Question

On assessment one hour later, vital signs are Blood Pressure-180/95; Pulse-108 beats per minute; Respirations- 22 per minute; Temperature-99.0; Saturation of Oxygen-90% on 2 liters per minute; Pain level 8/10. She says her chest pain hasn’t changed. Heart and lung sounds are unchanged. Color is pale without previous blue changes. EKG displays ST elevation in leads II, III, and AVF. The MD has decided not to perform a cardiac catherization, and has admitted the patient to the ICU with a cardiology consult.

1. What would the laboratory results be if the patient is having cardiac damage?

2. According to the results of the EKG, what type of MI might the patient be experiencing? What coronary artery is involved? What area of the heart does this artery supply blood?

3. A provider orders Aspirin 81 mg x 3 tabs by mouth chewed. What is the rationale for this order?

4. What is the reason for the diaphoresis?

5. The patient's skin color is abnormal, describe this in medical terms?

6. Does this patient need oxygen? If so what type of oxygen administration device would be applied and what rate of flow?

Answer 1

Answern1. serum troponin t more than 0.1ng/ml suggest myocardial damage, troponin I more than 0.2 ng/mL is consistent with MI, CK-MB rise in 3-8 hrs, peak in 10-24 hrs and returns to normal in 2-3 days after the heart attack. Myoglobin rise in the initial 1-3 hrs, peak in 6-9 hrs and back to normal in 24 hrs. myoglobin has lest specificity than any of the other cardiac markers.

Answer 2. Inferior ST segment elevation myocardiac infarction. right coronary artery.is involved

Answer 3.Aspirin 81 mg x 3 tabs by mouth chewed is ordered to prevent from heart attack. Aspirin helps in inhibiting platelet coagulation. Aspirin works fast by chewing atleast for 30 seconds before swollowing it.

Answer4.Diaphoresis occurs as a sign for heart attack. it is due to the activation of sympathetic nervous system

Answer 5. Cynosis is the blusih discoloration of the skin due to lack of blood supply

Answer 6. yes patient should be administered with oxygen. Nasal cannula is required for the administration of oxygen at 4l/min.