Mr. Ferguson - Nursing Assignment
Added on 2021-06-14
8 Pages2320 Words59 Views
Running head: NURSING ASSIGNMENTNURSING ASSIGNMENTName of the StudentName of the universityAuthor’s note
NURSING ASSIGNMENT1Pathophysiological linkage to the symptoms of the patientThe case study states the clinical condition of Mr. Ferguson who has been admitted in to theemergency department (ED) with the symptoms of chest heaviness. Mr. Ferguson’s past clinicalhistory tells that he had survived a Non ST Elevated Myocardial infarction (NSTEMI). Some ofthe complications following an NSTEMI are ischemic angina, re-infarction or infarct extension.The patient in this case is supposedly to be suffering from angina (Grodzinsky et al., 2012).Residual angina after an MI can be common in elderly patients, although residual angina afterMI represents poor quality of life and is normally, a major driver of hospitalization. The reasonsbehind the high burden of angina after a MI is unclear. But it has been well established that stressand anxiety can be related to the standard (Yilmaz & Sechtem, 2012). Whether or not the anginais caused due to the increased pain is still unclear. Angina pectoris is mostly caused due to themyocardial infarction that occurs due to the mismatch between the myocardial blood supply andthe oxygen demand. The chest heaviness is mainly caused due to the reduced flow of the bloodto the heart (Yilmaz & Sechtem, 2012). As the heart muscles do not get enough oxygen it givesrise to a condition called ischemia. This restriction of the outflow of the myocardial blood isusually caused due to the atherosclerotic narrowing of the epicardial coronary artery (Grodzinskyet al., 2012). Myocardial ischemia is determined by the increased heart rate which is due to the increasedmyocardial oxygen demand and the reduced diastolic perfusion. It is revealed from the casestudy that the patient had medical history of hypertension. Over time uncontrolled high bloodpressure can also damage the coronary arteries that can causes blockage, abnormal flow of blood
NURSING ASSIGNMENT2to the heart muscles. Mr. Feguson has been found to be diaphoretic. It has to be remembered thatprofuse sweating is a specific predictor of the an STEMI, which might have been caused due tothe linkage between the sympathetic nervous system innervating the myocardial pain fibers andthe sweat gland, originating from the thrombo-occular region (Gokhroo et al., 2012). The patientwas probably suffering from unstable angina as detected from the irregular heartbeat. PharmacokineticsIt is evident from the case study that the patients has been prescribed with 300 mg of proAspirin. The aspirin irreversibly inhibits the action of the cyclooxygenase enzyme in the plateletsthat prevents the activation and the aggregation of the platelet (Tarkin & Kaski, 2013). Thisprevents the activation of the clotting cascade. Aspirin may react with some of the anticoagulantslike warfarin resulting in excessive bleeding.Morpine sulphate is a potential analgesic that can be used as it causes peripheralvasodilation and thus lessens the myocardial workload (Tarkin & Kaski, 2013). It is also given asa sedative for enabling relaxation in the patient. It interrupts the flow of the catecholamines andgives relief from the chest discomfort. Some of the side effects involving morphine is vomitinghypotension and respiratory depression (Aronson, 2015). An observational study carried out byZhang et al., (2016) have indicated the risk of infections in patients receiving morphine. Thereare authors who have reported that morphine can delay the oral antiplatelet drug adsorptionalthough there is valid reasons behind this. It has to be remembered that rapid inhibition of theplatelet is the main treatment in coronary acute syndrome and any delaying in the antiplateleteffect may worsen the outcome (Zhang et al., 2016). Morphine sulphate extended tablets exposehe patients to the risks of opoid addiction and misuse. Serious life threatening respiratory
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