Peer Evaluation of Nursing Papers: SM-MI Case and HM-DVT Case Analysis

This document presents a peer evaluation of two nursing papers. The first paper, SM-MI, discusses a 78-year-old patient admitted with acute myocardial infarction who underwent heart catheterization, highlighting nursing interventions for managing high blood pressure and potential risks like bleeding and arrhythmias. The second paper, HM-DVT, focuses on an 80-year-old patient with deep vein thrombosis (DVT) following a coronary stent placement, emphasizing preventative measures such as compression stockings and anticoagulation therapy, as well as the importance of monitoring vital signs and educating patients on medication and potential complications. The evaluation assesses the appropriateness of nursing diagnoses, interventions, and discharge plans in both cases, referencing relevant literature to support the analysis.

Running head: PEER EVALUATION OF PAPERS
PEER EVALUATION OF PAPERS
Name of the Student
Name of the university
Author’s note

1PEER EVALUATION OF PAPERS
PEER EVALUATION
Student SM-MI and Catheterization Interventions
The case is based on a seventy eight years old patient, who had been admitted to the
hospital with a diagnosis of acute myocardial infarction. He was also taken to the laboratory for
heart catheterization.
The case study reveals that the patient was having high blood pressure. The other vital
signs of the patients were considered to be a bit abnormal than the normal limits.
There are certain risks of cardiac catheterizations such as bruising, bleeding, stroke,
arterial damage where the catheter was introduced, arrhythmias and anaphylactic reactions
against the drugs.
A nurse should be able to record the vital signs of the patient daily. The punctured site
should be monitored for 4 hours until ambulation. Manual compression should be necessarily
applied to prevent excess bleeding. In case of profuse bleeding it is advisable to stop the heparin
treatment (Ackley et al., 2016). The nursing interventions regarding the issue provided in the
paper was appropriate.
Seizures in older patient may bring up extra complications in older patients. To prevent
seizures it is advisable to put up the side rails of the bed. Neurovascular assessments should be
conducted in patients to prevent brain strokes and seizures. Prolonged bed rest may affect the
skin and develop sores. Therefore it is necessary to provide proper padding and medications to
prevent pressure injuries (Ackley et al., 2016). The case study shows that the patient did not
suffer from any skin injury, which proves that the nursing interventions taken were effective. All
the nursing interventions and the discharge plans that were taken in the paper were appropriate.

2PEER EVALUATION OF PAPERS
Student HM-DVT Clinical Analysis
This case study is about a patient of eighty years old, who was suffering from deep vein
thrombosis (DVT). DVT is a common complication after a coronary stent placement. For the
prevention of Deep vein thrombosis, patient care should involve graduated compression
stockings and the use of pneumatic compression device along with the application of appropriate
doses of anticoagulation agent (Goldhaber & Bounameaux 2012). A properly monitored post
operative therapy along with physical interventions can prevent the formation of the deep vein
thrombosis. The nurse did a commendable job to practice an evidence based method and find
that the blood clot might have reached the heart leading to pulmonary embolism. The vital signs
of the patient were monitored efficiently and shifts were found form the normal limits. Since the
patient was suffering from acute respiratory distress, it is important that he should be provided
with some respiratory aids. In this case the use of the nasal canulla has been appropriate
(Goldhaber & Bounameaux 2012).
Medications like unfractionated heparin, low molecular weight heparin (LMWH),
Warfarin and Fondaparinux can be given to treat DVT. Mechanical DVT prophylaxis can be
appropriate if there is bleeding. The case study reveals that the nurse educated the patient
regarding the signs of bleeding. A PPT lab value of 97.5 indicates that the patient's blood was
taking longer time to clot. In such a case it is advisable to lower the doses of Heparin (Anthony,
2013).
Throughout the stay of the patient, a nurse should be alert about some of the signs like
bleeding, shortness of breath, bloody sputum and rapid pulse. The diagnosis should be confirmed

3PEER EVALUATION OF PAPERS
by doing a CT scan, pulmonary angiography and ventilation- perfusion lung scan
(Anthony ,2013).
A patient should be kept under a continuous follow up. They should be imparted
education regarding the intake of medications. They should be explained that certain foods reacts
with Warfarin and can decrease the anticoagulant effect (Anthony, 2013)
Thus it can be said that imparting education to the patients and families assists in ensuring a
complete discharge plans. In this case study the nursing diagnosis provided by the nurses was
appropriate for the patient.

4PEER EVALUATION OF PAPERS
References
Ackley, B. J., Ladwig, G. B., & Makic, M. B. F. (2016). Nursing Diagnosis Handbook-E-Book:
An Evidence-Based Guide to Planning Care. Elsevier Health Sciences.
Anthony, M. (2013). Nursing assessment of deep vein thrombosis. Medsurg Nursing, 22(2), 95.
Goldhaber, S. Z., & Bounameaux, H. (2012). Pulmonary embolism and deep vein
thrombosis. The Lancet, 379(9828), 1835-1846.