaining of the same before. Writer came and check the patient again and her pulse is still high. Writer called the doctor in charge of the patient and relayed the information. The doctor ordered IV medication for nausea and he ordered an EKG STAT. The question is should I have called a code because of the high pulse ? Did I fail to exercise what is expected of me as a nurse?
We don't know the patient's age, the extent of the injuries, the details about the motor vehicle accident, patient's pertinent past history, etc. Nevertheless,
the story is disturbing because of the persistent rapid heart rate. The electrocardiogram is indicated, but it must be interpreted. I don't know if a code should be called because of the rapid heart rate, but certainly a proper diagnosis is indicated and particularly so because the patient has been in a motor vehicle accident. One can imagine such things as cardiac effusion, persistent hidden hemorrhage, etc.
I would agree that the circumstances call for proper attention and a diagnosis of what is going on. One should consider life-threatening events, and I commend you for your proper concern.
Please be aware that I am unable to diagnose medical conditions online.
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