Share your thoughts regarding this condition change. Although each level of prehospital provider possesses a different knowledge of pathophysiology and patient management, it is the combined contributions and efforts of each provider that will afford patients the high quality of care they deserve. Jugular veins: Normal, not distended. At 6:45 a.m., your unit is dispatched for a … Share your thoughts on possible reasons for Homers weakness. Female patient, 64 years old. After confirming no history of bleeding disorders or allergies, you administer 324 mg of aspirin to the patient. With regard to this understanding, it is vital for the doctor to establish a comprehensive understanding into the current health state of the patient. With regard to the fact that the patient is under a high dosage for digoxin, there exists the potential for digoxin toxicity due to insufficiencies in the renal system. Before discussing the physiologic effects of nitroglycerin, a brief review of coronary atherosclerosis, myocardial ischemia and angina pectoris is in order. initial tests show patient has bradycardia with 45 b/min. Pertinent past history: "I have high blood pressure and the doctor told me I may have a heart attack if I don't start Following additional assessment in the emergency department, the patient is diagnosed with an acute anterior wall myocardial infarction. The cardiovascular system or the heart is being affected that is causing Tom’s symptoms. According to Medscape (2016), heart failure patients should be administered with 0.125-0.25 mg per day. Overview Heart Failure – Case Study Mr. Jones, a 69-year old male, presents to the Emergency Department (ED) after visiting his primary physician complaining of general fatigue for 4 days, shortness of breath, and abdominal discomfort. Chest pain severity: 3 on a 0--10 scale. However, among the main signs and symptoms of COPD are shortness of breath and chest pains, which the patient denies. Since his blood pressure remains stable (130/84 mmHg), you administer another 2 mg dose of morphine via IV push. Radiation/Referred: "The pressure stays in my chest. These negative consequences of atherosclerosis reduce the ability of the heart to accommodate increases in myocardial oxygen demand, such as that caused by stress or exertion. Events leading to the present illness: "I was asleep when the pressure in my chest woke me up.". Coronary atherosclerosis is a progressive disease characterized by the buildup of lipid-laden plaque within the lumen (channel) of the coronary artery. Cardiac Case Study Cardiac Case Study Case Study Questions: Myocardial Infarction Question The ST segment is a portion of theisoelectric line, which becomes evident immediately after an S wave precedes the T wave. Blood pressure: 130/84 mmHg. Female, 56 years old, a teacher. Unstable angina occurs when the patient experiences a change in his typical anginal pattern, indicating advanced coronary atherosclerosis and an oxygen supply-demand mismatch that is not so easily balanced with rest and nitroglycerin. What tests or procedures would be important to perform ? Some patients with certain relative contraindications may still be eligible for fibrinolytic therapy, based on a careful evaluation by the physician. You have entered an incorrect email address! female •Hx: CAD, CABG, HTN, PVD, and recent NSTEMI with stenting to bypass graft •Presented by private vehicle to referring hospital ED after sudden onset of 10/10 chest pain, nausea, and diaphoresis while eating lunch at McDonald’s Read the case study, answer the questions, and write nursing diagnosis as directed. Cardiovascular system case studies. In order for the heart to beat stronger and faster, it requires and uses more oxygen. Digoxin is also used for patients demonstrating potential for heart failure conditions. ECG: Normal sinus rhythm at 90 beats/min. Marketing case study competition. Homer states that for the past two weeks he has not had any pep and that he feels too tired to finish chores. Additionally, patients are also aware of what they need to do to resolve their symptoms (e.g., a specific period of rest, nitroglycerin). He describes substernal chest pressure radiating to his jaw. A 58-year-old male presents to the ED after experiencing intermittent chest pain for 2 days. A clenched fist in the center of the chest (the precordium) conveys the feeling of pressure or squeezing and is called Levine's sign (see the photo on page 50). Nothing that I do makes it better or worse." (2014). Provocation/Palliation: "This pressure in my chest is Streptokinase (Streptase) Although EMT-Basics and EMT-Intermediates are not usually trained to interpret ECG rhythms, they can, through index of suspicion based on the patient's signs and symptoms, suspect AMI and conduct a field screening, especially if the time of onset is less than 12 hours. What information would be important to gather from this patient ? Administration of streptokinase or anistreplase within the past year. It is also important that weakness is one of the signs of a number of cardiovascular diseases including hypertension, COPD, heart arrhythmias among others (Siewe, 2012). Signs and symptoms of acute myocardial infarction: Table VII: Exclusion Criteria If given to the wrong patient, fibrinolytics can cause life-threatening hemorrhage. A physical assessment reveals Homers vital signs: T 37.1, P 120, R 24, and BP 108/76. Respirations: 22 breaths/min and unlabored. Unifocal PVCs are then treated with 150 mg of amiodarone IV over 10 minutes followed by an amiodarone drip at 1 mg/minute for 6 hours, then 0.5 mg/minute for 12 hours. Unfortunately, in this patient, an occluded coronary artery is blocking the flow of oxygenated blood to the area of the myocardium that needs it most--the injured area. Worsening cases of these illnesses could be a major cause of weaknesses experienced by the patient (Blackburn, 2006). Breath sounds: Clear and equal bilaterally to auscultation. Are there any special considerations for this patient? Atherosclerosis causes narrowing of the artery (decreasing coronary blood flow) and hardening of the artery (limiting the ability of the artery to dilate). GB is overweight and admits to exercising very infrequently. Acute coronary syndrome is a term used to describe many types of compromised circulation to the heart muscle, including unstable angina pectoris or acute myocardial infarction.
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