Perfusion Case Study First, please review the following case…

Question Answered step-by-step Perfusion Case Study First, please review the following case… Perfusion Case StudyFirst, please review the following case details:Overview: Casey Johnson is a 54-year-old male who travels frequently. He was seen in the Emergency Department at 1:30 p.m. for complaints of chest pain while at home resting, diaphoresis, and shortness of breath. He was treated in the Emergency Department with aspirin and two doses of sublingual nitroglycerin. Chest pain improved with nitroglycerin administration. IV infusion of normal saline was started in the Emergency Department and is running at 25 mL/hour. Ordered lab values are pending. Provider wants to be called as soon as the labs are available. Client is receiving oxygen at 4 L/min with SpO2 values at 97%. Chest pain was last rated as a “1” following a second nitroglycerin dose and nitroglycerin IV drip. He has just been admitted to the Telemetry Unit.Patient data: Male. Age 54 years. Weight 242 pounds (110 kg). Height 69 inches.                        DOB: 08/19/XX        MR#: RCS1201Prior medical history: History of hypertension and rheumatoid arthritis. He states he takes “water pills” for his blood pressure and has been trying to exercise and lose weight but admits it is very hard when he travels. He smokes less than half a pack of cigarettes a day and drinks alcohol occasionally. He also said he takes that “cancer pill” for his arthritis along with some Advil when needed.  He describes his work as “stressful.” Home Medications: Furosemide, Potassium Chloride, Methotrexate, and Ibuprofen.Recent medical history: Recent admit from Emergency Department with chest pain, diaphoresis, and shortness of breath.Provider’s Orders:IV normal saline at 25 mL/hourNitroglycerin drip, titrate rate for chest pain, keep SBP >100Oxygen to maintain SpO2 greater than 92%Continuous ECG and SpO2 monitoring Activity: bed rest with bathroom privilegesDiet: healthy heart dietMedsMorphine 2 mg IV push PRN chest pain every 10 minutes × 3; every 2 hours and notify care provider if chest pain returnsSerax (oxazepam) 5 mg oral every 6 hours for anxiety  Chest x-ray, basic metabolic panel, complete blood count, troponin and CK-MB every 6 hours × 3 (first set obtained in Emergency Department); notify provider with lab results as soon as available.Please answer the following questions:Casey is exhibiting signs of angina.  What are these signs and symptoms and do they indicate this is stable or unstable angina? How is angina different from myocardial infarction? (1 point) 2. What are your priority assessments for this client? Be specific- more than “Respiratory” or “Cardiac” or “Airway, breathing, circulation”. (1 point) 3. The ED provider prescribed aspirin and nitroglycerin, and the provider who admitted Casey prescribed morphine and serax for chest pain.  Please describe the purpose and possible side effects of each of these medications. (1 point for purpose and side effects of each medication, 4 points total)            Aspirin:            Nitroglycerin:            Serax:            Morphine: While going through the hospital admission questions with Casey, you notice he is becoming more diaphoretic and begins to vomit.  Then, you notice he becomes unresponsive and the reading on his ECG monitor changes from normal sinus rhythm to the following pattern: 4. You interpret the rhythm as ventricular fibrillation. What could have been the possible causes of this change in rhythm? (1 point) 5. What are your actions going to be as a result of this change in rhythm?      What interventions are important priorities?  (1 point)  6. What findings would you expect to see indicating the interventions performed were effective? Assuming they were effective, what would your next priority interventions be? (1 point)  7. Which lab values are you going to be most interested in and why? List and provide an explanation for at least 3 different labs. (1 point) Health Science Science Nursing NURSING 4634 Share QuestionEmailCopy link Comments (0)