Question

In: Nursing

Mr. Jones is a 75 year old male patient that presented in emergency room with a history of cardiovascular disease (CAD).

 

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.

Solutions

Expert Solution

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)


Related Solutions

A patient is a 74 years old white male presented in the emergency room with a...
A patient is a 74 years old white male presented in the emergency room with a chief c/o right flank pain radiating to the lower abdomen associated with painful, burning urination and a foul smelling urine. Patient denies fever or chills. A urinalysis was done which showed a 3+ bacteria with a positive nitrite and elevated WBC. Intravenous pyelogram showed a 6.5 mm kidney stone in the right ureter. The patient is being treated with broad spectrum intravenous antibiotic and...
Mr. Schmidt is a 56 year old male patient who presented to the emergency department with...
Mr. Schmidt is a 56 year old male patient who presented to the emergency department with complaints of left foot pain and swelling, fever and chills for 2-3 days. The client reported increasing discomfort to the foot with noticeable redness that also seems to be worsening. He has an ulcer to the dorsum of the left foot. The client noted that he was seen by his family physician a week ago and a swab was done on the ulcer which...
Patient Introduction Mr. Watkins is a 69-year-old male who presented to the Emergency Department 4 days...
Patient Introduction Mr. Watkins is a 69-year-old male who presented to the Emergency Department 4 days ago with complaints of nausea, vomiting, and severe abdominal pain and was admitted for emergent surgery for bowel perforation. He underwent a hemicolectomy. He has a midline abdominal incision without redness, swelling, or drainage. He is tolerating a soft diet without nausea or vomiting. Bowel sounds are present in all four abdominal quadrants. He had a bowel movement yesterday. Last urinary output was 400...
A 47-year-old patient has smoked for 25 years. The patient has a history of cardiovascular disease...
A 47-year-old patient has smoked for 25 years. The patient has a history of cardiovascular disease and now he has noticed his lower legs have been aching and are pale, hairless, and diminished or absent pulses. Develop assessment questions you would ask this patient to learn more about his problem. Explain the most likely pathophysiology. Describe the structures of the circulatory system most likely impacted by the patient’s symptoms. Describe key considerations regarding the education for the patient and his...
Mr. Green is a 65 year old male who presented to the emergency department with complaints...
Mr. Green is a 65 year old male who presented to the emergency department with complaints of weakness and a temperature of 102.4. Subjective Data: ·       “I feel rotten – I don’t know if my counts are down. I just had chemotherapy 8 days ago”. ·       “I have small cell lung cancer and just received Cis-Platin and Etoposide. ·       “I was hospitalized with SIADH two months ago”. Objective Data:               Physical examination ·       Cardiovascular: B/P – 82/62       AP – 118/min   ...
Mr. Grinch is a 68 year old male who presented to the Emergency Department (ED) with...
Mr. Grinch is a 68 year old male who presented to the Emergency Department (ED) with severe shortness of breath (SOB), fatigue, and recent weight gain of 5 kg. It is two days after Thanksgiving and Mr. Grinch has been eating salted ham and a large amount of leftovers for every meal. He is having trouble speaking, but reports he has been having difficulty sleeping and states, “I feel like I’m drowning. I’ve tried using multiple pillows to get rid...
Your patient presented to the emergency room with acute alcohol toxicity and has a history of...
Your patient presented to the emergency room with acute alcohol toxicity and has a history of drinking 1/5 of Vodka per day for the past 15 years. During his stay in the ICU he went through a very hard withdrawal period experiencing delirium tremens. He is now on your med / s * u * r * g floor not requiring CIWA protocol any longer but with severe pancreatitis. He will have to be NPO for weeks and will require...
Mr. Tan is a 69-year-old patient who is admitted from the Emergency Room with a diagnosis...
Mr. Tan is a 69-year-old patient who is admitted from the Emergency Room with a diagnosis of hypokalemia after 48 hours of vomiting, and diarrhea. The patient's potassium level is 2.9 upon admission. The patient's creatinine level is 0.9 mg/dL and the BUN is 10 mg/dL. As the primary nurse, use the SBAR mnemonic to contact the attending physician for desired orders to care for Mr. Tan. The admitting resident asks you if the ER physician checked a magnesium level....
A 45-year-old, 6-foot tall man presented to the emergency room with a two day history of...
A 45-year-old, 6-foot tall man presented to the emergency room with a two day history of fever and cough productive of brown sputum. He was hemodynamically stable at the time with a blood pressure of 130/87. His chest x-ray showed a right middle lobe infiltrate and his room air ABG showed: pH 7.32, PCO2 32, PO2 78, HCO3 - 18. He was started on antibiotics and admitted to the floor. Four hours later, the nurse calls because she is concerned...
Mr. Watkins is a 69-year-old male who presented to the Emergency Department 4 days ago with...
Mr. Watkins is a 69-year-old male who presented to the Emergency Department 4 days ago with complaints of nausea, vomiting, and severe abdominal pain and was admitted for emergent surgery for bowel perforation. He underwent a hemicolectomy. He has a midline abdominal incision without redness, swelling, or drainage. He is tolerating a soft diet without nausea or vomiting. Bowel sounds are present in all four abdominal quadrants. He had a bowel movement yesterday. Last urinary output was 400 ml at...
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT