Question

CASE SCENARIO

Mrs. Martha Davis is a 59 year old female is admitted at midnight with a diagnosis of Chest Pain. She complains of a squeezing type pain across her chest and into her left jaw area. Vital signs are: Blood Pressure-200/110; Pulse-128 beats per minute; Respirations- 26 per minute; Temperature-99.8; Saturation of Oxygen-86% on room air; pain level 9/10. During your initial assessment she is rubbing her mid-chest, grimacing and is diaphoretic. The pain has been occurring intermittently throughout the evening and night. Her color is pale except around her lips which are bluish. Cardiac auscultation reveals a rapid rhythm and a murmur, no pulse deficit. She has never had this pain before. Lungs sounds are crackles in both bases with clear upper lobes. She is afraid she is going to die. Per standing orders, a nurse administers & administers Nitroglycerine 0.4mg sublingually; applies cardiac electrodes for continuous cardiac monitoring; obtains an electrocardiogram; which indicates Mr. Davis is in a SVT (supraventricular tachycardia) and a Non-ST elevation MI. The nurse places a peripheral intravenous catheter with saline lock; positions patient in low Fowlers. On assessment vital signs are Blood Pressure-88/45; Pulse-188 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.

Question 1. What other treatments do you expect for her MI? Why?

atleast answer in 200 words

Answer 1

Patient came with chest pain with ecg changes immediately start medicine to relieve pain, pain relievers such as morphine, then dual antiplatelets aspirin loading dose of 325mg and clopilet or ticagrelol should give.and the statun to control blood cholesterol. iv nitroglycerin should start if, blood pressure normal.then correct the arrhythmia ie SVT..it is corrected by administration of adenosine or verapamil.check the vital signs of the patient, if bp is on the lower side start with ionotropes to stabilize the bloodpressure, start with oxygen to improve oxygen saturation.Other blood-thinning medications. likely be given other medications, such as heparin, to make blood less "sticky" and less likely to form clots. Heparin is given by IV or by an injection under skin. If the pain still persisting, immediately take the patient for coronary angio plasty and stenting.

A heart attack happens when blood flow to the heart suddenly becomes blocked. Without the blood coming in, the heart can't get oxygen. If not treated quickly, the heart muscle begins to die. But if you do get quick treatment, you may be able to prevent or limit damage to the heart muscle.

Early treatment aims to reduce the extent of myocardial damage. As the myocardium is damaged by a diminished oxygen supply due to the obstructed coronary artery, infarct size can be reduced in two ways: dissolution of the thrombus to restore coronary blood flow, decreasing myocardial oxygen consumption.

Restoration of flow by antiplatelet agent, thrombolytics, anti thrombins and ptca. It restore the blood flow. Decreasing the oxygen consumption ieved by lowering the heart rate, blood pressure, cardiac filling pressure. It is by betablockers, ace inhibitors and nitroglycerin.