Mr. Harry Bright Case Study

Running head: MR. HARRY BRIGHT CASE STUDY
Name of the Student
Name of the University
Author Note

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MR. HARRY BRIGHT CASE STUDY
Question 1:
The case study represents the severe chest pain of harry bright who was recently
undergone angioplasty. He was admitted in the hospital at 6:00 in the morning under the
supervision of Mr. Black. He was admitted in the emergency ward because of severe chest pain.
During the vital sign assessments his pulse rate was 90 and respiratory rate was 18. His blood
pressure was 150 /90 when he was monitored for vital signs which further unindicated he had
hypertension which is high blood pressure. He had unstable angina which is frequent and he had
40% of occlusion when he was administrated with coronary artery injections. When he was
monitored for cardiac condition during the stent placement, the condition indicated myocardial
ischemia. In the current scenario, it is priority of nurses to assess the health condition of the Mr.
Bright in order to provide accurate post-surgical care. The nurses are required to assess the
health condition of a patient so that the patient receives accurate and safe care. According to
NMBA standard of nursing, the standard 4 highlighted that a registered nurse is required to
conduct a comprehensive and systematic assessment in order engage patient in the
comprehensive care procedure. In the current context, after angioplasty patient chest x-ray was
performed in order to assess the chest pain. The common problem associated with the
angioplasty is a hematoma which can be detected through the chest ECG for cardiac assessment.
As discussed by Kuno et al. Manos, et al. (2018), diagnosis of hemorrhage is very difficult to
detect. Therefore, ECG can be a good assessment which provides the idea of heart rhythm. The
researchers showed the effect of ECG on patient through a case study of an old man who
undergone angioplasty. This case emphasizes the clinical importance of recognizing the
electrocardiographic pattern of left septal. Although ECG cannot directly detect the internal
bleeding but indirectly give the indication of heart rate. In the current context, if internal

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MR. HARRY BRIGHT CASE STUDY
bleeding is observed in the patient after angioplasty, ECG shows the electrical graph of
abnormal heart rhyme. ECG records the electrical activity generated by heart depolarization
which propagates in pulsating electrical waves through the skin. Therefore, if blood vessels are
damaged during angioplasty, it will affect the heart muscles since injured heart muscle failed to
conduct electrical impulses normally, then it can be detected indirectly through ECG. Therefore,
although ECG failed to provide the direct result of hematoma it can provide the idea of
hematoma by through abnormal electro gram. Hwoever, paper also highlighted several
challenges regarding the ECG through the case study. Vital assessments were also performed by
nurses in order to see the health condition of the patient.
In the current context, angiography was not performed in order to see the internal
hematoma. In the current context, the assessment would be renal assessment which would
provide the idea of internal bleeding. After internal bleeding, hematuria can be observed in
patient. If heart failed to supply blood to the kidney, shortages of blood give rise to the kidney
injury. It would be difficult for kidney to keep the accurate fluid balance of inside the body. A
study conducted by Caspi et al. (2017), and they conducted study with 2025 patients with ST-
segment elevation of myocardial infarction who underwent pPCI as well as 1025 patients
receiving fibrinolysis or no reperfusion was observed for the patients who were not exposed to
contrast material during the first 72 hours of hospital stay. The purpose of the researchers is to
evaluate acute kidney injury after primary angioplasty is observed or not. The result suggested
that the development of acute kidney injury in patient with myocardia infraction is mainly
depending on the age of the patient, heart failure and base line estimated glomerular infiltration
rate. Therefore, in order to gain the understanding of the internal bleeding of the patient after
angioplasty, it is crucial to check the glomerular infiltration which would further provide the