Nursing Case Study Assignment

Running head: NURSING CASE STUDY ASSIGNMENT
Nursing Case Study Assignment
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NURSING CASE STUDY ASSIGNMENT 2
Nursing Case Study Assignment
Acute coronary syndrome (ACS) is one of the leading causes of death in the world today.
According to Mayo Clinic, ACS is caused by the blockage of blood flow to the heart leading to
chest pain and other discomfort in the patient. The condition may cause sudden death of the
patient or slow weakening that eventually leads to death. ACS is an emergency medical
condition that requires emergency interventions to improve save life and continued nursing care
that seek to help the patient avoid future incidents of ACS. This paper reviews the risk factors
and health promotion, pathophysiology, homeostatic mechanisms, nursing care, and activities
from Roper and Tierney model of living in a case study of a patient that reported to the hospital
with signs and symptoms of ACS.
Modifiable and non-modifiable Risk Factors and Health Promotion
Several factors contribute to myocardial infarction, a condition under the umbrella of
ACS, and some of these factors can be modified. Mr. Papas myocardial infarction is caused by
some of the factors that he describes to have been doing. According to the case study, Mr. Papas
explains that he is a frequent smoker where he smokes at least fifteen cigars a day and also
drinks socially. He is fifty-four years old and does little exercise due to the nature of his work.
As an IT expert, he hardly moves around because he spends most of his time in office. These are
among the factors that Bhartia and Naik (2013) list as risk factors for myocardial infarction in
patients above the age of forty years. Additionally, Mr. Papas explains that there is no history of
ACS in his family, indicating that this condition is a product of his lifestyle. As a result the
health promotion interventions should target modifying his lifestyle so that he can alter his life to
avoid future incidents of ACS. However, age as a risk factor cannot be modified. This is because
age is an irreversible process and Mr. Papas will not manage to alter it.

NURSING CASE STUDY ASSIGNMENT 3
The first health promotion intervention is education on how the Mr. Papas could alter his
lifestyle and help him respond positively to medication while at the same time avoiding the
incidents of MI in future. Mr. Papas should be told that his lifestyle is having an impact on his
life and this is leading to myocardial infarction. Cigarette smoking contributes to myocardial
infarction in two ways. First, the amount of carbon monoxide in cigarettes reduces oxygen
supplied to the heart, contributing to high chances of developing myocardial infarctions
(Esmaeili et al., 2013). Additionally, cigarettes reduce the lining of arteries, damaging them
(Danhoff & Huecker, 2016). This may cause blood clot that blocks the flow of blood to the
heart. Lack of physical exercises as in the case of Mr. Papas also leads to high fats in arteries
that reduce their sizes, leading to increasing chances of myocardial infarction when arteries
rupture as blood strives to flow to the heart (Chaves et al., 2015). This can be prevented when
the patient understands that his lifestyle is exposing him to risk factors associated with
myocardial infarction.
Education will also help the patient to understand the need for taking medications and
why he should consider quitting alcohol and engaging in frequent physical exercises. Generally,
education acts as a health promotional tool for managing the MI condition and improving health
outcomes (Kiani, F., Hesabi, N., & Arbabisarjou, 2015). Educational intervention seeks to
modify behavior by encouraging the patient to undertake frequent exercise, avoid risk factors,
and engage monitor diets to avoid exposure to conditions that may increase the risk of worsening
the condition. If the condition is not worse, the intervention can be delivered at home or within
the community nursing setting where the patient can access the services. Education also targets
the family of the patient to make sure that they are informed of the characteristics of the MI and
other associated conditions for them to take early interventions whenever they realize the

NURSING CASE STUDY ASSIGNMENT 4
problem with the patient. Family members may extend services such as helping Mr. Papas
whenever he is in distress or taking him to hospital whenever they realize that he heeds
immediate and urgent medical attention.
Pathophysiology behind the ST Elevated Myocardial Infarction (STEMI) and its
Difference from Non-ST Elevated Myocardial Infarction
Myocardial infarction occurs when blood clot occurs in the arteries, leading to the
blockage of the blood flow to the heart. Generally, the heart acts as an engine that pumps blood
to all parts of the body. Blood flows from other parts of the body to the heart through arteries
and leaves the heart through veins. The heart pumps blood continuously to and from the heart to
all other parts of the body. STEMI may be caused by partial clotting of blood or complete
clotting. Whether partial or complete, the occurrence of a clot within the blood vessels is serious
condition because blood will continue coagulating on the clot until the point where the diameter
of the blood vessel can no longer sustain the clot. This eventually leads to complete blockage of
the artery. The heart pumps blood automatically and it is not aware that there is a clot in the path
of the blood. As a result, the heart will respond by using excessive force to overcome resistance
to the flow of blood. Depending on the size of the clot, the force may force it into the heart or
cause the blood vessel to rapture, releasing the blood into the body.
Compared to STEMI, the non-STEMI (NSTEMI) condition occurs due to partial
coagulation or clotting of blood within the coronary artery. The primary difference between
NSTEMI and STEMI is that while STEMI may be sudden and fatal, NSTEMI does not cause a
hundred percent blockage of the coronary artery. The heart may still manage to pump blood
through the artery due to the weakened or narrowed artery, but it still uses excessive force than
normal. If NSTEMI is caused by a clot in the coronary, it can still be a fatal condition because