In: Nursing
D.J., a 67-year-old woman, is taken to the emergency department by her daughter. D.J. reports, “I’m feeling queasy, and I’m very anxious.” She is hyperventilating and visibly sweating. Laboratory tests and a 12-lead electrocardiogram (ECG) have been ordered by the physician. She is on continuous ECG monitoring, and oxygen has been started. Baseline vital signs include the following: blood pressure (BP) of 175/105 mm Hg, pulse rate of 120 beats/minute, and respiratory rate of 34 breaths/minute. D.J’s diagnostic studies are completed, and the results include the following: Elevated cardiac-specific troponin I level Cholesterol level of 8.03 mmol/L Question 3 What should be included in this assessment after the diagnostic studies are completed?
Elevated troponin level and cholesterol level may be the indication of acute coronary syndrome, assessment includes following physical examination for symptoms such asNew transient mitral regurgitation, hypotension, diaphoresis, pulmonary edema or rales.
Ecg for any change in the st segment, presence of Q wave in ecg or t wave inversion.
Check for elevetade cardiac marker such as elevated cardiac troponin T or I, or elevated CK-MB.
Echo cardiography is important to confirm the diagnosis.An echocardiogram uses sound waves, directed at your heart from a wand-like device, to produce a live image of your heart. An echocardiogram can help determine whether the heart is pumping correctly.it determines which wall of heartbis necrotised.whether regional wall motion abnormalities there or not.
Chest xary :it helps to identify the size of heart, any distended pulmonary artery, any fluids in the lungs.
Coronary angiogram. This procedure uses X-ray imaging to see your heart's blood vessels.
Computerized tomography (CT) angiogram:it identifies narrowed and blocked artery which causing acs.