cardiac case study

 

1. Dylan Radin, 55 years of age, is a male patient who is admitted to the ED via ambulance with acute onset of midsternal chest pain radiating down the left arm and radiating up the left side of the neck. The patient complains of shortness of breath and is cool, pale, and diaphoretic. The vital signs include: blood pressure 160/90 mm Hg, heart rate 110 bpm, respiratory rate 26 breaths/min, and temperature 99°F. The 12-lead ECG reveals an anterior wall ST-elevation myocardial infarction (STEMI).

1. What first actions should the nurse take after the patient has arrived in the emergency department?

1. The emergency physician has contacted a cardiologist and the patient is scheduled for a percutaneous coronary intervention (PCI) in less than 60 minutes from the door-to-balloon time. Explain the reasoning for this action based on evidence- based guidelines and considering the clinical manifestations and the pathophysiology of the STEMI.

2. The home health care nurse is visiting Mr. Simpson, a 62-year-old man with a significant history of angina pectoris. During the visit, the nurse assesses Mr. Simpson’s current status, including his vital signs, activity level, and dietary intake. Mr. Simpson’s medications include nitroglycerin sublingual as needed for chest pain, metoprolol, Cardizem, and ticlopidine.

1. What are the rationales for the ordered medications?

1. Mr. Simpson continues to smoke despite his disease process. How does smoking increase Mr. Simpson’s chances of angina episodes?

1. The nurse reviews the correct procedure for taking nitroglycerin for chest pain, and includes what information?

1. The nurse uses the PQRST acronym to assess for symptoms of angina. What is the nurse assessing?

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