2 Running head: ASSIGNMENT 1. The order of nursing intervention based on the condition is 2, 3, 4, 5, and 1. (the breathing rate is low that why 2 that will manage the breathing, cardiac monitoring that will show beats and breathing rate improvement, in case reliable results is not there 12-lead ECG, blood pressure and systolic BP and lastly collection of blood for pathology). (Felton et al., 2019) 2. Central crushing chest pain with radiation to the jaw is defined as the pain that is located in the right or either left chest. It can be symptoms of the condition or an indication that a particular condition is there (New South Wales, 2019). Radiation of the chest pain to the jaw is the severe one that is indicating the serious condition of the patient and indicates the risk of life. In case the patient is facing such sort of pain, the probability is there that there are heart condition lies or there is any blockage present. - ST elevation indicates the total blockage of the coronary artery and implies that heart muscle is currently dying. ST elevation in an ECG can be seen if the vertical distance inside the ECG trace and the baseline are at the point of 0.04 seconds followed by the J-point that is at least at 0.1 mV (Khan et al., 2018). It shows the current injury in the heart cells. Pathogenesis of ST elevation shows that it takes place due to the occlusion in one or more arteries that is leading to the myocardial injury. Elevated troponin (35ng/l), troponin is the diagnostic marker present that is indicating the damage to the heart. A very high level of troponin indicates a sign of heart attack. In the majority of patients, the level of troponin gets rises within the 6 hours of the heart attack(Bhatia et al., 2019). The range of the troponin is indicative that there is a severe problem lies with the heart. 3. Category 2 pharmacological intervention is provided to the patient to take control over the symptom that is imposing the risk to the life. In addition, the medication administration will lead to the regain of the vitals in the patient. Morphine (IV) is the drug present that is provided to the patient suspected of any kind of heart problem. The action of the drug is related to the residual platelet activity. It gives relief to the chest pain when there is the presence of ST elevation. The rationale for giving the drug is that it will lead to the dissolution of the clot if anyone is present in the vessel(Guo et al., 2019). In addition, it controls the sensation of the pain with the binding to the CNS. Nitroglycerin isa vasodilator drug that serves the primary function in terms of relieving chest pain in the case of angina chest pain (radiation to the jaw). The rationale for using the drug is that
3 Running head: ASSIGNMENT it will lead to the formation of the free radical of nitric oxide that further activates the guanylate cyclase that is resulting in an increase in the GMP in the smooth muscle and tissue. It gives rise to the contractile movement in the smooth muscle(Szőke et al., 2019). The drugs are provided with the sublingual route of administration that is leading to rapid absorption in the blood. The mean peak value of the drug is going to attain in the time of 6 to 7 minutes the post-dose of the drug. The comparison of the route of administration of drug shows that it is the sublingual one that is creating an instant effect. That's why in this case also the patient is provided with the SL route(Aggarwal, 2021). Aspirin is used to reduce the fever and moderate rate of pain that is taking place due to muscle. It is also a type of blood thinner that is having the ability to reduce the red blood cells to clump together. In this case, the medication is provided so that if there is any kind of clotting or blood dynamic gets changed it can be improved(Batchelor et al., 2020). Heparin is used to prevent or treat blood vessels or heart conditions. It acts as a drug that prevents blood clotting in the vessel. The medication is sued in the treatment of heart attacks and unstable angina. The rationale behind using the drug involves the acceleration of the rate of coagulation factor by anti-thrombin(Zhu et al., 2022). Clopidogrel is the class of medication present that is considered antiplatelet medication. It works with the prevention of collection and forming clots that are resulting in a heart attack or stroke. The rationale for giving the drug is that it will lead to a reduction in platelet aggregation (Buckley, 2019).In addition, it will help in the clearance of the passage that will lead to the effective flow of the blood. With the sake of this pharmacological intervention, the main causative of the situation can be overcome.
4 Running head: ASSIGNMENT References: Batchelor,R., Liu,D.H.,Bloom,J., Noaman,S., &Chan,W.(2020). Associationof periproceduralintravenousmorphineuseonclinicaloutcomesinST‐elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention: Systematicreviewandmeta‐analysis.CatheterizationandCardiovascular Interventions,96(1), 76-88.https://doi.org/10.1016/j.ejps.2019.02.020 Bhatia, S., Anstine, C., Jaffe, A. S., Gersh, B. J., Chandrasekaran, K., Foley, T. A., ... & Anavekar, N. S. (2019). Cardiac magnetic resonance in patients with elevated troponin andnormalcoronaryangiography.Heart,105(16),1231-1236. http://dx.doi.org/10.1136/heartjnl-2018-314631 Buckley, T. (2019). Alterations to cardiovascular function across the lifespan In J, Craft. C, Gordon.S,Heuther.K,McCance.V,Brashers.&N,Rote.Understanding pathophysiology(3rded.,pp627-634).Australia:Elsevier. https://www.elsevier.com/books/understanding-pathophysiology-anz/craft/978-0-7295- 4264-7 Guo, M. Z., Wang, T. Y., Yang, J., Chang, H., Ji, S., & Tang, D. Q. (2019). Interaction of clopidogrel and fufang danshen dripping pills assay in coronary heart disease based on non-targetmetabolomics.JournalofEthnopharmacology,234,189-196. https://doi.org/10.1016/j.jep.2019.01.030 Khan, E., Brieger, D., Amerena, J., Atherton, J. J., Chew, D. P., Farshid, A., ... & Chow, C. K. (2018). Differences in management and outcomes for men and women with ST‐elevation myocardialinfarction.MedicalJournalofAustralia,209(3),118-123. https://doi.org/10.5694/mja17.01109 New South Wales. (2019). Pathway for Acute Coronary Syndrome Assessment (PACSA). https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/GL2019_014.pdf Szőke, K., Czompa, A., Lekli, I., Szabados-Fürjesi, P., Herczeg, M., Csávás, M., ... & Tósaki, Á. (2019).Anew,vasoactivehybridaspirincontainingnitrogenmonoxide-releasing molsidominemoiety.EuropeanJournalofPharmaceuticalSciences,131,159-166. https://doi.org/10.1002/ccd.28561 Aggarwal, P. (2021). High-Dose Nitroglycerin Bolus for Sympathetic Crashing Acute Pulmonary Edema: A Prospective Observational Pilot Study.The Journal of Emergency Medicine,61(3), 271-277. https://doi.org/10.1016/S0140-6736(00)03539-X Zhu, H., Hu, J., Dong, Z., Liu, Y., Sun, X., & Sun, A. (2022). ALDH2 mutation results in excessive basal nitric oxide production and a delayed response to nitroglycerin.Cardiology Plus,7(2), 85-91. https://doi.org/10.2147%2FOAEM.S340513
Paraphrase This Document
Need a fresh take? Get an instant paraphrase of this document with our AI Paraphraser
5 Running head: ASSIGNMENT Felton, L. A., Lauber, D. A., Koury, J., & Nawarskas, J. J. (2019). Readers' Comments An Explanation for theEffectofDifferentStorageConditionsonSublingualNitroglycerinTabletStability.The AmericanJournalofCardiology,124(6),990. https://www.proquest.com/openview/d68a5e356fec50dac86bf803fdfc090d/1?pq- origsite=gscholar&cbl=41200