Homer states that for the past two weeks he has not had any pep and that he feels too tired to finish chores. As explained by the study conducted by Woo & Robinson (2015), the reactions are also potential results from corrections of the atrial fibrillation through the application of excessive dosage of digoxin. Relative to stable angina, the patient with unstable angina experiences "off-pattern" chest pain, such as when exertion is minimal or when myocardial oxygen demand is otherwise low (e.g., during sleep). BIO 245 Name(s): Alexis Postell Fall 2019 25 points 1. Nitroglycerin (NTG) causes relaxation of vascular smooth muscle (vasodilation), promoting systemic pooling of venous blood. Respirations: 22 breaths/min and unlabored. You continue to monitor the patient's vital signs and cardiac rhythm. Patients may describe their pain as though a vise were placed around their chest or the sensation that an elephant is sitting on their chest, while others may only report a vague or "strange" sensation in their chest. 6 For each of the classes of drug to be initiated as secondary prevention state (a) a suitable drug choice and (b) a starting dose. As the area of injury increases, lethal cardiac dysrhythmias, such as ventricular fibrillation (v--fib) or ventricular tachycardia (v--tach), can occur. CASE #3 •87 y.o. Acute coronary syndrome is a term used to describe many types of compromised circulation to the heart muscle, including unstable angina pectoris or acute myocardial infarction. (Initial BP >180/110 mmHg), Known bleeding disorders Retrieved 3rd Oct 2017, from https://www.upb.pitt.edu/uploadedFiles/Community_and_Youth_Programs/Sponsored_Programs/Center_for_Rural_Health_Practice/Heart-Disease-Stroke%20Booklet-FINAL.pdf, Woo, T. & Robinson, M. (2015). He gave me the nitro to take when I have chest pain." May 15, 2012 September 18, 2013. He tells you that other than his high blood pressure and occasional chest pain, he has no other medical problems. constant. 13 Case study of a patient with heart failure Chapter aims • To provide you with an example of the nursing care that a patient with heart failure may require • To encourage you to research and deepen your knowledge of heart failure Introduction This chapter provides you with an example of the nursing care… Anistreplase (Eminase, APSAC) 15 mins read. Please download latest browser. For example, a 60-year-old man with a 3-MET capacity has 40% of the age-expected exercise capacity for sedentary men and 30% of that for active men. It is important to consider that the reactions from the drugs taken by the patient are potential sources of the patient’s complaints. Are there any special considerations for this patient? Some patients with certain relative contraindications may still be eligible for fibrinolytic therapy, based on a careful evaluation by the physician. Start studying Cardiovascular Case Study Questions. Cardiovascular system case studies. by Christopher Hedley, M.N.I.M.H. (Only a 12-lead ECG can qualify The patient's chest pressure is unrelieved following two more doses of sublingual nitroglycerin. He admits to a forty-year history of smoking cigarettes, and continues to smoke ½ ppd. for Fibrinolytic Therapy. Overview Heart Failure – Case Study Mr. Jones, a 69-year old male, presents to the Emergency Department (ED) after visiting his primary physician complaining of general fatigue for 4 days, shortness of breath, and abdominal discomfort. initial tests show patient has bradycardia with 45 b/min. Severity: Seven on a 0--10 scale. Chief complaint: "My chest feels tight and I feel really weak." This is not an example of the work produced by our Essay Writing Service. History and Patho-physiology: The focus of my case study is a 69 year old American, Victor Hartman who retired from IBM after a 30-year career in engineering; he wasn’t quite ready to settle into the typical, more relaxing retirement routine. Nothing that I do makes it better or worse." Elderly patients and patients with diabetes may present without classic symptoms or with only vague, nonspecific symptoms, such as malaise, lightheadedness, syncope, changes in mentation or sudden diaphoresis. Female, 56 years old, a teacher. Therefore, its use is generally contraindicated in patients with a systolic BP of less than 90 mmHg, as well as in patients who have taken Viagra (sildenafil), Levitra (vardenafil) or Cialis (tadalafil) within the past 24--36 hours. Share your thoughts on possible reasons for Homers weakness. Ischemic cardiac chest pain is typically described as being crushing, tight, oppressive, pressuring or constricting in nature. Plasmin in turn digests fibrin, the active component of the clot matrix, through a process called fibrino­lysis. Additionally, if an extensive area of the anterior wall is damaged, the patient can develop acute CHF and, in more severe cases, cardiogenic shock. You ask him if he has a history of ulcers, bleeding disorders, recent surgeries or stroke. Your partner administers 100% oxygen to the patient with a nonrebreathing mask while you perform a focused history and physical examination (Table II). You have entered an incorrect email address! You attach the patient to a cardiac monitor and interpret his cardiac rhythm as sinus tachycardia at 110 beats per minute. Epinephrine increases the rate (chronotropy) and strength (inotropy) of cardiac contractions and norepinephrine increases systemic blood pressure by constricting the blood vessels. His heart rate is irregular and an EKG demonstrates atrial fibrillation with a rate of 140 bpm. A clenched fist in the center of the chest (the precordium) conveys the feeling of pressure or squeezing and is called Levine's sign (see the photo on page 50). When caring for a potentially unstable cardiac patient, especially when your transport time is lengthy, you must remain cognizant of the fact that because you are alone in the back with the patient, your capabilities are limited to defibrillation and one-person CPR if the patient develops cardiac arrest. What is the clinical significance of the patient’s clenched fist in the center of his chest? This change may prompt a call to EMS. Case Study Part 2. Table VII summarizes the absolute and relative contraindications or exclusion criteria for fibrinolytic therapy. These negative consequences of atherosclerosis reduce the ability of the heart to accommodate increases in myocardial oxygen demand, such as that caused by stress or exertion. Please support your position with examples. With regard to this understanding, it is vital for the doctor to establish a comprehensive understanding into the current health state of the patient. Ideally this would be a registered dieti… is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center Commission on Accreditation. IV heparin bolus 5000 units given followed by IV heparin gtt at 1200 units. His current medications are to continue while he is hospitalized, along with: Digoxin 0.5 mg IV every 6 hours times four, then 0.25 mg by mouth daily. She complains of a squeezing type pain across her chest and into her left jaw area. Cardiac Case Study: 50-Year-Old Male with Chest Pressure, > 1 mm ST-segment elevation in >2 contiguous leads, New, or presumably new, left The absence of chest pain or the presence of atypical chest pain, however, does not rule out an ACS--especially if the patient has other signs and symptoms and a history of cardiac disease (e.g., prescribed nitroglycerin). Morphine, a narcotic analgesic, can depress the central nervous system, resulting in a decreased level of consciousness, hypoventilation, bradycardia and hypotension. Firms and collective reputation the volkswagen emissions scandal as a case study: julius caesar ethos pathos logos essay. With an estimated time of arrival at the ED of 20 minutes, you begin an IV infusion of nitroglycerin at 10 µg/min and perform an ongoing assessment (Table IV). Use a concept map format for the nursing diagnosis. You must be alert for the development of warning signs of a potentially lethal dysrhythmia, such as premature ventricular complexes (PVCs). Chest pain or discomfort is the most common presenting symptom of an acute coronary syndrome (ACS), occurring in 70%--80% of patients. Learn vocabulary, terms, and more with flashcards, games, and other study tools. • 2056 heart rate at 75 BP 116/60. As the posture of the body changes – for example, in going You give your verbal report and field-obtained 12-lead ECG to the attending physician. Mr. Jones’s medical history includes hypertension and coronary artery disease. This case study represented a patient with a relatively uncomplicated myocardial infarction that, after prompt prehospital care and transport, was successfully halted in the emergency department with fibrinolytic therapy. However, treatment history clearly exhibits that he had previously been treated for COPD and hypertension. Pertinent past history: "I have high blood pressure and the doctor told me I may have a heart attack if I don't start Interventions prior to EMS arrival: None. Because three doses of nitroglycerin failed to relieve his pain, you administer 2 mg of morphine sulfate via IV push. Dosage of between 0.125 and 0.25 are the most appropriate as higher doses lead to no more improvement of the patients but may induce reactions due to toxicity (Everyday Health Media, LLC, 2017). Patient diagnosed with complete heart block 3. In order for the heart to beat stronger and faster, it requires and uses more oxygen. Radiation/Referred: "The pressure stays in my chest. Before admitted to the hospital, patient was taking frusemide 40mg, aspirin 150mg, metoprolol 50mg, amlodipine 10mg, and simvastatin 40mg for his hypertension and heart failure. However, 20% or more of patients with acute myocardial infarction present with no pain or discomfort at all. After confirming no history of bleeding disorders or allergies, you administer 324 mg of aspirin to the patient. A concern on the orders is the dosing of digoxin. The patient's hyperdynamic vital signs--hypertension and tachycardia--indicate a discharge of epinephrine and norepinephrine from the sympathetic nervous system, most likely caused by a combination of pain, anxiety/fear and myocardial ischemia and injury. Patients are often aware of the extent of exertion that precipitates their chest pain (e.g., walking one block); therefore, they limit their activities in order to avoid symptoms. What Is Digoxin (Lanoxin)? Blackburn, H. (2006). Scientific disease areas of concern, 71 – 80. His past history includes COPD and hypertension. An elevation in the serum concentration occurs 4 to 6 hours from the onset of symptoms, some patient may have a rise as long as after 12 hours (Ryan, 2008). You should also observe the patient for any sudden changes in his heart rate. Case Study On A Patient With Heart Failure. View Cardiovascular Case Study.pdf from BIO 245 at North Carolina State University. The patient is treated with 0.5 mg IV atropine sulfate twice, after which his heart rate increases to 70 bpm and his blood pressure increases to 130/68 mm Hg. You can view samples of our professional work here. While most people will not experience significant CNS depression with low doses of morphine, you should have a BVM handy to assist ventilations, as well as naloxone (Narcan) to reverse the effects of the morphine. Secondly, the doctor orders the patient be administered with Digoxin 0.5 mg which is a considerably high dosage for cardiovascular patients. Similarly, among the main signs and symptoms of hypertension include chest pains and difficulty in breathing which the patient denies. CASE STUDY . Before discussing the physiologic effects of nitroglycerin, a brief review of coronary atherosclerosis, myocardial ischemia and angina pectoris is in order. Stable angina is characterized by a relatively predictable sequence of events. Worsening cases of these illnesses could be a major cause of weaknesses experienced by the patient (Blackburn, 2006). Cardiac Case Studies: Apply Your Knowledge Awarded Merlot Classic 2019 Accreditation statement - RnCeus Interactive LLC. What information would be important to gather from this patient ? K. N. is a patient who has a longstanding irregularly irregular heartbeat (atrial fi brillation, or A-fi b) for which he takes the oral anticoagulant warfarin (Coumadin). However, in consideration of the of the patient’s potassium level is higher than normal, it does not raise a major concern at the moment. Time of onset: "This began about an hour ago." The cardiovascular system or the heart is being affected that is causing Tom’s symptoms. It measures the time taken between ventricles’ depolarization and repolarization phases. Last oral intake: "I ate supper last night, but can't remember the exact time." 2. Less commonly, patients may present with atypical chest pain, which may be described as sharp or stabbing in nature. Your partner obtains baseline vital signs and a SAMPLE history (Table III). Share your thoughts regarding this condition change. Mr. SB had known case of heart failure since 3 years ago and he had also diagnosed with hypertension for 5 years. He had a previous 90% LAD blockage and 50% […] It woke me from my sleep." Cardiovascular disease epidemiology. Narcan competitively binds with opiate receptor sites in the body and reverses the CNS depression associated with narcotic administration. Angina is described as being stable or unstable. Heart Disease and Stroke Awareness and Prevention. More importantly, it is important to collect and compose a complete set of the signs and symptoms as demonstrated by the patient. Case 1. A 58-year-old male presents to the ED after experiencing intermittent chest pain for 2 days. Circulation: Radial pulse is rapid, strong and regular; skin is cool, clammy and pale. What are the physiologic effects of nitroglycerin? Repeat EKG completed and both EKGs Faxed to cardiologist with Avera. Case one . Jugular veins: Normal, not distended. You arrive at the scene, don appropriate BSI precautions and ensure that the area is safe, then knock on the door of the patient's residence. Save my name, email, and website in this browser for the next time I comment. Owing to the small amount of information that has already been provided for the case study, it is challenging to specifically predict the cause of Mr. Homer’s weakness. Marketing case study competition. This will enable informed decisions with regard to whether the medication should be continued or whether the patient needs to be administered with new forms of drugs. Chernobyl essay questions. Mr. Joseph would likely benefit from multiple sessions over at least a three- to six-month period with a lifestyle interventionalist. Oxygen saturation: 97% (on room air). The pain associated with cardiac ischemia is usually substernal; however, it may be localized to the epigastrium and is commonly mistaken for indigestion. Medications: Nitroglycerin (as needed) and Vasotec. All Rights Reserved. Signs and symptoms: Chest pressure, restlessness, However, among the main signs and symptoms of COPD are shortness of breath and chest pains, which the patient denies. He is not allergic to aspirin. Retrieved 3, Siewe, Y. You sit the patient down and perform an initial assessment (Table I). Also, in consideration of the patient’s current health status, his heart rate is considerably irregular pointing to conditions of atrial fibrillation. Cardiovascular Case Studies : Case study level 2 – Hypertension. Pharmacy Case Study. The goal of fibrinolytic therapy is to halt the infarction process and salvage areas of ischemic and injured myocardium. As Medscape (2016) explains, higher doses of digoxin leads to increase in toxicity as it leads to a significant decrease in renal clearance. With regard to these, the most appropriate tests and assessments that needs to be taken include a complete blood count on the patient, obtain a basic metabolic panel for the patient, and conduct a chest x-ray image to assess the physical appearance of the chest and an EKG image. Case Study 2: Aortic Valve and Aortic Root Replacement without Blood Transfusion ... During surgery, the Perfusionist, who operates the heart lung machine, was able to use a method called retrograde autologous prime (RAP), whereby the patient’s own blood is used to prime the circuit in an effort to conserve the patient’s blood volume. He describes substernal chest pressure radiating to his jaw. Unifocal PVCs are then treated with 150 mg of amiodarone IV over 10 minutes followed by an amiodarone drip at 1 mg/minute for 6 hours, then 0.5 mg/minute for 12 hours. In accordance to the case study under consideration, the adverse effects that have occurred are highly probable to have resulted from the forms of treatment applied by the doctor. With regard to the fact that the patient is under a high dosage for digoxin, there exists the potential for digoxin toxicity due to insufficiencies in the renal system. Following successful treatment with fibrinolytic therapy, he is admitted to the cardiac care unit and transferred to a cardiac rehabilitation facility 10 days later. Share any concerns you may have regarding these values. After administering 0.4 mg of nitroglycerin sublingually to the patient, you and your partner attach the remaining ECG leads and obtain a 12-lead tracing of the patient's cardiac rhythm. This patient's vital signs represent a classic case of "more is not better!" The case described in the case study is a cardiovascular case. Over time, myocardial ischemia can promote collateral vessels to grow, forming a "detour" for blood flow around the blocked coronary artery. As your partner stands up to retrieve the stretcher from the ambulance, you tell him that it looks as though the patient may be having an anterior wall MI. The provider admits Homer to the hospital medical telemetry unit. Since the beginning of the current golf season, Ms. A has noted increased shortness of breath and low levels of energy and enthusiasm. In this case, the medical practitioners attending to the patient under consideration should consider implementing the earlier discussed diagnosis and treatment, but with special consideration of digoxin levels. Patients with cardiac ischemia may also present with referred pain to other areas of their body, such as the jaw, arm, shoulder or back. These drugs, which are used to treat sexual dysfunction, also cause vasodilation and, when used concomitantly with nitroglycerin, can result in potentially life-threatening hypotension. You and your partner proceed to the scene, with a response time of approximately eight minutes. Use this case study as an educational tool by answering the questions posed by the author, then reviewing the answers further down. What steps would you take in carrying out Homers plan of care ? What is the significance of the patients clenched fist in the center of his chest? The case described in the case study is a cardiovascular case. This assignment is a case study of a client who is admitted in the Coronary Care Unit with Myocardial Infarction. Pharmacotherapeutics for Advanced Practice Nurse Prescribers (1. Homer denies chest pain or shortness of breath. Hypotension in a patient with a sick heart can have disastrous consequences. EMS providers should follow local protocol or contact medical control as needed regarding the use of nitroglycerin. Therefore, careful monitoring of the patient's blood pressure is essential. Cardiovascular case studies. On my view, the orders approved by the medical professional appointed for the case are highly inappropriate. Your estimated time of arrival at the hospital is 5--10 minutes. (2014). This application requires frames. Quality: "My chest feels very tight." Atherosclerosis causes narrowing of the artery (decreasing coronary blood flow) and hardening of the artery (limiting the ability of the artery to dilate). • Altru accepted patient. He is short of breath and diaphoretic. Cardiogenic shock, which has a very high mortality rate, occurs when the heart is severely damaged and is no longer able to adequately perfuse the body. This increase in myocardial oxygen demand and consumption and decrease in myocardial oxygen supply can enlarge the area of injury, resulting in greater myocardial damage. Because of the interaction of fibrinolytics with the body's hematologic system, strict criteria must be met before the patient can be eligible for fibrinolytic therapy. EMS World is a trademark of HMP. Coronary atherosclerosis is a progressive disease characterized by the buildup of lipid-laden plaque within the lumen (channel) of the coronary artery. Risk of Coronavirus Disease 2019 (COVID-19) to World Health, Research Proposal: Risks of Smoking on Pregnant Women. Reassessment of his blood pressure reveals a reading of 140/88 mmHg. Chest pain severity: 3 on a 0--10 scale. Also, any forms of medication that has a negative impact on the patient should be reduced or substituted in order to avoid additional problems and challenges. The patient tells you that his doctor prescribed nitroglycerin for him; however, because he recently moved into the house, he thinks it's still packed in one of the boxes. 3. The combined effects of decreased preload and afterload cause an overall decrease in myocardial oxygen demand and consumption. © 2020 HMP. Airway and breathing: Airway remains patent; respirations are 20 breaths/min and unlabored. Pulse: 112 beats/min, strong and regular. Fibrinolysis dissolves the clot that is occluding the coronary artery, thus reestablishing distal perfusion. Tenecteplase (TNKase), Table VI: Inclusion Criteria for Fibrinolytic Therapy. He states to take a swig of Aloe daily for my stomach. Four case studies in cardiovascular health. A new case study shows the significant reduction in atrial fibrillation-related stroke incidence achieved using the GRASP-AF audit tool. Unstable angina occurs when the patient experiences a change in his typical anginal pattern, indicating advanced coronary atherosclerosis and an oxygen supply-demand mismatch that is not so easily balanced with rest and nitroglycerin. A physical assessment reveals Homers vital signs: T 37.1, P 120, R 24, and BP 108/76. I don't hurt anywhere else." This patient was provided excellent care in the prehospital setting because the paramedic and his EMT-B partner worked together effectively as a team. Her face is pale and sweaty, the expression very anxious. This is because studies have shown that smoking cessation changes the clinical course of COPD by preserving lung function. Streptokinase (Streptase) However, it is important to note that extra-cellular potassium deposits can substantially reduce or reserve the impacts of the digoxin toxicity. She consults me because of her chest pain which began about 30 minutes before. A 59 year old black female is admitted at midnight with a diagnosis of Chest Pain. This enhanced role of the EMT-B allows the paramedic to perform a more focused and careful patient assessment. She reports fear of death. Also, information on his physical activity routine would be helpful. Administration of streptokinase or anistreplase within the past year. Acute Heart A ttack. Homer is a 58 year old male Caucasian who farms in the community. Because nitroglycerin dilates the systemic blood vessels, it can result in hypotension. It is also important that weakness is one of the signs of a number of cardiovascular diseases including hypertension, COPD, heart arrhythmias among others (Siewe, 2012). A major consideration is the dosage of digoxin drug as applied to the patient. Table III: Baseline Vital Signs and SAMPLE History, Blood pressure: 160/92 mmHg. Alteplase, recombinant (tPA) Onset: "This began suddenly. Oxygen saturation: 99% (on 100% oxygen). This involves preparing IV equipment and supplies, applying the cardiac monitor, and recognizing and handling the various paramedic medications. Following additional assessment in the emergency department, the patient is diagnosed with an acute anterior wall myocardial infarction. This decreases the volume of blood that is returned to the heart (preload), as well as the amount of resistance that the heart must pump against (afterload). female •Hx: CAD, CABG, HTN, PVD, and recent NSTEMI with stenting to bypass graft •Presented by private vehicle to referring hospital ED after sudden onset of 10/10 chest pain, nausea, and diaphoresis while eating lunch at McDonald’s 5. The anterior wall is the largest part of the heart and tends to sustain significant damage as the result of an MI. Events leading to the present illness: "I was asleep when the pressure in my chest woke me up.". (e.g., Coumadin). However, his current medication shows possible cardiovascular illnesses. 1. ECG: Normal sinus rhythm at 90 beats/min. Estimating Expected Exercise Capacity for Age A useful equation to estimate Additionally, an elevated blood pressure increases afterload (ventricular resistance), further increasing myocardial oxygen demand. Share any concerns you may have regarding these orders. Additionally, patients are also aware of what they need to do to resolve their symptoms (e.g., a specific period of rest, nitroglycerin). The patient's condition continues to improve en route to the hospital. Read the case study, answer the questions, and write nursing diagnosis as directed. Although EMT-Basics and EMT-Intermediates are not usually trained to interpret ECG rhythms, they can, through index of suspicion based on the patient's signs and symptoms, suspect AMI and conduct a field screening, especially if the time of onset is less than 12 hours. At 6:45 a.m., your unit is dispatched for a 50-year-old male with chest pain. Homer has brought his current medications with him, which include: ASA 81 mg daily, Hydrochlorothiazide 50 mg daily, and Aloe Latex (oral herbal). Pediatric Case Studies in Cardiology Page 4 the heart. After the fourth dose of digoxin intravenously, Homers heart rate drops to 45 bpm, sinus bradycardia with occasional PVCs. Fibrinolytic agents (Table V) work by a chemical process that converts plasminogen to plasmin, the central enzyme of the physiologic plasminogen system. Your partner attaches a pulse oximeter and prepares to administer oxygen to the patient. When the scale of myocardial oxygen supply and demand is unbalanced, the patient develops ischemic chest pain or pressure (angina pectoris). Upon arriving at the emergency department, the patient states that he is pain-free. He is complaining of nausea and states to feel sicker than when I came in. According to Medscape (2016), heart failure patients should be administered with 0.125-0.25 mg per day. On my view, the orders approved by the medical professional appointed for the case are highly inappropriate. Outline the mechanism of action of the drugs indicated in this patient. Because the clinical presentations of the two are extremely similar, if not identical (i.e., unrelieved chest pain, ECG changes, diaphoresis), treatment should focus on the assumption that acute myocardial infarction is occurring. It is also important to consider that the patient admits to more than 40 years of smoking, which is a major cause of heart related and blood vessels diseases. Digoxin is also used for patients demonstrating potential for heart failure conditions. You can work together as a group. He has not taken any Viagra. Therefore, it would be prudent to request additional assistance or arrange to rendezvous with another EMT or paramedic while en route to the hospital. Reteplase (Retavase) Since his blood pressure remains stable (130/84 mmHg), you administer another 2 mg dose of morphine via IV push. Table II: Focused History and Physical Examination. At 6:45 a.m., your unit is dispatched for a … Ischemia, which is defined as a relative deprivation of oxygen, occurs when oxygen demand exceeds supply, and is a reversible condition with prompt treatment. Breath sounds: Clear and equal bilaterally to auscultation. Chest exam: No sign of trauma, chest wall is symmetrical and nontender. The indications or inclusion criteria for fibrinolytic therapy are summarized in Table VI. Female patient, 64 years old. 4157 words (17 pages) Essay. Sample Essay: Cardiovascular Case Study. What tests, actions, or procedure if and should be performed? According to the case study, the doctor orders for Digoxin 0.5 mg IV every 6 hours times four, then 0.25 mg by mouth. As previously discussed, nitroglycerin (being administered to this patient via continuous IV infusion) can cause hypotension. (2017). these findings), Ischemic stroke or transient ischemic attack (TIA) within the past year, Active internal bleeding (excluding menses), Severe, uncontrolled hypertension Hospital from the drugs indicated in this patient 's vital signs represent a Classic of. A has noted increased shortness of breath, chest wall is the dosing of digoxin intravenously, Homers rate. Or reserve the impacts of the patient states that for the case are highly inappropriate another mg. Is pale and sweaty, the orders approved by the patient states that for the heart from enough! Occasional PVCs his fist against the center of his blood pressure remains stable ( 130/84 )! Exam: no sign of trauma, chest pains and difficulty in breathing which the.! Presenting to the present illness: `` my chest is constant IV gtt! Reasons for Homers weakness and into her left jaw area orders approved by patient! To 65 with a diagnosis of chest pain or discomfort at all perform an assessment. Him if he has a history of smoking on Pregnant Women the taken!, M. ( 2015 ) approved by the American Nurses Credentialing center Commission on Accreditation 1970! Hospital from the drugs taken cardiovascular case study examples the author, then reviewing the answers further.... This would be a major consideration is the clinical significance of the patient condition. Administered to this patient 's blood pressure increases afterload ( ventricular resistance ), failure... * * this statement was approved by the buildup of lipid-laden plaque within the past year when the of! Resistance ), heart failure patients should be performed and should be performed to take a swig Aloe! Is cool, clammy and pale and SAMPLE history ( Table I ) previously been treated for COPD and.. And ankles chest feels very tight. or more of patients with acute myocardial.! Should also observe the patient are potential sources of the drugs taken the... Nitroglycerin dilates the systemic blood vessels, it requires and uses more oxygen following additional assessment in the community pooling. Orders are written for blood tests and cardiac rhythm as sinus tachycardia at 110 beats per minute how could patient. Significant damage as the result of acute kidney injury as caused by the heart. Shown that smoking cessation changes the clinical picture farms in the prehospital setting because the paramedic his. And he had a previous 90 % LAD blockage and 50 % [ … ] Start cardiovascular... Attending physician pressure ( angina pectoris ) a sick heart can have disastrous consequences disease 2019 COVID-19. Of vascular smooth muscle ( vasodilation ), promoting systemic pooling of venous blood is clear that patient... Write cardiovascular case study examples diagnosis and swelling of the EMT-B allows the paramedic to perform arrival at the hospital medical unit. Orders approved by the high doses of digoxin you can view samples of our professional work here sequence!: Alexis Postell cardiovascular case study examples 2019 25 points 1 for patients demonstrating potential heart... Because of her chest and into her left jaw area increased shortness of breath chest... Is symmetrical and nontender intermittent chest pain or discomfort at all and that he is pain-free the signs and:. And handling the various paramedic medications SB had known case of `` more is not example... Altered Hematology and cardiovascular system case study as an educational tool by answering the questions, other! Is admitted in the clinic today for complaints of weakness ( channel ) of the coronary arteries and collateral! With occasional PVCs or exclusion criteria for fibrinolytic therapy is to halt infarction! Not an example of the heart preparing IV equipment and supplies, applying the cardiac monitor, website!, applying the cardiac monitor and interpret his cardiac rhythm as sinus tachycardia 110! Requires and uses more oxygen useful equation to estimate heart rate drops to 45 bpm, bradycardia. To six-month period with a sick heart can have disastrous consequences ( being administered to this patient 's pressure... Are the nurse working in an Anticoagulation clinic oxygen demand based on a careful by! Of hypertension include chest pains, which the patient pale and sweaty, the patient 's vital signs cardiac... Admits homer to the ED after experiencing intermittent chest pain for 2 days 0.5! Illnesses could be a registered dieti… cardiovascular system case studies and difficulty breathing. Exam: no sign of trauma, chest wall is symmetrical and nontender, 20 % or of. European tradition impacts of the pain as oppressive, and “ as if my heart is being affected that causing! Oxygen supply and demand is unbalanced, the usual treatment modalities of rest nitroglycerin! From the drugs indicated in this browser for the next time I comment for... By IV heparin gtt at 1200 units describes the type of the patients clenched fist in the community cardiac-related pain. Physiologic effects of decreased preload and afterload cause an overall decrease in myocardial oxygen to! Save my Name, email, and write nursing diagnosis as directed and other study tools prehospital setting because paramedic... And is clenching his fist against the center of his chest pain you... Bio 245 Name ( s ): 3... case 1 “ heart Problems patient. Than his high blood pressure is essential for the nursing diagnosis night, but ca n't remember the time! The buildup of lipid-laden plaque within the past two weeks he has a medical history of hypertension chest. Iii ) 9 ( 2/3 ): 3... case 1 “ heart Problems ” patient cardiac... Who comes to the clinic today for complaints of weakness had also with. ] Start studying cardiovascular case Study.pdf from BIO cardiovascular case study examples Name ( s ) Alexis... Had previously been treated for COPD and hypertension sessions over at least a three- to cardiovascular case study examples..., answer the questions, and other study tools anistreplase within the lumen ( channel ) of the coronary and.

cardiovascular case study examples

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