Nursing assignment : Cardiovascular System
Added on 2021-05-31
20 Pages5070 Words26 Views
Disease and DisordersNutrition and WellnessHealthcare and Research
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Nursing Students name:Institutional Name:
PART A: COMPREHENSIVE HEALTH HISTORYIDENTIFYING DATA AND SOURCE OF THE HISTORYThe case study involves Mr. Porter who is a 59 years old male. He is the primary source of data for this case. Other data are obtained observations done and also the measurements recorded.CHIEF COMPLAINT(S)The patient complains of mild central chest pain radiating to the left arm with severe shortness ofbreath while doing some boxing training. The pain was of sudden onset. He now he complains that he feels his heart racing.PRESENT ILLNESSMr. Porter came looking sweaty and pale complaining of mild central chest pain radiating to the left arm with severe shortness of breath while he is doing his boxing training and he also feels hisheart racing. On examination his blood pressure(BP) is 130/90 mmHg which is under the normal range of 90/60 mm Hg to120/80 mm Hg , heart rate 181 b/min which is high above the normal average range of 60 to 100 b/min in adults, respiration rate 24 breaths per minute, oxygen saturation 98% and electrocardiogram(ECG) findings showed ventricular tachycardia.PAST HISTORYThe patient was admitted six years ago due to myocardial infarction. He was done percutaneous coronary intervention (PCI) whereby stent was put in place to keep the coronary arteries open thus improving blood supply to the myocardium which will result in chest pain reduction. The patient also has type 2 diabetes mellitus and hypertension. He does not have any known drug allergies.
PERSONAL AND SOCIAL HISTORYMr. Porter is active in exercise because he actively participates in boxing training. The patient also sort immediate health care intervention on feeling mild central chest pain.REVIEW OF SYSTEMSCardiovascular SystemOn inspection the patient looked sweaty and pale due to decreased blood supply to the peripheraltissues. Also electrocardiogram findings showed ventricular tachycardia due to heart overworking to pump more blood to meet oxygen supply to the tissues (Chummun, 2009). .On auscultation the pulse rate was 181 beats per minute which is high due to tachycardia. Normal average is about 72 beats per minute. Blood pressure is 130/90 mmHg which is slightly higher than the normal (120/80 mm Hg). Cardiology review shows that the patient has a new bundle branch block which leads to altered ventricular depolarization and conduction of impulses. This leads to impulses directed to muscles or different direction decreasing cardiac output.Respiratory SystemOn inspection respiratory rate was 24 breaths per minute. The client also presents with shortness of breath while he was doing his boxing training. This is due to th radiating pain that he felt and thus he responds by having shallow breaths. Oxygen saturation was 98% which is within the normal range (95%-100%).MUSCULOSKELETAL SYSTEMOn investigations show that Mr. Porter has elevated troponin levels of 230. This is due to necrosis of cardiac cells due to oxygen deprivation. This leads to high troponin levels. The pain
also radiates to the left arm and this in turn interferes with functioning of the arm hence his daily activities impaired.CURRENT MANAGEMENT PLAN Mr. Porter has to be under prolonged bed rest so that the pain can be alleviated. This helps because it reduces oxygen consumption by other organs and tissues and thus increasing oxygen supply to vital organs such as the heart. Resting also reduces heart workload and hence lower oxygen consumption. It is important to nurse the patient in left lateral. He also has to be advised and monitored closely to avoid strenuous exercises such boxing as it requires more oxygen.Teach the patient on breathing exercises and pattern. This involves the client taking shallow breaths but faster. This will increase oxygen supply to the tissues and also reduce pain.Give aspirin 300 mgs as it is an antiplatelet hence it will prevent platelet aggregation and formation of clots in the coronary vessels. This ensures that blood is supplied to all cells in the heart and thus the occurrence of cardiac cells necrosis is minimized.Analgesics can also be administered if necessary. Also administer glyceride trinitrate spray which acts as a vasodilator reducing both pre-load and stroke volume. This reduces myocardial oxygen consumption.Mr. Porter should also be taught about his medication, this includes the dosage and side effects tobe expected. He should be informed the importance of adhering to the medications prescribed and to report any abnormal changes experienced while undergoing his treatment.The client should also be counseled and reassure concerning his condition as this would help alleviate any worries or anxiety that he is experiencing (Pincus, Holt, Vogel, Underwood,
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