Critically think and analyze this case study to complete a detailed plan of care for Mr. Z. Assume the patient knows nothing of his conditions, medications, or diet.
Mr. Z is a 59-year-old man who was admitted to the acute-care hospital with a diagnosis of possible myocardial infarction. Subsequent testing proved Mr. Z did not have an infarction. His medical diagnoses are stage 2 hypertension and myocardial ischemia. He is being readied for discharge to home.
Mr. Z is vice president for sales of a large manufacturing company. His business activities involve luncheon and dinner meetings at which alcohol consumption is common. He stated that he has “at least one cocktail, usually two” with lunch and with dinner.
The clinical dietitian visited Mr. Z to evaluate his food behaviors as requested by the physician. After the dietitian left, Mr. Z said to the nurse, “That diet is impossible for my situation. She just doesn’t understand the business world. I don’t believe there’s anything wrong with my heart anyway. It was just indigestion.”
Providing client care is a dynamic process. Based on the above information, the nurse added the following modifications to Mr. Z’s care plan.
Trending nowThis is a popular solution!
Step by stepSolved in 3 steps
- A 69-year-old woman presents with crushing substernal chest pain and nausea. Laboratory studies show elevated serum levels of cardiac proteins (CK-MB = 8.5 ng/mL; troponin-I = 3.2 ng/mL). A diagnosis of myocardial infarction is confirmed by ECG. Despite treatment, the patient becomes hypotensive and resuscitation attempts are unsuccessful. A cross section of the patient's right coronary artery at autopsy is shown in the image. Which of the following pathologic changes are evident in this autopsy specimen?arrow_forwardCase study: Acute Coronary Syndrome non ST elevation MI Possible diagnoses (differential diagnosis) (50 points). After analyzing the patient’s case, you need to make 3 (minimum) to 4 (maximum) possible diagnoses (rank by the most possible to the least possible). You need to be specific: e.g. a diagnoses of anemia is not specific enough, you need to elaborate: which type of anemia. If you make less than 3 differential diagnosis, your points will bededucted. Explanation of Pathophysiology of each of differential diagnoses (30 points). You need to write all of the pathophysiology thoroughlyof each of your differential diagnoses you write on the first part. This has to be detail enough so that you can explain all the signs, symptoms, patient’s history and all diagnostic tests results. There are no minimum or maximum number of pages you need to write, but comprehensive pathophysiology shouldsuffice. Your suggestions of what extra work-up/laboratory/diagnostic tests/information needed to…arrow_forwardCardiovascular Case Histories A 32-year-old nurse who had rheumatic fever as a child noticed a persistent tachycardia and light-headedness. Upon examination, chest x-rays showed an enlarged left atrium and left ventricle. ECG analysis showed atrial fibrillation. There was also mild pulmonary edema. Cardiac evaluation resulted in the following information: Cardiac output (CO) 3.4 L/min Blood pressure (BP) 100/58 mm Hg Left atrial pressure (LAP) 16 mm Hg (normal 8-10) Right ventricular pressure (RVP) 44/8 mm Hg (normal 25/4) Heart Rate (HR) = 120 bpm Heart sounds revealed valvular regurgitation. Based on the information provided, which A-V valve is incompetent, allowing the regurgitation? How did you determine this? If the other A-V valve were incompetent instead of this one, would the CO (L ventricle), and BP be different? If so, how? Would you expect the LAP to be normal? Pulmonary hypertension can develop with L sided heart…arrow_forward
- Match the following heart defects with its therapeutic management (medical/surgical) Prostaglandin E1/placement of Prostaglandin Pulmonary artery banding shunt Balloon E1/ arterial (Pulmonary to systemic artery anastomosis) angioplasty switch procedure Ventricular septal defects Coarctation of aorta Tricuspid atresia Transposition of great arteries Matoh the tynes of diarrhea with its description O o O O O Oarrow_forwardA client who had rheumatic fever as a child has mitral valve stenosis. She is currently 6 weeks pregnant with her first child and is classified as Class II according to the New York Heart Association functional classification of heart disease in pregnant women. What recommended therapeutic plan can the nurse discuss with this client regarding rest/activity, prevention of infection, nutrition, and bowel elimination to reduce her risk of cardiac decompensation? What physiologic events after birth take place to put this client at risk for cardiac decompensation in the postpartum period?arrow_forwardCase #2: A new 60-year-old patient presents to the medical clinic with severe angina. He noted that after taking several doses of his sublingual nitroglycerin, he was unable to relieve his anginal pain. His cardiac troponins are elevated and his ECG shows ST wave elevation. He is currently also taking a low dose aspirin. He is 1.8 meters tall with a waist measurement of 1.1 m. Weight is 97 kg, blood pressure is 150/95 mm Hg, and pulse is 85.arrow_forward
- The cardiovascular systemarrow_forwardCASE STUDY SCENARIO Mr. Zane is a 65 –year-old African Canadian male from Brampton, Ontario, Canada. He came to the Emergency Department with his wife of 30 years. Mr. Zane was sent to the Emergency Department by his primary healthcare provider because “he has not been feeling well” for the past few days. He describes a fullness in his head and chest without any associated symptoms. His medical history is pertinent only for primary hypertension, and he states that he ran out of his medication two weeks before he started experiencing symptoms. Physical examination reveals an anxious man with a BP of 230/130 mm Hg and a heart rate of 108 beats per minute. Respirations are elevated at 22 breaths per minute. No papilledema is seen on funduscopic examination. Lungs have bilateral crackles, one quarter up from the bases. Cardiac examination reveals a regular tachycardic rhythm with normal S1 and S2. Jugular venous pressure is normal but demonstrates sustained fullness with abdominal…arrow_forwardDescribe how the healthcare team differentiates between myocardial infarction and angina. There should be a minimum of 3 waysarrow_forward
- Answer the questionsarrow_forwardMs Nahed is 66year old woman with a history of MI,HTN hyperlipidemia, and diabetes mellitus presents with sudden onset of chest pain radiating to her left arm. Electrocardiography showed ST segment depression and positive cardiac enzymes. Home medications are aspirin, simvastatin, metoprolol, and metformin. Which regimen is the best treatment strategy for this patient? A Abciximab bolus then infusion for 12hours plus enoxaparin 80mg subcutaneously. B Aspirin and clopidogrel plus UFH bolus; then 15units/kg/hour infusion. C Aspirin and clopidogrel +UFH bolus then infusion titrated to maintain 50-70seconds a PTT plus eptifibatide with an early invasive approach. D Aspirin and enoxaparin subcutaneously twice daily with an early invasive approach.arrow_forwardDisorders of Circulatory System Read the statements given below and select the correct option: I. A defect in the region of fossa ovalis leads to the formation of ostium secundum type ASD. II. Malformation of the cusps of aortic valve causes pressure hypertrophy of the left ventricle and atrium. III. When the deoxygenated blood by passes the lungs and enters the systemic circulation, a condition called left-to-right circulatory shunt takes place. (a) I and II are incorrect; III is correct (b) II and III are correct; I is incorrect (c) I and II are correct; III is incorrect (d) II and III are incorrect; I is correctarrow_forward
- Phlebotomy EssentialsNursingISBN:9781451194524Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)Publisher:JONES+BARTLETT PUBLISHERS, INC.Gould's Pathophysiology for the Health Profession...NursingISBN:9780323414425Author:Robert J Hubert BSPublisher:SaundersFundamentals Of NursingNursingISBN:9781496362179Author:Taylor, Carol (carol R.), LYNN, Pamela (pamela Barbara), Bartlett, Jennifer L.Publisher:Wolters Kluwer,
- Fundamentals of Nursing, 9eNursingISBN:9780323327404Author:Patricia A. Potter RN MSN PhD FAAN, Anne Griffin Perry RN EdD FAAN, Patricia Stockert RN BSN MS PhD, Amy Hall RN BSN MS PhD CNEPublisher:Elsevier ScienceStudy Guide for Gould's Pathophysiology for the H...NursingISBN:9780323414142Author:Hubert BS, Robert J; VanMeter PhD, Karin C.Publisher:SaundersIssues and Ethics in the Helping Professions (Min...NursingISBN:9781337406291Author:Gerald Corey, Marianne Schneider Corey, Cindy CoreyPublisher:Cengage Learning