1. What are the signs and symptoms of and symptoms of an acute myocardial infarction? • The signs and symptoms are pressure, stiffness, pain in the chest or/ and arms that may advanced to the neck, jaw, or back • Nausea, indigestion, heartburn, abdominal • Dyspnea • Cold sweat • Fatigue • Lightheadedness or vertigo 2. Does this patient exhibit any of them based upon the data you have? Yes, she has cold sweats and hypotension 3. What was the purpose of the stent? The purpose for the stent was to hold the coronary artery open to allow the blood to flow more freely. 4. What is the significance of the ejection fraction? What is normal? It determines how well your heart pumps with each beat by measuring the percentage of blood leaving your heart …show more content…
What is the purpose of each of the medications the patient is on? Why is this patient receiving them? • Dopamine: Increases cardiac output / The patient has hypotension • Diprivan: Relaxes and sedates the patient before surgery / In order to insert the IABP and intubation on the patient. • Dobutamine: Increases cardiac output / To treat the myocardial …show more content…
8. Examine the vital signs. Which are abnormal? What are normal ranges? The abnormal ranges are the temperature (100.5) and the blood pressure (119/56) The normal range: temperature- 97-99.5 blood pressure- 90-100/60-90 9. Analyze the ABG. How would you interpret it? Partially compensated metabolic acidosis w/ hyperoxygenation 10. What would you correct? I would correct the bicarbonate 11. What is the most likely cause for the acid-base balance? The cause for the acid-base balance would be the sedative, the patient’s weight which is obese, respiratory, bicarbonate and metabolic problem. 12. If the barometric pressure is 760 using the ABG data what is the patient’s PAO2? (760-47)*1.0-(21/.8) 713 - 26.25 = 686.75 13. What is the a-A ratio? Is this normal for this FIO2? 686.75 - 124 = 562.75 14. Calculate the CaO2? Is this normal? Is this patient well oxygenated? ( Hb x 1.34 x SAO2 ) + ( PAO2 x .003 ) ( 8.9 x 1.34 x .99 ) + ( 124 x .003 ) 11.81 + 0.372 12.18 No, it is abnormal. The normal range is ( 16 – 20 ) Yes, this patient is well oxygenated because she is on 100 %
Allegra 180 mg OTA - this medication should not make the patient drowsy and since he is a student it is helpful so that he does not get tired during class and can study.
The Mayo Clinic’s book on High Blood Pressure was full of detailed facts about blood pressure and what it is. This is extremely significant to the experiment because blood pressure is one of the variables being tested. Understanding blood pressure is one of the key components to receiving accurate results from this experiment. Most of the book is on high blood pressure, which is not necessary for the experiment, but the book still had plenty of useful information about blood pressure itself. The book explains that when the heart beats, a surge of blood is released from the left ventricle. It also tells of how arteries are blood vessels that move nutrients and oxygenated blood from the heart to the body’s tissues. The aorta, or the largest artery in the heart, is connected to the left ventricle and is the main place for blood to leave the heart as the aorta branches off into many different smaller
After review of the clinical information provided by North Central Bronx Hospital, the Medical Director has denied your admission to North Central Bronx Hospital. It was determined that the clinical information did not justify an inpatient stay. Acute inpatient hospitalization was not medically necessary. You are a 56 year old female with complaints of worsening pressure-like chest pain on the left sided that radiated to your left arm and neck. The symptoms began when you were at rest and woke you from your sleep. Based on the Interqual guideline (a decision based program to determine medical need) criteria to for acute coronary syndrome the clinical guidelines were not met because troponins were negative, there was no diagnostic testing such as a stress test, or documentation of ischemia in the clinical information that was submitted.
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
Upon assessment the patient had a total output of 320 mL. The patient had generalized edema and seemed to have gained weight. The patient showed signs of restlessness and change in mental status.
The physician’s notes indicated a temperature of 98 degrees F, an elevated heart rate and respiratory rate, and low blood pressure. When the amount of oxygen available for the heart is low, it puts pressure on the heart and causes the heart rates to increase. To compensate for the low amount of oxygen the respiratory rate also increases to enable the intake of more oxygen that is be available for the body.
The primary concern for Mr. Miller would be preventing further ischemia and necrosis of the myocardial tissues, preventing serious complications such as cardiac dysrhythmias and heart failure, as well as relieving his chest pain that radiates to his left arm. Preventing further ischemia and necrosis of the myocardial tissue will help prevent the development of heart failure due to myocardial infarction, whereas relieving his pain will help reduce his episodes of shortness of breath, and will also help to reduce any anxiety and restlessness he may be having from being in pain and short of breath.
Medications that maybe make her symptoms worse, or maybe even are the cause of some of her actions. We already know that he is defiantly giving her medications when she states “I have a scheduled prescription for each hour of the day”. (Gilman 108) But she never states that she is aware of exactly what she is taking, this leads to many possibilities. It also leads us to the next question.
Polypharmacy is the “concurrent use of several differ drugs and becomes an issue in older adults when the high number of drugs in a medication regimen includes overlapping drugs for the same therapeutic effect”(Woo & Wynne, 2011, p. 1426). The patient is currently taking several medications that can potential interact with each other, perform the same therapeutic effect, and creating side effects. The following is a list of her medications and their indications:
A documented patient evaluation, including history and physical examination to establish the diagnosis for which any legend drug is prescribed.
Nurse has to be very alert about his medication, because if he is having his OTC medication, any dietary supplements or herbal
The two major things that will help an athlete while measuring the cardiovascular drift are progression and hydration levels. The heart rate of an athlete working hard during a workout should be no more than their maximum heart rate which is found by, if you’re a female take 226-age, if you’re a male take 220-age. If while doing a workout the maximum heart rate is exceeded by too much it may be necessary to take a break or slow down greatly. This may also help with traking the hydration of an athlete. If an athlete stays hydrated their core temperature will stay regulated which means they won’t sweat as much, which also means the heart won’t be under as much stress while transporting the oxygenated blood throughout the body to the
Oxygen was first admitted to the client with chest pain over 100 years ago (Metcalfe, 2011). Chest pain is a large bracket that can contain many different conditions, but for the purpose of this analysis it is focused manly upon a myocardial infarction. A myocardial infarction is mainly referred to as a heart attack, and occurs when one or more coronary arteries leading to the heart reduce or completely stop blood flow (Tuipulotu, 2013 ). Administering high concentrations of oxygen to patients with chest pain is now embedded in guidelines, protocols and care pathways, even with a lack of clear supporting evidence (Nicholson, 2004 ). High concentration of oxygen means that up to 60% is administered (Knott, 2012). More recent research has suggested that the use of oxygen in this scenario is unnecessary and can lead to unwanted side effects, especially in normoxic cardiac patients (Moradkham & Sinoway, 2010 ). The aim of this comparative analysis is to dismantle and understand both the benefits and risks of the commonly known practice of administration of oxygen to the client with chest pain. Through completing this analysis using recent and appropriate evidence a more improved practice can be given and understood.
D. standing near her room, breathing sharply. While asked what has just happened, she answered, ‘I feel dizzy and can faint!’ Mrs. D. then explained that she rose up from her chair in the television room and felt lightheaded. I decided to bring her to the room hoping she would feel less dizziness if she could sit. After consultation with my mentor and third year unit nursing student, I decided to perform measurement of her vital signs. Since only electronic sphygmomanometer was available for me that time, I had to use it for my procedure. Gladly, I discovered that I have already used such equipment in my previous nursing practice. Using the standard sized calf, I found that her blood pressure was 135/85, respirations were 16, and her pulse was 96 beats per minute (bpm). However, I decided to recheck the pulse manually, founding that it was irregular (78 bpm). The patient stated that she felt better after rest. Immediately after the incident I made a decision to explore carefully the medical chart of Mrs. D., along with her nursing care plan. That helped me to discover multiple medical diagnoses influencing her