Question

3. Your patient is a 73year old male with a medical diagnosis of Coronary Artery Disease.

     He complains of chest pain with no shortness of breath. You need to check his pulse before administering medication.

Name and describe 2 sites and 2 ways to measure his pulse. (20pts)

What are some of the factors that affect the Pulse rate and rhythm?     (25 pts)

(include physiology and normal and abnormal Pulse parameters)      

Discuss the advantages and disadvantages of the 2 sites and 2 ways of Pulse                                                                             

      Measurement from your answer in question “A”                                       (20 pts)

From your discussion in question “C” discuss how will this have an impact in your

          Nursing practice                                                                                              (20 pts)

E. State and Discuss one Nursing Diagnosis associated with your patients’ problem (15 pts)

Answer 1

73 year old male with Coronary Artery Disease, having complains of chest pain with no shortness of breath.

A. Name and describe 2 sites and 2 ways to measure his pulse....

SITES...1. Radial artery.....2..Femoral artery....3...Other sites....carotid, poplitial, dorsalis pedis, temporal...

WAYS...1. Manual Method....choose the derired arterial site and just palpate it agsinst the underlying structure..and fell the pulse and corelate it with the heart beat..2....Moniter Method...by pulse oxymeter, by cardio moniter.

B...Factors that affect the Pulse rate and rhythm....

The pulse that you feel is The pulse is usually determination of systolic blood pressure as in systol and it move the arterial wall...

so there are various factors which affect the heart and leads to change in pulse rate and rhythm..

(1)Sex. Women have a slightly faster pulse rate than men.

(2)  Age. The pulse rate gradually decreases from birth to adulthood then increases with advancing old age.

(3)  Body temperature. The pulse rate generally increases 7-10 beats for each degree of temperature elevation.

(4)  Digestion. The increased metabolic rate during digestion will increase the pulse rate slightly.

(5)Pain. Pain increases pulse rate.

(6)Emotion. Fear, anger, anxiety, and excitement increase the pulse rate.

(7)  Exercise. The heart must beat faster during exercise to meet the increased demand for oxygen.

(8)  Blood pressure. In general, heart rate and blood pressure have an inverse relationship. as the blood pressure is low, there is an increase in pulse rate ans vice varsa...

C...Discuss the advantages and disadvantages of the 2 sites and 2 ways of Pulse.....

manual method....advantage.... simple, easy to perform, need no mechenical instruments, easy on counting, ....disadvantages.... chances of error in manual counting, not so accurate measure the rate, low probability in low volume pulse, depends on local conditions as low temp. height and short neck, amputed limbs etc..

.Moniter Method.....advantage... accurate measure, no need of counting, no personal attention.....Disadvantages....need electronic monitering, costly, need extra source, use some attachment with patients body..

D..discuss how will this have an impact in your Nursing practice.....

As a trained nurse you have to awere about the correct methedology and techenique about the measurement of pulse as the measurement of pulse is the first basic clinical application towards the management of your patient..

by just feeling the pulse by manual method you gain the trust of the patient by touching science and healing theory...and on feeling the pulse you just predict the normal nature of the disease in some instance as mentioned in above question...

as by use of moniter method... u freely perform your work without engaging only on pulse and does an accurate eye on the vitals of the patient...

E..State and Discuss one Nursing Diagnosis associated with your patients’ problem​ ....

there are various medical conditions that can be associated with Coronary Artery Disease...but as you specifically mention one medical condition that is associated with Coronary Artery Disease with complains of chest pain with no shortness of breath....so tthe condition can be sudden dissection of aorta...OR ACUTE MYOCARDIAL INFRACTION ....

IN dissection of aorta.... VARIATION of radio-femoral delay....with Chest pain...mostly managed surgically

and in ACUTE MYOCARDIAL INFRACTION .... alteration of pulse pressure... with chest pain...and managed conservativelly with antifibrinolytics, analgesics, oxygen and anticoagulants...