Question

 

Discuss the underlying pathophysiology of the following patient. Describe the alterations in health and treatment modalities. Please respond thoughtfully and in details of what a nurse would do.
1. Mr. Jones is a 75 year old male patient that presented in emergency room with a history of cardiovascular disease (CAD). He came to emergency room with complaints of crushing chest pain, dizziness and nausea. The patient is able to communicate but his wife is also present.

Abnormal ECG readings reveal an elevated anterior ST segment. VS: 184/120, 144, 32, 99.1

WBC 11.2

Na 3.0

K 5.5

Discuss the underlying pathophysiology of the following patient. Describe the alterations in health and treatment modalities. Please respond thoughtfully and in details of what a nurse would have done.

2. Mrs. Smith presents at the ER with c/o headache and dizziness. She is alert and oriented upon admission. This patient is admitted to a neuro floor. The next day she is being assisted to eat with the nurse’s aide. The patient demonstrates dysphagia and hemiplegia. An MRI reveals an acute hemorrhagic stroke. Describe a complete neuro assessment (NIH stroke scale) and safety concerns when caring for this patient.

Answer 1

Person has - ST elevation myocardial infarction of type anterior
Management:- Nurses have crucial role in management of myocardial infarction.
- they must respond rapidly and efficiently to the patient with MI.
- Administration of sublingual nitroglycerin and aspirin.
- Quickly obtain a 12-lead EKG if directed by physician.
- maintain airway , breathing , circulation ( ABC of resuscitation)
- detect enzymes in blood with help of devices enzymes like creatine kinase, lactate dehydrogenase etc.
- closely monitor the patient and inform doctor.

Management of acute myocardial infarction:-
- morphine is given to the patient for fast relief from chest pain.
- Aspirin (160-325mg)is given for chewing.
- Sublingual nitroglycerin(0.4mg) should be given for pain relief and coronary artery dilation.
-4L/min oxygen if a patient's oxygen saturation is less than 95%.(according to current AHA guidelines)
- Low molecular weight heparin.
E.g. enoxaparin sodium

# PERCUTANEOUS INTERVENTION:-

-PTCA(percutaneous coronary angioplasty)
-CABG (coronary artery bypass grafting)